Colorectal cancer has become the leading cause of cancer death in Americans under 50. Why has this happened?

To find out, WellTuned spoke with Dr. Brian Delashmitt, a medical director at BlueCross BlueShield of Tennessee.

“Colorectal cancer deaths in people under 50 have been rising about 1.1% per year since 2005,” says Dr. Delashmitt. “It was the 5th leading cause of cancer death in the 1990s, but it has risen steadily over the years.”

Why are colorectal cancer deaths rising in younger people?

Dr. Delashmitt: Colorectal cancer moved into the No. 1 spot because deaths from it increased while deaths from other major cancers decreased. So even as progress was made against other cancers in younger people, colorectal cancers went the opposite direction.

The big concern is that many younger patients are being diagnosed at a later stage. Screening can often find colorectal cancer early when it might be easier to treat. Unfortunately, about 3 in 4 people under 50 diagnosed with colorectal cancer are diagnosed with advanced disease.  This can make treatment harder.

Risk factors may include:

• Family medical history of colorectal cancer
• Inflammatory bowel disease
• Inherited genetic syndromes

There are also modifiable or lifestyle-related risk factors like:

• Being overweight
• Not getting regular physical activity
• Smoking
• Heavy alcohol use

Symptoms younger people shouldn’t ignore

Dr. Delashmitt: Don’t ignore symptoms just because you’re young. Common warning signs include:

• Rectal bleeding or blood in stool
• Changes in bowel habits, such as new constipation or diarrhea
• Abdominal pain
• Unexplained weight loss

Screening is for people without symptoms like those mentioned above. If you have symptoms, you need a medical evaluation regardless of your age.

Average-risk adults are recommended to start regular screening at age 45, not 50 as once recommended.

For people at increased risk — those with family medical history, certain genetic syndromes or inflammatory bowel disease — screening may need to start even earlier.

Screening options that save lives

Dr. Delashmitt: There are stool-based tests (often done at home) and visual exams that look inside the colon. Screening options include:

• FIT (fecal immunochemical test) every year
• Stool DNA test every 3 years
• Colonoscopy every 10 years if nothing abnormal is found

The best screening test is the one that gets done. The most important thing is to get screened. Talk to your doctor about the test you need. If a non-colonoscopy test is abnormal, a follow-up colonoscopy is needed.

Early detection matters for two reasons. First, treatment works best when cancer is found early. And screening may help prevent cancer by removing precancerous polyps before they turn into cancer.

“Colorectal cancer is no longer an older adult issue,” Dr. Delashmitt says. “Know your family’s medical history, take symptoms seriously, and start screening at 45. Screening can help to prevent cancer and save lives.”

More on colon cancer from WellTuned

Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.