Most people think of colorectal cancer as something that affects older folks. New research — and personal experience — shows that young people are affected, too.
In November of 2015, at the age of 22, I had a colonoscopy as part of an extensive workup for a pancreatic condition I had been living with for almost five years. Much to my doctor’s surprise, the procedure turned up an adenoma, a precancerous growth in the lining of my large intestine. Had it not been for the colonoscopy, it would have grown undetected for years, and almost certainly turned into colon cancer.
I didn’t have any context for understanding the presence of this growth. In a discussion of possible risks I had with my doctor before the colonoscopy, he told me that the procedure would never find cancerous growths in someone so young. When it did find the adenoma, I was told that “it looked benign.” It wasn’t.
That experience prompted me to start searching for statistics about colorectal cancer and precancerous growths in my age group. I couldn’t find anything. The adenoma seemed to be nothing but an impossibility. A freak occurrence.
Not so, says a new report from the American Cancer Society. It shows an ongoing and dramatic rise in the rate of colorectal cancer among people under the age of 50. Among adults between the ages of 20 and 39, colon cancer has increased by 1 percent to 2.4 percent a year since the mid-1980s. This rise has been so dramatic that those born in 1990 and afterward have rates of colon cancer not seen since 1890.
The cancer society report and coverage related to it — including a New York Times article with comments from a young woman whose cancerous growth was discovered when she was 22 — confirms that my experience, and that of untold numbers of other “young people,” is not a rarity.
The change in colorectal cancer rates suggests that a profound and undeniable shift has exposed more people, at younger ages, to factors known to influence the development of colorectal cancer such as obesity; a high-fat, low-fiber diet with large amounts of red meat; lack of exercise; and others. The shift also suggests the need for new public health practices.
Faced by a lack of information about how often adenomas or full-blown colorectal cancer occur in young women and a seeming wealth of information that colorectal cancer happens mainly to middle-aged or older people — especially middle-aged men — I could come to only one conclusion: As a young woman, I am not the “public” of public health.
To base public health guidelines on the bodies of middle-aged men has profound implications for those of us not within that group. Current guidelines call for men and women to begin having regular colonoscopies at age 50. Had I not needed a colonoscopy at age 22 for something else, my adenoma would not have been detected and removed and, most likely, I would have had colon cancer by age 30. Even now, two years later, the significance of the fact that I underwent the procedure the day before Thanksgiving hasn’t been lost on me.
Colon cancer often grows slowly and causes vague or nonspecific symptoms like constipation, abdominal pain, and bleeding. It is not a leap to assume that many 20-somethings who see a doctor with symptoms like these are far more likely to be diagnosed with irritable bowel syndrome and aren’t screened for colorectal cancer. Young women are especially vulnerable to this kind of dismissal.
Instead of waiting for colorectal cancer rates to rise further, and perhaps even before fully turning to investigating possible causes, the medical community must first address the inadequacies of current prevention and education practices. Colorectal cancer must be considered a possible diagnosis for a person with gastrointestinal symptoms, regardless of that person’s age. Colonoscopy — a brief, outpatient procedure — has proven extremely effective in lowering the rates of colorectal cancer in people who receive them routinely after the age of 50.
Perhaps it is time to revise these screening recommendations. How many more people must develop seemingly impossible cancers before we institute safer practices?
Maia Dolphin-Krute is a writer and artist based in Boston and the author of the forthcoming books “Ghostbodies: Towards a New Theory of Invalidism” (Intellect, 2017) and “Visceral: Essays on Illness Not as Metaphor” (punctum books, 2017). More information about her work can be found at www.ghostbodies.com.
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