Rectal Cancer Rising in Patients Younger than 50
Overall, the incidence of rectal cancer has decreased over the decades, largely in part due to the use of screening modalities such as colonoscopy. Even so, the incidence of rectal cancer in patients younger than the age of 50 is on the rise.
The terms colon and rectal cancer are often used interchangeably to describe tumors found within the large intestine; however rectal cancer often follows a different treatment pathway. Rectal cancer is defined as cancer found within 15 centimeters of the anus, while cancer found higher up in the large intestine is called colon cancer.
Studies point to variable risk factors that are likely culprits in the development of colon and rectal cancer at a young age, including:
When concerning symptoms present, your provider will likely recommend a colonoscopy. This is an outpatient procedure where a small camera is inserted into the rectum and passed to the end of the colon while you are asleep. If polyps are present, they are typically removed at that time. If a mass is found that is concerning for cancer, biopsies are taken for further diagnosis. There are several ways to screen for colorectal cancer, but a colonoscopy is the only one that can prevent cancer by early removal of colon and rectal polyps.
Rectal cancer begins with a polyp or a growth of abnormal cells in the wall of the rectum. The cells then continue to change and eventually become a collection of cancerous cells. The first presentation is often rectal bleeding, but patients may also notice a change in the size or shape of their stool, abdominal bloating or weight loss. If rectal cancer is caught early, surgery alone will typically cure it. More advanced rectal cancers require a combination of chemotherapy, radiation and surgery.
Previously, 50 years was the recommended age to begin screening for colorectal cancer. Because the incidence of colon and rectal cancer in people under the age of 50 has increased, the guideline has changed to begin screening at age 45. If you have a family history of colon or rectal cancer, screening should begin at age 40 or possibly sooner depending on the age of the relative when they were diagnosed.
Regardless of your age, if you are experiencing any new onset rectal bleeding or other concerning changes in bowel habits, contact your primary care provider for further work-up.
Sarah E. Diaz, D.O., is a board-certified, fellowship-trained colon and rectal surgeon and a member of the comprehensive cancer care team at MyMichigan Health. Dr. Diaz specializes in the diagnosis and medical and surgical treatment of disorders and diseases of the intestinal tract, colon and rectum, pelvic floor, anal canal and perianal area. Dr. Diaz has extensive training in robotic abdominal and pelvic surgery and has a special interest in colon and rectal cancer as well as pelvic floor surgery for rectal prolapse.
