Think You're Too Young For Colon Cancer? Think Again

To paraphrase a well-known children’s book, everyone goes number two. Despite this universal biological fact, few adults feel comfortable discussing their bowel habits. While most of the time that’s not a problem—the topic doesn’t exactly make for great cocktail party conversation—you do need to brush past any embarrassment you might feel and discuss with your doctor if there’s been a change to your pattern of elimination.

There are many reasons why you might be more constipated than usual or suddenly find yourself running to the bathroom with diarrhea, and most of them aren’t serious. But if your bowel movements have changed and the change has lasted more than a few days, it’s worth getting checked out, and severe abdominal pain, relentless vomiting, or blood in your stool always warrants a call to your provider. You might have irritable bowel syndrome (IBS) or hemorrhoids, but it could also turn out to be an autoimmune ailment like Crohn’s disease or even colon cancer.

If you’re thinking that you’re too young for colon cancer or that you’re safe because no one in your family has had it, guess again. There are a lot of misconceptions about this disease, but getting the facts straight could save your life. Here are 5 things to know about colon cancer.

As with most types of cancer, the risk of colon cancer goes up as you get older, and most people are diagnosed after age 50. That said, you can develop colon cancer at any age, and it’s actually becoming more common among younger people: Research from the American Cancer Society examined data from the mid-1990s to 2013 and determined that incidence among people in their 20s and 30s had increased 1% to 2% each year. That might not sound like a lot, but it means that people born in 1990 are twice as likely to develop colon cancer at some point in their lives compared to people who were born around 1950. The same research also determined that the younger group is now four times more likely to get rectal cancer.

Why? No one really knows. Studies have examined the connection between colon cancer and factors like weight and fiber intake, but there aren’t any clear answers. While scientists continue to investigate this trend, the most important thing for people (and their doctors) to know is that colon cancer shouldn’t be dismissed simply because of someone’s age. If you have blood in your stool, your doctor shouldn’t brush you off and say, “Oh, it’s just hemorrhoids,” without investigating further.

Colon cancer certainly runs in families, so if you have a family history of the disease—or of ovarian or uterine cancer, which seem to be related—make sure your doctor knows about it. You may need to start getting colonoscopy screenings at a younger age. It may also be wise to talk to a genetic counselor about whether genetic tests are in order.

Heredity seems to be especially important for people who get colon cancer prior to age 35, but it still only accounts for about one-third of those cases. Overall, only 5% of colon cancer cases are linked to a known genetic mutation. The takeaway: Most people who develop it have no family history of the disease, so don’t assume you’re immune because none of your relatives have had it.

This is absolutely the most important point: Many types of cancer can be caught early if you stay on top of recommended screenings, but colon cancer is unique in that it can actually be prevented 80% to 90% of the time! That’s because precancerous polyps almost always crop up in the colon and grow for several years before invasive cancer sets in.

Colonoscopies are designed to both detect these precancerous polyps and remove them before they have a chance to become problematic. Starting at age 45, per recent guidelines from the American Cancer Society, everyone who’s at average risk (no family history or other known risk factors) should get a baseline colonoscopy. I know many people are hesitant to have this procedure, in part because of the prep that it entails, but if you get the all-clear you won’t have to repeat it for 10 years. Need a little extra convincing? Many doctors tell their patients that, in addition to broth and other clear liquids, you’re also allowed to eat vanilla ice cream the day before your procedure. It doesn’t show up in the colon, so why not? This is the only time you’ll be “prescribed” ice cream, so you might as well enjoy it.

Noninvasive tests, like Cologuard, may also be used to check for colon cancer. But they aren’t as effective as colonoscopies because they don’t let a doctor actually look at your colon and they have to be repeated more frequently. Plus, if the results are abnormal, you’ll still need a colonoscopy. But at the end of the day, the best test is the one that gets done.

You might have heard that taking probiotics, vitamin D, or zinc will lower your risk of colon cancer, but there’s no good proof at this time that any supplements will protect you. I tell all my patients who want to buy supplements to save their money and buy jewelry instead—at least you’ll come home with earrings!

A better bet is to eat an overall healthy diet, ideally one that contains plenty of fruits, vegetables, and fish. The American Cancer Society also advises cutting back on processed meats, like hot dogs and some luncheon meats. Perhaps even more important: Don’t smoke, and limit your intake of alcohol. Both are known carcinogens that raise your risk of many different types of cancer, including colon cancer.

If you see blood in your stool, it could be from hemorrhoids—and nobody ever dies from hemorrhoids. If that’s all it is, some increased fiber should take care of the problem. If it doesn’t (or if you’re not sure), see a doctor to confirm that nothing else is going on. You should also alert your doctor if you have a change in your bowel habits, your stool appears narrowed, or if you’re losing weight for no apparent reason or are feeling unusually fatigued. It might not turn out to be colon cancer, but if it is you’ll want to know about it as soon as possible. If you catch it early, your chances of survival are as high as 90%.

• Meet Dr. Maurice A. Cerulli, gastroenterologist.
• So, you’re getting a colonoscopy? Here’s how mine went down.
•  Why you need colon cancer screening earlier than you think.