What should we do if there are more and more young people suffering from colorectal cancer?

In recent years, we have repeatedly seen news in the media that middle-aged or young people have died of colorectal cancer
.

In August 2020, in the Marvel Cinematic Universe, Chadwick Boseman, the actor of the superhero Black Panther, died of colorectal cancer at the age of 43
.

Recently, anti-cancer blogger A Jian, after fighting with colorectal cancer for more than a year, also unfortunately passed away.

Seeing these news, while mourning and heartache, I can't help but wonder.
Most cancers occur in the elderly.
Why do more and more young people suffer from colorectal cancer? How can young people find colorectal cancer early? What measures should be taken to prevent it?

Colorectal cancer seems to be younger

Colorectal cancer seems to be younger

In 2017, a study led by researchers from the American Cancer Society (ACS) analyzed the incidence of colorectal cancer in the United States from 1974 to 2013
.

The results of the study show that the incidence of early-onset colorectal cancer in the United States (age less than 50 years old at the time of colorectal cancer) is rising, while the incidence of elderly people is declining, and colorectal cancer seems to be younger:

Compared with people born around 1950, people born around 1990 have a 140% higher risk of colon cancer and a 332% higher risk of rectal cancer
.

From the mid-1980s to 2013, the incidence of colon cancer in adults aged 20-29 increased by 2.
4% per year, and adults aged 30-39 increased by 1.
0% per year; from the mid-1990s to 2013, the incidence of colon cancer increased by 1.
0% per year.
The adult incidence rate increases by 1.
3% every year
.

The incidence of rectal cancer has increased even more
.

From 1974 to 2013, the incidence of rectal cancer among adults aged 20-29 has increased by 3.

Although the research object of this study is the American population, it also provides reference and warning for other countries
.

In addition, a study published in the well-known journal Cancer of the American Cancer Society analyzed the epidemiological characteristics of colorectal cancer in China from 2005 to 2014

Why are more and more young people suffering from colorectal cancer?

Why are more and more young people suffering from colorectal cancer?

The increasing incidence of colorectal cancer among young people is related to many factors
.

In 2020, a study published in JAMA Network Open, a sub-issue of the Journal of the American Medical Association, concluded that unhealthy diets, including small amounts of vegetables and fruits, excessive consumption of fats and processed meats; increased obesity rates among children and adolescents; and Lack of exercise is a potential risk factor leading to an increase in the incidence of early-onset colorectal cancer
.

A study published by Harvard University researchers in the Gut (GUT) suggests that early-onset colorectal cancer is associated with frequent consumption of sugary drinks during adolescence (13-18 years) and adulthood
.

In adulthood, compared with subjects who drank less than 1 cup (about 240ml) of sugary beverages a week, drinking 1 cup of sugary beverages a day was associated with a 16% increase in the risk of early-onset colorectal cancer; at least every day Drinking 2 cups of sugar-sweetened beverages is associated with an increased risk of early-onset colorectal cancer by 118%

Colorectal cancer in young adults may also be related to a family history of early-onset colorectal cancer
.

A study published in Cancer Epidemiology showed that compared with people with a family history of early-onset colorectal cancer, first-degree relatives (parents, children, and brothers) of patients with early-onset colorectal cancer Sisters), the risk of early-onset colorectal cancer increased by 500%; second-degree relatives (uncles, aunts, aunts, uncles, nephews, nieces, grandchildren, granddaughters, etc.

In addition, early-onset colorectal cancer may be related to some genetic diseases, such as familial adenomatous polyposis (FAP), MYH-related polyposis (MAP), Lynch syndrome (Lynch syndrome), and juvenile polyposis syndrome (JPS) and so on
.

If patients with familial adenomatous polyposis are not treated in time, almost all patients will develop colorectal cancer in their 40s; patients with MYH-related polyposis may develop colorectal cancer under the age of 50; 70%-90% Of Lynch syndrome patients will develop colorectal cancer

How to detect colorectal cancer as early as possible?

How to detect colorectal cancer as early as possible?

Early detection of colorectal cancer helps to treat it at an early stage and reduces the risk of death from colorectal cancer
.

Paying attention to physical changes and detecting early symptoms of colorectal cancer in time will help to detect colorectal cancer as soon as possible

The common symptoms of early colorectal cancer include:

Changes in bowel habits, such as changes in the original regular bowel habits, increased bowel frequency, or intractable constipation, thinner stools, and sometimes constipation and diarrhea alternately appear
.

There is blood in the stool
.

Blood in the stool is one of the obvious symptoms of colorectal cancer.
The blood volume in the stool is not much, and it is mainly dark red
.

