The war on cancer has made significant strides over the past 50 years. The cancer mortality rate has declined while the general understanding of the disease has increased significantly.
Overall, there’s hope for a world without cancer. However, every war has its inevitable setbacks.
According to the American Cancer Society Cancer Statistics Report for 2024, the past year has seen an alarming increase in certain types of cancers, especially in younger Americans. The report identifies colorectal cancer as one of the types that is on the rise in younger patients. For men under 50 years of age, colorectal cancer is now the leading cause of cancer death. For women in that age range, it is the second leading cause of cancer death.
Breast cancer is the leading cause of cancer death among women under 50, and it is also growing among younger patients, a finding that matches reports that began surfacing in mid-2023. According to a study published in the Journal of the American Medical Association (JAMA) in August, early-onset breast cancer increased by nearly 8% between 2010 and 2019. The American Cancer Society report says cases of breast cancer among women younger than 50 are now outpacing cases among those older than 50.
The news has sparked a fresh wave of concern, prompting the medical community to call for a heightened offensive against cancer. Knowing why cancer occurs and how to catch it early is critical to achieving ongoing success in prevention and treatment.
Why is cancer among young people on the rise?
Cancer has no single cause. Carcinogens – which include tobacco, alcohol, asbestos, certain types of radiation and certain viruses and bacteria – can cause damage to DNA in cells that leads to cancer. Genetics is also a consideration in cancer diagnoses, with 5% to 10% of cancers considered hereditary.
Hormonal imbalances are another factor that can lead to certain cancers, including breast and gynecological cancers.
The wide variety of factors makes identifying the reason for the recent rise in rates a complex challenge. Still, the American Cancer Society report points to a few possibilities.
An overall increase in excess body weight among the U.S. population is one of the factors the report cites. Obesity can lead to inflammation and higher levels of insulin in the body, both of which promote tumor growth. With breast cancer, obesity can also make early detection challenging.
Changes in reproductive trends are another factor the report cites as a potential trigger for the increased breast cancer rates. Women who have children later in life – or no children at all – have been shown to be more susceptible to breast cancer, the report says. The trend of women having fewer children is also cited as a potential reason for the increase.
The American Cancer Society report does not offer any insights into the reasons behind the rise in colorectal cancer among younger people, although it does state that one in three of those under the age of 50 who are diagnosed with that form of cancer have a genetic predisposition. Cancer research has yet to zero in on specific factors that seem predictably to lead to colorectal cancer. General factors, such as obesity, a lack of exercise and exposure to carcinogens, are among those most experts point to as having the potential to lead to colorectal cancer.
How can you detect cancer in its early stages?
Regular testing, sometimes referred to as cancer screening, is the best course for early detection of breast and colorectal cancer. This begins with an awareness of the early warning signs for each, though it is also important to understand the best schedule for screening, including how early to begin and how often it should be done.
For breast cancer, early signs include lumps in the breast or underarm areas. A change in the size or shape of the breast, including thickening or swelling of any part, can also be an indicator. Changes to the condition of the skin on the breast, such as dimpling, redness or flakiness, are other early warning signs.
Breast cancer screening typically involves a mammogram, which uses film or digital media to capture a picture of the inside of the breast. For those who have a higher risk of breast cancer, magnetic image resonance (MRI) may be used to provide a more comprehensive screening.
For colorectal cancer, early signs include abdominal discomfort, bloody stool, weight loss and fatigue. Changes in bowel habits, such as excessive gas, constipation or diarrhea, can also be indicators. There are a number of tests utilized to screen for colorectal cancer. A fecal occult blood test checks stool for blood, which can be a sign of cancer. A colonoscopy is a screening procedure that looks inside the rectum and colon for polyps or other warning signs of cancer.
The key takeaway from the recent American Cancer Society report is that cancer screening is more important than ever. In the past, screenings for both breast and colorectal cancer were recommended for patients as they neared or arrived at age 50. The report’s findings reveal that waiting until 50 is no longer the best course of action. Winning the war on cancer now must involve starting sooner and being more diligent about education and testing.
