Colorectal cancer, once a cancer of late life, is on the verge of exploding among young people. The ominous trend has had researchers, physicians, and hospitals scrambling at breakneck paces to determine the reasons and create prevention and early diagnosis. Dr. Vikesh Shah, a well-known cancer doctor in Ahmedabad, argues, “The increased incidence of colorectal cancer among young adults presages a radical transformation of cancer trends driven by lifestyle, nutrition, and the environment.”
Colorectal cancer incidence at an advanced age has been declining as a result of improved screening and lifestyle awareness, while consistent rises in individuals younger than 50 years have been witnessed. Colorectal cancer incidence in young adults is estimated to have increased 1-2% annually over the last decades by the American Cancer Society.
This isn’t an issue only in Western nations; Indian oncologists, too, have seen increased cases among their younger populations. But why? What is the reason? And what are the solutions to reduce the risk?
Colorectal Cancer: A New Epidemic among Young Adults
Hitherto, cancer of the colorectum had been most commonly linked to age. Yet recent evidence points increasingly towards lifestyle shifts, environment, genes, and diet as being the probable force behind this adolescent epidemic.
Another chilling truth is that adults in their teens and twenties get diagnosed at later stages when it is harder to treat and kills more than when older patients catch it at their routine screening checks.
Global and Indian Trends in Colorectal Cancer
Colorectal cancer is among the top 10 most common cancers in India, and increasing cases are being seen in people who are in their 20s, 30s, and 40s.
The disease is currently the second most common cause of cancer deaths globally.
Research has established that the frequency of occurrence of colorectal cancer in people younger than 50 years will have risen by 90% by 2030.
It would seem that this is an issue that needs to be addressed as a matter of urgency by doctors, policymakers, and the public at large.
Why is colorectal cancer increasing in young adults?
Various factors are linked and are said to be behind the increase in the incidence of colorectal cancer in young adults. Experts are sure it is a mix of lifestyle, diet, genetics, and the environment.
1. Poor Diet and Processed Foods
One of the largest lifestyle changes in recent decades is diet. The fast pace of life these days has prompted the intake of:
- Processed and fast foods are rich in preservatives, additives, and toxic fats.
- Red meat and processed meat like sausages, bacon, and ham, which the World Health Organization (WHO) identifies as carcinogenic.
- Food with low fiber content and slow digestibility damages the gut.
It has been proven through a study that a diet of high red and processed meat doubles the risk of colorectal cancer by 20–30%. On the other hand, a diet high in fiber (fruit, vegetables, whole grain) lowers the risk due to better digestion and balancing of gut bacteria.
2. Physical Inactivity and Obesity
Working hours on the computer have grown, physical activity has declined with the advent of office work, and obesity has emerged as the preeminent risk factor for colorectal cancer.
- Obesity triggers endogenous chronic inflammation, insulin resistance, and endocrine disorders that all encourage tumor growth.
- Physical inactivity prolongs digestion, which maintains carcinogenic compounds in the intestine for a longer duration.
- Obese individuals are indicated by research to have a 30–50% higher risk of developing colorectal cancer compared to individuals with normal weight.
3. Changes in Gut Microbiome
The gut microbiome is a significant contributor to overall health, i.e., digestion and immunity. However, food changes and prolonged use of antibiotics have altered gut bacteria.
- Dysbalanced gut bacteria even trigger inflammation, resulting in DNA mutation and tumor growth.
- Some bacteria, like Fusobacterium nucleatum, are more prevalent in patients with colorectal cancer, as some studies have proven.
- An optimal gut microbiome is attained by consuming fermented foods (yogurt, kimchi, kefir) and a high-fiber diet.
4. Environmental Toxins and Pollutants
Exposure to industrial chemicals, pesticide use, air pollution, and microplastic exposure have been causally linked with increased cancer risk. The chemicals would be most likely to be involved in the DNA damage and inflammation that cause uncontrolled growth of cells in the colon.
- Young adult colon cancer has been linked by recent studies to contamination of drinking water and food contact surfaces by toxic chemicals.
5. Tobacco Smoking and Alcohol Use
Tobacco smoking and alcohol consumption are known carcinogens that enhance the risk of most cancers, including colorectal cancer.
- Heavy alcohol drinking raises the level of acetaldehyde, a very toxic compound that is a DNA-damaging agent and is carcinogenic.
- Tobacco smoking adds carcinogens to the body, which have been directly linked with the causation of colorectal tumors.
- Alcohol drinking and tobacco smoking lower the incidence of colorectal cancer considerably.
6. Genetic and Hereditary Causes
Even though lifestyle is responsible for most cases of colorectal cancer, genetics also plays an extremely vital role.
- Those with a family history of colorectal cancer are at 2-3 times the risk of those with no family history.
- FAP and Lynch syndrome are two genetic syndromes that highly predispose to colorectal cancer.
- A family history positive means that from age 40 or less, patients should have early screening (colonoscopies).
Symptoms Young Adults Need to Know
One of the largest barriers to young adults’ diagnosis of colorectal cancer is that early symptoms are dismissed or blamed on less severe conditions such as hemorrhoids or irritable bowel syndrome (IBS).
Warning Signs:
- Persistent changes in bowel habits (diarrhea, constipation, or stringy stools).
- Gastric, colonic, or rectal bleeding (even a trace amount).
- Abdominal pain or cramps that linger.
- Weight loss and unexplained weakness.
- Loss of sensation of complete bowel evacuation.
If all these symptoms persist for over a few weeks, it is very essential to visit a doctor at the earliest. Consultation with a cancer specialist in India can result in early detection and proper treatment.
The Importance of Early Detection
As the regular screening for colorectal cancer is usually from age 45 or 50, the majority of young adults are not screened early enough. Therefore, the majority end up being diagnosed late in life, and this minimizes the opportunity for successful treatment.
Who Needs to Be Screened Early?
- Those with a history of colorectal cancer.
- Those with a family history of colorectal cancer.
- Those who have chronic gastrointestinal illnesses such as ulcerative colitis or Crohn’s disease.
- Any patient with chronic gastrointestinal complaints.
Screening investigations are
- Colonoscopy (gold standard for removal and detection of adenomatous precancerous polyps).
- Stool tests like FIT or Cologuard for early detection.
Routine screening is the optimal means of attaining maximum survival with decreased complications for early detection.
Preventive Steps to Lessen Colorectal Cancer Risk
Although all cases cannot be avoided, specific lifestyle modifications can decrease the risk to an extremely large measure.
Important Prevention Methods:
- High-fiber diet (fruits, vegetables, whole grains).
- 30 minutes of daily exercise.
- Healthy weight.
- processed foods and sweets.
- Smoking cessation and alcohol use reduction.
- Proper water intake and probiotics for gut health.
- Early screening for those at high risk.
Final Thoughts
Young adult colorectal cancer is a rapidly increasing worldwide phenomenon. A sedentary lifestyle, poor diet, environmental pollution, and genetic predisposition are all etiologic factors against the trend.
The silver lining. Colorectal cancer is among the most preventable kinds of cancer if caught early on. By following a healthy lifestyle, regularly monitoring their symptoms and signs, and screening when and if needed, young adults will be able to take a giant step in lowering their risks.
If you, or the person sitting next to you, develop symptoms, don’t ignore them. Get early detection and counseling from an Indian cancer expert like Dr. Vikesh Shah. Prevention, knowledge, and timely treatment can be lifesavers. For more information, expert advice, or appointment scheduling, call now. Your health is valuable—don’t let the symptoms turn critical.