Increasing Cases of Colorectal Cancer in the Younger Population

Introduction:

The incidence of colorectal cancer among younger people has increased recently. More alarmingly, most cases identified are in an advanced stage, and the exact cause of the cancers is unknown. According to the report by the American Cancer Society, the death rate from colorectal cancer has been declining from earlier in elderly patients, which may be attributed to regular colonoscopies and a decrease in the smoking rate in elderly patients. However, the rates and deaths from colorectal cancer have been rising among young people at rates that have experts worried and searching for explanations. As per research work, the rising trend has had a greater impact on some groups than others. For instance, although colorectal cancer can strike at a young age in people of all races, the increase has primarily been observed in Alaska Native, American Indian, and White people.

Why Are the Incidences of Colorectal Cancer Increasing Among the Young Population?

Medical researchers can only make presumptions as to why cases of colorectal cancer have been rising among younger adults in recent decades. Researchers say there is evidence linking obesity, sedentary lifestyles, poor diets, and other environmental factors to the rise in colorectal cancer cases. These factors may also be linked to the higher rates of colorectal cancer with an early onset. However, the exact cause of the early onset of colorectal cancer is unknown.

• Diet, Gut Bacteria, and Inflammation:

  • Diet: An unhealthy diet, particularly one that is high in processed meat and fat and low in fruits and vegetables, is increasingly being linked to colorectal cancer with early onset.

  • Gut Microflora: The gut microbiome, also known as gut bacteria, is the subject of research by other scientists. Some bacteria may have an impact on how well some cancer treatments work, and some have been involved in helping colorectal cancer grow and spread. Toxins from several types of bacteria that are typically found in the human gut were found to cause cancer in the intestines of mice in laboratory studies. The foods and chemicals we consume and breathe have an impact on the bacteria in the gut. Numerous factors, including diet, obesity, exercise, and some medications (such as antibiotics), have been shown to alter the variety and quantity of bacteria in our guts.

  • Inflammation: It is the body's response to injury, illness, or irritation and can be caused by either or both diet and gut flora. In one of the lab studies on mice, it was found that a high-fat diet-induced gut inflammation and sped up the development of intestinal tumors. Inflammation can worsen due to bacterial toxins produced by gut bacteria. Studies have also revealed that specific gut bacteria can recruit immune cells that support the growth of cancer and block immune cells that would otherwise fight the disease. Inflammation can also produce toxic chemicals that can alter DNA and advance cancer.

• Chronic Conditions: Inflammation in the gut is also caused by a number of chronic conditions, such as diabetes, Crohn's disease, and irritable bowel syndrome. These chronic conditions cause inflammation of the gut and are often seen in young individuals these days and hence predispose them to the risk of colorectal cancer.

• Genetics: If either the mother, father, brother, or sister had colorectal cancer, the risk of developing colorectal cancer becomes high. A few genetic disorders are connected to the development of colorectal cancer, but they are uncommon and will only affect a small number of people under the age of 40.

• Chemicals in the Environment:
  • Environmental elements are being investigated by researchers as potential contributors to colorectal cancer with early onset. These include things like pesticide usage, soil and food contamination, and air and water pollution.
  • Some of the chemicals present can affect the gut bacteria leading to inflammation of the gut. A few of these chemicals, also called endocrine disruptors, can cause an imbalance of the body’s metabolism leading to obesity and other damages.
  • The National Toxicology Program run by NIEHS (National Institute of Environmental Health Sciences) has identified 18 chemicals that can cause intestinal cancer in mice or rats. Some of these substances may harm DNA (deoxyribonucleic acid), which could result in dangerous mutations in colon and rectum cell DNA.

What Are the Precautions That a Patient Must Take in Order to Avoid Colorectal Cancer?

There is no denying the seriousness of colorectal cancer. It is the second most prevalent cancer after lung cancer and the third most frequent reason for cancer-related death. While some patients cannot change their risk factors, almost everyone can take precautions to lower their risk. Even though the risk is minimal before the age of 40, taking preventative measures offers a significant benefit. Healthy behaviors must be adopted, such as the following:

• Maintaining a Healthy Weight: Excess increase in weight also elevates the risk of colorectal cancer. The risk is higher for men.

• Remaining Active: People who exercise regularly are at a lower risk as it also aids in weight management.

• Maintaining a Proper Diet: Increase the consumption of foods high in fiber, such as whole grains, fruits, and vegetables. Reduce intake of processed and packaged food.

• Quit Smoking: Quitting smoking prevents the risk of cancer of all sorts in people, and hence its cessation prevents several health-related issues.

• Cessation From Alcohol: Quitting alcohol not only improves health but also helps to prevent various other diseases, including cancer.

What Are the Symptoms of Colorectal Cancer?

• Bleeding - Most rectal bleeding is caused by benign conditions like hemorrhoids or tiny tears called fissures. However, it is not normal, and hence the doctor should be contacted immediately for those symptoms.

• Alteration in the Bowel Movements - If the bowel movements become irregular or constipated, or if there is a noticeable change in the color or texture of the stool that lasts for more than a month, the doctor should be contacted immediately.

• Weight Loss: Weight loss without cause.

• Stomach Pain: Persistent stomach pain.

Why Is Screening Important for Colorectal Cancer?

Colorectal cancer screening has proven to be one of the most effective ways to lower cancer-specific mortality. The primary purpose of colorectal cancer screening is to identify early-stage colorectal cancer and remove sessile serrated lesions (SSLs) and adenomas(a tumor that is non-cancerous but can turn into cancer). Screening helps to prevent cancer by identifying cancer at its earliest stage and also by identifying the precursor lesions that may develop into cancer (adenomatous polyps and sessile serrated lesions).Adenomatous polyps account for about 70 percent of sporadic colorectal cancer development, and sessile serrated lesions (SSLs) account for 25 percent to 30 percent of colorectal cancer lesions. The average screening age has been reduced from 50 to 45 years of age. Patients who have a history of colorectal cancer in their families should begin screening at age 40. The different screening exams are:

• Stool Test: It includes fecal immunohistochemical testing and multitarget DNA testing

• Screening Based on Visualization: It includes colonoscopy, sigmoidoscopy, and CT-colonography.

Conclusion:

Additional research is required to determine the underlying causes and etiology of the onset of colorectal cancer in the younger population. The research work will also help determine whether and to what extent genetic, cultural, and behavioral factors contribute to the rising colorectal cancer risk in younger adults. The ability to pinpoint the causal factors is constrained by surveillance studies like ours; additional epidemiologic studies (case-control, cohort) are required.