Colorectal cancer is surging in an unexpected group

Key Points:

• Colorectal cancer (CRC) rates have declined in adults over 65 but are rising sharply among younger populations, especially children aged 10 to early 20s, with a six-fold increase in ages 10-14 from 1999 to 2020.
• Younger CRC patients often present with advanced, aggressive cancers (Stage 3 or 4) and face worse outcomes, including higher recurrence rates and mortality, suggesting the disease may behave differently than in older adults.
• Scientists suspect lifestyle factors like consumption of ultra-processed foods, obesity, lack of exercise, and disruptions to the gut microbiome contribute to this trend, possibly combined with antibiotic use and environmental exposures such as microplastics.
• Although CRC remains rare in those under 20, awareness of symptoms is critical since routine screenings are uncommon; rectal bleeding is the strongest predictor of CRC in people under 50 and should prompt consideration of colonoscopy.
• Common symptoms in younger patients include back and abdominal pain, changes in bowel habits, weight loss, and rectal bleeding, emphasizing the need for early diagnosis despite the disease's rarity in this age group.