As Rates of Colorectal Cancer Rise for People Under 50, UVM Cancer Center Highlights Screening Recommendations, Risk Factors
Experts from UVM Cancer Center are available to speak with members of the media through the end of this week
South Burlington, VT – With rates of colorectal cancer rising for adults under the age of 50, experts at University of Vermont Cancer Center are highlighting risk factors, updated guidance and guidelines, and urging people to get screened starting at age 45.
While most cases of colorectal cancer still occur in individuals over the age of 50, both the rate of cancer diagnoses and mortality for that age group is falling significantly, said Randall Holcombe, MD, MBA, director of UVM Cancer Center and chief of the Division of Hematology/Oncology. At the same time, these rates are rising for younger individuals.
“We don’t know exactly why that is, or why it’s occurring more frequently,” said Dr. Holcombe. “That’s an area of intense research.”
Rates of colorectal cancer are increasing by about 2% per year in people under the age of 50. Mortality rates for those individuals is rising by about 1% each year, according to data published by the American Cancer Society.
Risk Factors
Fifty-four percent of colorectal cancer diagnoses in the United States are caused by risk factors that experts say are usually either modifiable or preventable. Those risk factors include excess body weight, physical inactivity, long-term cigarette smoking, diets high in red or processed meats, heavy alcohol use, and diets that are low in calcium, whole-grain or fiber-rich foods.
“Being aware of and working to address risk factors for colorectal cancer is especially important for those with a family history of colorectal cancer,” said Dr. Holcombe, “because they are at increased risk of developing the disease.”
The Importance of Screening
“It’s important for people to know that ninety percent of colorectal cancer cases are beatable if detected early with proper screening,” said Dr. Holcombe.
Current guidelines for average-risk, asymptomatic people recommend that individuals begin receiving routine screening for colorectal cancer at age 45.
Following screening guidelines and recommendations is crucial because proper screening can prevent colorectal cancer through detection and removal of pre-cancerous growths, or polyps. It can also detect cancer at an early stage, making treatment much more likely to succeed. Proper screening reduces both the rate of colorectal cancer diagnoses and the disease’s mortality rate.
Colonoscopies – an outpatient medical procedure during which a physician uses a camera to look inside the colon for cancers and polyps – are the gold standard for colorectal screening. During the procedure, polyps can also be removed using the camera, or colonoscope, making a colonoscopy not just a screening test, but a prevention test as well.
Other screening options, like the Fecal Immunochemical Test (FIT) and Cologuard give individuals more options to monitor their colorectal health and risk. FIT tests look for microscopic blood in a person’s stool, which is a common symptom of colorectal cancer. Cologuard combines the FIT test with a DNA test that looks for mutations common in colorectal cancer.
Improving Outcomes for Colorectal Cancer Patients
At UVM Cancer Center, multiple clinical trials are underway as researchers search for ways to improve outcomes for colorectal cancer patients – particularly with the goal of avoiding surgical procedures and instead treating patients through chemotherapy and radiation therapy.
“We may be able to spare people from having surgery up to fifty percent of the time,” said Dr. Holcombe. “They can still go into remission for their rectal cancer from the radiation and chemotherapy.”
One trial, CIRCULATE-NORTH AMERICA, is being funded by the National Cancer Institute and focuses on tracking colorectal cancer patients after they have surgery. Researchers check for circulating tumor DNA in patients’ blood, which helps them determine whether individuals are at a higher risk of relapse and will need chemotherapy following surgery. The goal, said Dr. Holcombe, is to reduce unnecessary post-surgical treatments.
“We have the opportunity to really tailor therapy for patients who potentially need no chemotherapy and those who may need more treatment,” he said.