Today’s colorectal cancer statistics come with a harsh reality: the disease is rising swiftly among younger adults.
According to the Cancer Research Institute, one in five people with a colorectal cancer diagnosis are younger than age 55. In fact, it is currently the number one cause of cancer-related death in those younger than 50. And these numbers are increasing by almost 3% annually, a stark contrast to the common assumption that colorectal cancer is a disease reserved for the older population.
Dr. Minesh Mehta, a board-certified gastroenterologist with University Health Alliance, recently gave his professional perspective regarding this alarming trend, the importance of screening and early detection, risk factors, and advancements in treatment.
Question: With colorectal cancer now the leading cause of cancer death in adults younger than 50, what’s your personal perspective as a gastroenterologist, and what are you seeing?
Dr. Mehta: As far as a perspective on these numbers, data is data, and it doesn’t lie. We have definitely seen an increased rate and frequency of colon cancer in patients well under the age of 50, sometimes in their 20s and 30s. Locally around Athens and the greater Athens area, I would say at least once a month, sometimes twice a month, we are diagnosing patients under the age of 40 with colon cancer. Oftentimes it is a more aggressive variety, because we expect it least in that age group.
Q.: Why is this happening?
Dr. Mehta: The process of colorectal cancer, the stimuli for it, and the underlying risk factors are not fully elucidated. But we do understand now that there’s an element from diet, whether it be ultra-processed foods or foods with high sugar content, particularly feeding into cancer growth. These are areas that need more research, but I do frequently discuss them with patients. However, because of my specialty and how patient referrals work, we mostly see older patients. So I think it really behooves primary care doctors to start the colorectal cancer conversation earlier.
Q.: For their 2024-2025 updates, major health organizations lowered the recommended age for colorectal cancer screening to 45. How are you navigating adults ages 20 to 44 who are seeing the steepest rise in diagnoses, but aren’t yet eligible for routine screening?
Dr. Mehta: We don’t ignore any symptoms from younger patients. If there’s a patient irrespective of age, and especially now even younger folks, with a change in bowel habits, maybe some bloating, maybe some nausea, maybe some mild discomfort that previously used to be written off as IBS or poor diet, I offer them a colonoscopy. And I load them up with the data and facts that show we’re seeing a rise in colon cancer amongst folks that are under 45. I explain that it’s always worth doing a colonoscopy just to be sure, because catching colorectal cancer earlier can be highly treatable.
Q.: What about the importance of diet and lifestyle factors?
Dr. Mehta: Nutrition is important. I think society in general is already moving away from common things like cigarette smoking and alcohol for cancer prevention. And now more people are aware of the risks of ultra-processed foods or those high in sugar, which we know are provocative of cancer. When it comes to cutting out ultra-processed food, the biggest priorities are avoiding deli meats like salami and pastrami, which are heavily processed and have preservatives. And then also cutting out sugary drinks like Coca-Cola, probably even diet sodas, to be honest. One of the best things you can do is just read food labels. If there’s something on the label that you’ve never heard of or don’t understand, then you probably shouldn’t be ingesting it. You want to be focusing on whole fruits and vegetables. Substitute a processed snack like chips with an apple or a banana, or maybe some nuts like walnuts, cashews, or almonds. You’re going to be much better off, have more regular bowel movements, and get other nutrients like vitamins and minerals that you really need for a healthy body.
Q.: Some people have hereditary risk factors. You lead the High Risk GI Clinic. Can you explain its importance for adults, no matter their age?
Dr. Mehta: The High Risk GI Clinic basically helps us identify people or a subset of people within a population that may have family history of cancer or personal history of cancer to see if they have some genetic risk factor that may predispose them to experiencing or developing cancer. And by having a High Risk GI Clinic, we’re able to carefully monitor this group of people more closely. And oftentimes they require different screening intervals than most people for colon cancer, maybe every two or three years. Also they may be at risk of other GI tract malignancies or cancers of the skin, the brain, or the pancreas, which we can then monitor and educate them on as well.
Q.: In addition to the High Risk GI Clinic, you are part of the University Health Alliance division of University Cancer & Blood Center. This allows your patients to have access to the full breadth of cancer care, not just gastroenterology. How do you see this impact patients?
Dr. Mehta: Having a team-based approach is really important. Patients feel more comfortable knowing multiple people are looking out for them and are keyed in on different aspects of their care. It also allows us to streamline care. So from the moment of a diagnosis, we can usually get them staged and seen by an oncologist and a surgeon within a week. I believe that can certainly make a difference in outcomes.