Because of the recent trend, screening recommendations have shifted to begin at a younger age. – A colorectal cancer diagnosis in people under the age of 50 can come as a shock. Even more surprising is that rates of colorectal cancer are rising among younger individuals.
According to the American Cancer Society (ACS), people born around 1990 are two times more likely to develop colon cancer and four times as likely to develop rectal cancer, compared to those born in 1950.
“This is real -- we’re seeing young people being diagnosed in person and it’s unsettling,” said Dr. Ernesto Drelichman, 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 the trend, screening recommendations have shifted. For those at average risk, colonoscopy screenings now begin at age 45 instead of 50. Dr. Drelichman said he anticipates the screening age could even drop to as young as 40 in the future.
Possible culprits behind increased risk
The reasons behind rising colorectal cancer rates in younger people aren’t completely clear, but several factors could contribute -- many of which affect the microbiome and the trillions of bacteria that live on and in our bodies that help maintain health.
“Evidence shows toxins and pollutants in our environment, along with antibiotic overuse, the Western diet -- and more -- affect our healthy bacteria,” Dr. Drelichman said. “They’re changing our microbiome and causing inflammation, which may lead to cancer.”
Some factors that can alter the microbiome include:
- Antibiotic overuse: “People are taking antibiotics for everything,” Dr. Drelichman said. “Even for viral illnesses, some expect antibiotics, but these drugs only treat bacterial infections. Overuse kills healthy gut bacteria.”
- Sedentary lifestyle: Modern habits of inactivity like prolonged sitting and screen time reduce gut bacteria diversity and increase cancer risk.
- Stress: Chronic stress causes inflammation and disrupts the gut microbiome.
- Toxins like PFAs and microplastics: Known as “forever chemicals,” PFAs are found in cleaning products, non-stick cookware, packaging, stain-resistant fabrics and more. They accumulate in the body and are linked to various health issues. Microplastics (tiny plastic particles) can also lodge in the body and bloodstream due to widespread plastic use.
- Western diet: “Fiber is what feeds our healthy bacteria, and people are eating little fiber these days,” Dr. Drelichman said. “Ultra-processed foods, high fat, synthetic dyes and high-fructose corn syrup all contribute to unhealthy changes in the gut microbiome.”
7 methods to lower colorectal cancer risk
Regardless of age, you can reduce your colorectal cancer risk by adopting healthy habits:
- Exercise regularly: Aim for at least 150 minutes of moderate exercise weekly to lower cancer risk.
- Get annual physicals: Regular check-ups with bloodwork can detect signs of low iron or abnormal hemoglobin, which could indicate colorectal cancer.
- Increase fiber intake: “Fiber is essential -- it feeds our microbiome,” Dr. Drelichman said. “Getting enough fiber can help avoid a lot of digestive problems I see every day -- like diverticular disease and hemorrhoids -- not just colorectal cancer.” Eat fresh fruits, legumes, vegetables and whole grains. If you struggle to get enough fiber, consider supplements. “It’s the best supplement you can take,” he added.
- Know your family history: About 15% of colorectal cancers are hereditary. “Talk to your doctor,” Dr. Drelichman urged. “They may recommend earlier or more frequent screenings based on your risk.”
- Maintain a healthy BMI: Obesity increases risk for colorectal and other cancers.
- Stay hydrated: Water helps keep your colon clean. “Keep a big water bottle with you,” Dr. Drelichman advised. “Think about ways you can add extra water and fiber into your diet every day. My mantra is: ‘fiber, fiber, water, water.’”
- Watch for symptoms: Be alert to changes in bowel habits that last more than a few days, dark or bloody stools, fatigue, weakness or iron deficiency.
To learn more about colorectal cancer care, or to make an appointment for your screening, click or tap here.