When people under 50 are diagnosed with colorectal cancer, it comes as a shock. But equally shocking is the fact that colorectal cancer rates are rising in younger people. Those born around 1990 are twice as likely to get colon cancer and four times as likely to get rectal cancer than those born in 1950, according to the American Cancer Society (ACS).
“This is real - we’re seeing young people being diagnosed in person and it’s unsettling,” says Ernesto Drelichman, M.D., a colorectal surgeon at Henry Ford Health. “It’s not just happening in the United States – it’s happening all over the world.”
Because of this, for those at average risk of colorectal cancer, it’s recommended to begin screening colonoscopy at age 45 instead of the previously recommended age 50. Dr. Drelichman believes the screening age may drop even further in the future to age 40.
Factors That May Increase Colorectal Cancer Risk
The reasons behind the rising rates in young people aren’t fully understood, but several factors may be at play – and they all affect our microbiome, or the trillions of bacteria living on and in us that work to keep us healthy.
“Evidence shows that toxins and pollutants in our environment, along with antibiotic overuse, the Western diet – and more – affect our healthy bacteria,” says Dr. Drelichman. “They’re changing our microbiome and causing inflammation, which may lead to cancer.”
Factors that may alter the health of our microbiome include:
- Toxins like PFAs and microplastics. Known as “forever chemicals,” PFAs are found in non-stick cookware, cleaning and personal care products, stain- and water-resistant fabrics, product packaging…and the list continues. They’re called “forever chemicals” because they build up in our bodies and don’t degrade easily – and they are linked to a host of health issues. Microplastics are also linked to a variety of health problems. They’re small pieces of plastic that get lodged into our bodies and bloodstream due to the large amount of plastic we use in our everyday lives.
- A Western diet. “Fiber is what feeds our healthy bacteria, and people are eating little fiber these days,” says Dr. Drelichman. “Ultra-processed foods, lots of fat, synthetic dyes, high-fructose corn syrup – all of this is leading to unhealthy alterations in our gut microbiome. If you’re not eating fiber, you’re not going to have a healthy microbiome.”
- Overuse of antibiotics. “People are taking antibiotics for everything,” says Dr. Drelichman. “Even if you go to the doctor for a viral illness, some people want a prescription for an antibiotic. But antibiotics are only for bacterial infections. Taking them too often kills the healthy bacteria in our microbiome.”
- A sedentary lifestyle. Scrolling on our phones, working at a computer all day – our modern lifestyles are making it easy to stay inactive. Inactivity can lessen the diversity of healthy gut bacteria and raise your risk for a variety of cancers, including colorectal.
- Stress. From world events to personal issues, it seems everyone is stressed these days. Chronic stress has been shown to cause inflammation and alter the bacteria in your gut microbiome.
Colorectal Cancer Care at Henry Ford
Ways To Lower Your Risk of Colorectal Cancer
Regardless of your age, it’s possible to lower your risk of colorectal cancer by taking certain health measures:
- Increase your fiber intake. “Fiber is so important – it’s what our microbiome feeds on,” says Dr. Drelichman. Think: fresh fruits, vegetables, legumes and whole grains. “If you don’t always get enough fiber, cheat and take a fiber supplement,” says Dr. Drelichman. “I have one on my desk. Make it part of your routine. As an American, it’s the best supplement you can take. Getting enough fiber can help avoid a lot of digestive problems I see every day – like diverticular disease and hemorrhoids – not just colorectal cancer.”
- Drink water. Water is essential to keep your colon clean, yet many people don’t drink enough. “Keep a big water bottle with you,” says Dr. Drelichman. “Think about ways you can add extra water and fiber into your diet every day. My mantra is: ‘fiber, fiber, water, water.’ I always say that to my patients.”
- Exercise regularly. It’s recommended to get at least 150 minutes of moderate-intensity exercise per week. Studies show physical activity may lower your risk of many types of cancer, including colorectal.
- Maintain a healthy body mass index (BMI). Obesity is linked to a host of health issues and increases your risk for colorectal cancer, among other cancers.
- Get an annual physical. Most young people only go to a doctor if they’re sick. But regular check-ups, especially those that include bloodwork, can detect low iron levels or abnormal levels of hemoglobin — both of which can be signs of colorectal cancer.
- Know your family history. About 15% of colorectal cancer cases are due to genetic history. “Talk to your doctor,” says Dr. Drelichman. “Based upon your risk factors, they may recommend more vigilant screening – and starting screenings at a younger age.”
And always pay attention to any symptoms of colorectal cancer, like a change in bowel habits (diarrhea, constipation, narrowing of the stool) that lasts for more than a few days, dark stools or blood in the stool, weakness, fatigue and iron deficiency.
Reviewed by Ernesto Drelichman, M.D., a colorectal surgeon who sees patients at Henry Ford Cornerstone Keystone Partners – Macomb, Rochester Hills and Southfield, and Henry Ford Eastside Endoscopy – New Baltimore.
