Gen X and Millennials
Why is the risk rising among younger people? “We don’t have the answers quite yet. We think it’s a combination of factors,” says Shaukat.
One factor is the rising rates of metabolic syndrome. An unhealthy diet and a lack of exercise contribute. “We know that in the younger adult population, the rates of diabetes and obesity are increasing,” says Dr. Lee.
Additionally, eating a typical meat and processed food–heavy Western diet changes the composition of our microbiome — the trillions of bacteria and other microorganisms living in our gut. It decreases the population of beneficial bacteria while increasing the population of harmful bacteria. This imbalance, which scientists call dysbiosis, leads to inflammation and DNA damage that can cause healthy colon cells to turn into cancer.
“The third hypothesis is that this younger generation received a lot more antibiotics when they were growing up,” Shaukat says. Taking antibiotics also alters the balance of bacteria in the gut in ways that can make cells in the colon turn cancerous, she says.
Colorectal cancer is often missed in younger people because doctors may not immediately suspect it in this age group. “Myself and many of my colleagues see far too many cases of young individuals with very advanced cancers who tell us they were having rectal bleeding and ongoing symptoms, sometimes for a year or longer, yet their physician dismissed them as hemorrhoids or nothing to worry about,” says Shaukat.
Survey results from 2017 showed that an estimated 82 percent of people who developed colon cancer before age 50 were misdiagnosed. This continues to be an issue — a more recent survey of more than 1,000 colorectal cancer patients and survivors found that 75 percent of them saw at least two doctors before diagnosis, and 20 percent saw four or more doctors before receiving a correct diagnosis.
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