Mona Jhaveri, Ph.D., is a biochemist and founding executive director and chair of Music Beats Cancer, a Ridgefield-based nonprofit that addresses the growing gap in funding – sometimes known as the “Valley of Death” – that constrains the translation of cancer research discoveries into clinical applications. Prior to launching Music Beats Cancer, Jhaveri founded Foligo Therapeutics Inc. in 2005 to develop and commercialize a DNA-based therapeutic compound as a potential treatment for ovarian cancer. While Foligo was able initially to attract funding from various state-run venture programs and business plan competitions, the company ultimately succumbed to the “Valley of Death.”
Another vote for colonoscopy
Another vote for colonoscopyMarch is National Colon Cancer Awareness Month, and GI Alliance – a physician-owned and led network of gastroenterology practices in the U.S. that includes Connecticut GI (CTGI), with 25 locations, including Fairfield and Stamford – is encouraging everyone to get tested now, especially those under 55 with a history of colon cancer or bowel issues. That appeal has taken on new urgency, given the American Cancer Society’s (ACS’) findings that colorectal cancer has been increasing at an alarming rate in people under 55 for several years now. In 2019, 20% (1 in 5) of colorectal cancers were found in people 54 years or younger, up from 11% (1 in 10) in 1995. It is estimated there will be more than 150,000 new colorectal cancer cases in 2024, with 53,000 resulting in death, according to the ACS. The financial cost is disturbing as well: David Fenstermacher, Ph.D., senior director of research and medical affairs at the Colorectal Cancer Alliance in Washington, D.C., said that in 2020, approximately $22 billion was spent on colorectal cancer care, making it the second most expensive cancer type after female breast cancer.
According to Connecticut GI, the challenge of colorectal cancer is exacerbated by home detection kits and insurance restrictions. While most private insurers will cover colonoscopies for high-risk individuals under age 45 when recommended, they may not pay 100%. Some people prefer at-home testing to avoid the now-simplified but still grueling preparation for colonoscopy. But Fecal Immunochemical Tests (FIT), an at-home testing alternative, lag behind colonoscopy with an average accuracy rate of only about 79%. Physicians from GI Alliance remind people that at-home kits are also prone to false-positives and struggle to detect all polyps that may be present. Also, if you resort to home testing and later require a colonoscopy, insurance may not cover it.
With a 98% accuracy rate, colonoscopy is the most effective tool for cancer detection and prevention. Colonoscopy not only detects and prevents colorectal cancer but enables your physician to remove precancerous polyps during the procedure, said Priyanka Chugh, M.D., a GI Alliance gastroenterologist practicing with Connecticut GI in Stamford:
“What our older population has realized is how simple and painless colonoscopy testing is. Where at-home testing kits have trouble detecting smaller polyps, we see everything. We look behind every corner and remove them right then and there so they can’t develop into cancer.”
In the evolving landscape of colon cancer prevention, colonoscopy stands out as the best and safest option at preventing, detecting and treating this disease, she said. (The survival rate for stage 1 and 2 colorectal cancer is 90%.)
“What’s it going to be?” she added. “Getting a colonoscopy is far cheaper than paying for chemotherapy and cancer treatment.”
During Colorectal Cancer Awareness Month, Phelps Hospital in Sleepy Hollow will host an “Early Onset Colorectal Cancer Symposium” on March 21 for all interested medical professionals (internists, gastroenterologists, colorectal surgeons, nurse practitioners, physician assistants and primary care doctors). Parul Shukla, MD., regional chief of colon and rectal surgery for Westchester, and Christine Molmenti, M.D., associate professor and cancer epidemiologist at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, will lead the symposium. Part of it will include three young patients who will discuss their personal stories in a panel discussion with Crystal Antoine, M.D., a medical oncologist/hematologist. To register, visit https://www.eventbrite.com/e/early-onset-colorectal-cancer-symposium-tickets-836545779947?aff=oddtdtcreator.
