As people approach the age of 50, they start hearing jokes about that first colonoscopy, doctors looking for evidence of colorectal cancer. However, doctors are starting to drop the age for that first colonoscopy, as a lot of colon cancer is turning up in people as young as 30.
Colon cancer isn't completely unusual in young people because there are people with family histories that doctors watch carefully. However, these new cases among young people have no risk factors, creating flashing red lights to medicine.
"Some of these patients that are early-onset just because they feel like it's something else going on, a good percentage of them, I'd say probably about a quarter or so, will be coming in with later-stage disease, like stage III or stage IV disease," said Dr. Steven Nurkin, associate professor of surgery at Roswell Park Comprehensive Cancer Center.
Nurkin said he is treating 30-40 young people in a year and he isn't the only oncologist at the cancer center. He said there are the usual risk factors showing up, but there is something else.
"Those kind of lifestyle risk factors, such as diet associated with high red meat as opposed to fruits and vegetables, smoking, alcohol use, sedentary lifestyles, obesity," he said, "but what's interesting in these early-onset colorectal cancers is that, for sure, we are seeing some of those patients having some of those risk factors, but there's something else going on."
Nurkin said he is seeing cases of young patients showing up in late stages of colorectal cancers because their cases weren't spotted early enough, with physicians focusing on the usual ages, not the rapidly increasing ranks of young people with the lethal cancer.
"Maybe some of the GPs out there, some other physicians that aren't aware of the early-onset colorectal cancer, again saying this is probably just hemmorhoids, I wouldn't worry about it," Nurkin said, "and unfortunately, some of these younger folks are coming in with later-stage disease because they are getting diagnosed much later in their course."