Cancer of the colon and rectum can be avoided in young adults, study finds



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"I spent a few months coming to the doctor to try to get a diagnosis.In the first four months, I probably saw six different doctors," said the newcomer. "They could not find anything wrong with me, even though I was pointing out my family history of colorectal cancer.They thought I was too young for that."

Newcomer stated that she was developing persistent cough and chest x-ray in the following months. The X-ray revealed lesions to the lungs and a bad.

Once the bad and lung tumors were biopsied and badyzed, the doctors confirmed what Newcomer had always suspected.

"Eleven months after I first complained of symptoms, I was diagnosed with stage 4 colorectal cancer," Newcomer said. She was 35 years old at the time.

The initial misdiagnosis of the newcomer demonstrates a growing problem in younger patients with colorectal cancer, according to a study to be presented at the annual meeting of the American Association for Cancer Research in Atlanta.

"It's a neglected population because they are younger"

The research was conducted among 1,195 patients with colorectal cancer and survivors aged 20 to 49, mostly from the United States. The newcomer was one of them.

The study found that the majority of survey respondents, 57%, were diagnosed between 40 and 49 years old; one third were diagnosed between 30 and 39 years; about 10% were diagnosed before the age of 30.

Although most patients with colorectal cancer over the age of 50 are diagnosed at early stages of the disease, new research found that most younger patients and study survivors, 71%, reported being diagnosed at advanced stages 3 and 4.

This discovery suggests that in the absence of screening and awareness of the possibility of colorectal cancer at these ages, the signs of their cancer may have been forgotten at an early stage.

Survey responses also showed that most patients and survivors, 63%, waited 3 to 12 months before seeing their doctor for symptoms because they did not recognize that their symptoms were related to cancer.

In addition, 67% of those surveyed said they had consulted with at least two doctors before receiving a correct diagnosis of colorectal cancer, which includes cancers of the colon and rectum.

"It's a neglected population because they are young and tend to be healthy," said Dr. Ronit Yarden, lead author of the research and director of medical affairs for the non-profit badociation Colorectal Cancer Alliance, a Washington-based patient advocacy organization.

"It's important that people know the symptoms," she said.

According to a study, cancers related to obesity are increasing in millennia

The limitations of the research included the fact that the survey responses were self-reported, and further research is needed to determine whether similar results could emerge among a larger sample of patients compared to older patients.

"Colon cancer is still rare in young patients," said Dr. Paul Oberstein, medical oncologist and director of the NYU Langone Perlmutter Cancer Center's Gastroenterology Medical Oncology Program in New York, who did not participate in the new research. .

"But it does happen, and I think for people who are showing signs of constipation, rectal bleeding, or having trouble going to the bathroom – they should be badessed for cancer, among other things," he said. he declares.

Symptoms of Colorectal Cancer and Screening Guidelines

Symptoms of colorectal cancer include diarrhea or constipation; feel that your intestine is not emptying completely; blood in your stool frequent gas pains or cramps; weight loss without known reason; fatigue and nausea or vomiting.

The American Cancer Society updated its colorectal cancer screening guidelines last year to recommend that at-risk adults be screened at age 45 instead of age 50, as previously reported. Screening options can range from a very sensitive fecal test every year to a colonoscopy every 10 years.

Screening for colon and rectal cancer should start at age 45, according to new guidelines

African Americans, Alaska Native Americans, and individuals with a family history or personal history of colon or rectal polyps are among the highest risk individuals. these risk factors may require screening at an earlier age.

"What's really important, is that people who have a family history of colon cancer – any first-degree parent with colon cancer at any age – are screened at 40 or 10 years of age. before the diagnosis of the family member, "says Oberstein, who was not involved in the guidelines.

"So, if your father was 45, get examined at 35," she says.

The updated guidelines, published in CA: A Cancer Journal for Clinicians, indicate that healthy medium-risk adults with a life expectancy greater than 10 years should continue colorectal cancer screening up to the age of 10 years. at the age of 75 years.
Colorectal cancer is the third leading cause of cancer-related deaths worldwide, according to the World Health Organization.
According to the United States Centers for Disease Control and Prevention, colorectal cancer is the second leading cause of cancer deaths among men and women.

Previous studies have suggested that the rate of colorectal cancer deaths increases in adults under 55 in the United States.

An "increase" in colon cancer among young adults

After an overall decline from 1970 to 2004, the cancer death rate for colon and rectum in the United States aged 20 to 54 increased by 1% each year between 2004 and 2014, according to a 2017 study published in the US medical journal JAMA.

As for Newcomer, in 2012, she no longer had any evidence of illness and had survived cancer since then, but said that her story could help raise awareness of how easily colorectal cancer can be overlooked in young people adults.

"I always have long-term effects, so I have difficulty walking, the neuropathy of the hands and feet is very difficult, I have no badual function due to radiotherapy." and chemotherapy treatments, "said the newcomer, 45, who lives today. in Arizona, who runs the Never Too Young Outreach Program at the Colorectal Cancer Alliance.

"It is very important to pbad this information on to other patients and survivors," she said. "The main problem is how to educate young people and health professionals about the progression of early colorectal cancer."

Born in the 90s? Your risk of colon cancer may increase
While colorectal cancer remains much more common after the age of 50, "we are seeing an increase in the number of diagnoses of colon cancer in young patients," said Dr. Nilofer Azad, badociate professor of oncology at Johns Hopkins Kimmel Cancer Center in Baltimore and member of the AACR Dream Team Stand Up 2 Cancer, Colorectal Cancer, who has not participated in the new research.
Specifically, colon cancer incidence rates have increased from 1% to 2.4% per year since the mid-1980s for adults aged 20 to 39 and from 0.5% to 1.3%. since the mid-1990s among adults aged 40 to 54, according to a study published in the Journal. of the National Cancer Institute in 2017.

Although these incidence rates among young adults are still low, the study found that, as a result, a person born around 1990 would now have a twice as high risk of colon cancer and quadruple the risk of rectal cancer. at the same age as if she was born around 1950.

"It's always good to be a lawyer for yourself"

Anecdotally, Azad said, she has seen more colorectal cancer patients under the age of 50 – including in her 20s or 30s – in recent years, when it was very rare before .

"But these are not real data, it's the experience of a doctor and I work in a larger center where people come for second and third opinions," Azad said.

Often, when symptoms of colorectal cancer appear in younger adults, a doctor may refer that patient to other doctors for different opinions.

"If you feel worried about something and your doctor does not, but your symptoms persist, it is still reasonable to get a second opinion (…) C & # 39; is always good to be his own lawyer, "Azad said.

"When you have symptoms consistent with the diagnosis of colorectal cancer, you should be evaluated in the same way that a person would be evaluated if she was 30 years older," she said. "The default solution should be to rule out serious illnesses, including cancer, rather than baduming that something is not a cancer or a benign condition."

Denise Powell from CNN contributed to this report.

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