An American Cancer Society analysis indicates that colorectal cancer is now the leading cause of cancer death in the US for people under 50. For younger people, colorectal cancer has jumped from the fifth to the first leading cause of cancer death since the 1990s. In contrast, for people over age 65, colorectal cancer is continuing to decline rapidly by more than two percent a year.
According to The Guardian - World, Rebecca Siegel described that younger patients often do not take their symptoms seriously because they think they are too young, and they have not been screened through regular colonoscopies. Insurance coverage disparities in the US create barriers for younger individuals seeking diagnostic tests. The Affordable Care Act requires insurance companies to cover colonoscopies for people over 45 because it has been recommended by the US Preventive Services Task Force.
I chalked it up to stress.
For people under 45 with symptoms like rectal bleeding, a colonoscopy would be considered a diagnostic test and not covered in the same way as a screening test. According to The Guardian - World, Caitlin Murphy described that she hears at least once a week about someone who has had symptoms for years and gets stuck in referral loops. Age-specific trends show sharp increases among the youngest adults.
The increase in colon cancer is proportionally a lot higher among adults in their 20s and 30s, as opposed to those in their 40s. Rates of colon cancer for people over 60 are declining. According to The Guardian - World, Becca Lynch described chalking up her symptoms to stress before her diagnosis.
Because they haven't been screened through regular colonoscopies, and they don't take their symptoms seriously, because they think they're too young.
In the UK, screening variations exist, with Northern Ireland lagging behind other regions. In Northern Ireland, bowel cancer screening is offered between the ages 60-74. Northern Ireland is the only UK region yet to lower the level at which traces of blood in a home screening test trigger further investigation to detect more bowel cancers early.
In England, Scotland and Wales, the level at which traces of blood in FITs trigger further investigation is 80 micrograms of blood per gram of poo. According to BBC News - UK, Dr Jonny Dillon described calling for the age to be brought down in Northern Ireland from 60 to 50 and for the investigation threshold to be reduced in line with other UK regions. Demographic context in Northern Ireland shows a persistent older median age despite global trends.
Doctors are used to treating people in their 70s who aren't concerned about fertility. They're not as concerned about sexual dysfunction.
According to the NI cancer registry, the median age of patients diagnosed with colorectal cancer during 2018-2022 was 71 years. More young people are being diagnosed with bowel cancer right across the board, particularly in wealthier countries. According to The Guardian - World, Rebecca Siegel described that doctors are used to treating people in their 70s who are not concerned about fertility or sexual dysfunction, unlike younger patients.
Prevention strategies emphasize lifestyle changes as a key factor. Cancer Research UK suggests 54% of bowel cancer cases can be prevented through eating whole foods, especially plants with lots of fibre, minimising alcohol, stopping smoking, keeping active and getting to a healthy weight. Dr Amir Khan, an ITV doctor, echoed this, noting that it is never anyone's fault they get cancer, but Cancer Research UK suggests over half of cases are preventable through such measures.
It was just terrifying in the moment. I'd already gone through my prep.
According to The Guardian - World, Dominick described his colonoscopy experience as terrifying in the moment after going through his prep.
It's awful. I hear at least once a week, someone who has had symptoms for years, and they get stuck in these referral loops.
I'm calling for the age to be brought down in Northern Ireland from 60 down to 50 and also for the level at which you get further investigations to be reduced in line with England, Scotland, Wales.
We are seeing younger people getting diagnosed with bowel cancer right across the board, particularly in wealthier countries.
It's never anyone's fault they get cancer, but Cancer Research UK suggest 54% of bowel cancer cases can be prevented through eating whole foods, especially plants with lots of fibre, minimising alcohol, stopping smoking, keeping active and getting to a healthy weight.