Abdominal pain
.
Persistent abdominal discomfort, sometimes postprandial abdominal pain may occur
.
When colorectal cancer is complicated by intestinal obstruction, abdominal pain may increase or paroxysmal colic may occur
.

Lumps in the rectum and abdomen
.
Most patients with colorectal cancer can find a rectal mass through digital examination, which indicates that the colorectal cancer has entered the middle and advanced stages
.

Systemic symptoms
.
Symptoms such as anemia, low fever, weight loss, weakness or fatigue, and fluid in the abdominal cavity may occur
.

It should be noted that the appearance of the above symptoms does not mean that you have colorectal cancer; it should be paid attention to, and seek medical examination to confirm whether it is colorectal cancer, find the cause, and target treatment
.

Screening for colorectal cancer is another effective method that is expected to detect colorectal cancer early
.

According to the "Expert Consensus on Early Diagnosis and Screening Strategies for Colorectal Cancer in China", it is recommended that the 40-74 year-old general population be screened for colorectal cancer, especially the urban population
.

The available screening methods are:

Immune fecal occult blood detection, the recommended screening cycle is once a year;

For multi-target stool detection, the recommended screening cycle is once every 3 years or once every 1 year;

Questionnaire risk assessment, there is no recommended screening cycle, it is recommended to use the colorectal cancer screening high-risk factor quantitative questionnaire, the Asia-Pacific colorectal cancer screening score, and the opportunistic screening risk score questionnaire;

For colonoscopy, the recommended screening cycle is once every 5-10 years.
It is recommended to use a colonoscope that can reach the ileocecal area
.

If there are risk factors for colorectal cancer, such as ulcerative colitis, personal or family history of colorectal cancer, or familial adenomatous polyposis, Lynch syndrome, MYH-related polyposis, and juvenile polyposis syndrome Personal or family history, colonoscopy is needed more often
.

At the same time, colorectal cancer screening is not only helpful for early detection of colorectal cancer, but also for detecting precancerous lesions, such as colorectal polyps
.
If it can be detected and removed in time, the risk of polyps cancer can be controlled and the incidence of colorectal cancer can be reduced
.

How to prevent the occurrence of colorectal cancer?

How to prevent the occurrence of colorectal cancer?

To prevent colorectal cancer, in addition to screening, a healthy life>
.
The World Cancer Research Foundation (WCRF) and the American Institute of Cancer Research (AICR) have put forward cancer prevention recommendations on life>

Eat ≥5 servings of vegetables and fruits a day;

Dietary fiber intake ≥30g/day;

Eat a diet rich in whole grains, non-starchy vegetables, fruits and legumes, and eat at least 3 servings of whole grains or legumes a day;

Restrict the consumption of "fast food" and other high-fat, high-starch, and high-sugar processed foods, and avoid eating refined grains, cakes, candies and salty snacks;

Restrict the consumption of red meat and processed meat, the consumption of red meat should not exceed 3 servings per week, and eat less or no processed meat;

Limit the consumption of sugary drinks and fruit juices;

Not drinking or abstaining from alcohol;

Maintain a healthy weight and waist circumference, with a body mass index (BMI) in the range of 18-25, waist circumference of men <94cm, and waist circumference of women <80cm;

9) Increase physical activity, limit sedentary behavior, perform at least 150 minutes of physical activity a week, and spend less than 5 hours/week sitting and watching TV
.

In addition, Harvard University researchers published in Cancer Epidemiology, Biomarkers & Prevention (Cancer Epidemiology, Biomarkers & Prevention) study showed that compliance with WCRF/AICR cancer prevention recommendations is also associated with a reduced risk of death in patients with colorectal cancer.
Compared with the 1/4 subjects who followed the WCRF/AICR recommendations the least, the 1/4 subjects who followed the WCRF/AICR recommendations had a 37% reduction in the risk of all-cause death and a 24% reduction in the risk of colorectal cancer-specific death.

.

All in all, cancer does not happen suddenly, it takes time to accumulate, which also gives us enough time to detect, treat and prevent them in advance
.
Maintaining a healthy life>
.

Reference

[1] Heather M.
Ochs-Balcom, et al.
,(2021).
Early-onset colorectal cancer risk extends to second- and third-degree relatives.
Cancer Epidemiology, DOI: https://doi.
org/10.
1016/j .
canep.
2021.
101973.

[1] Jinhee Hur, et al.
,(2021).
Sugar-sweetened beverage intake in adulthood and adolescence and risk of early-onset colorectal cancer among women.
Gut, DOI: http://dx.
doi.
org/10.
1136/ gutjnl-2020-323450.

[3] Rebecca L.
Siegel, et al.
,(2017).
Colorectal Cancer Incidence Patterns in the United States, 1974–2013.
JNCI: Journal of the National Cancer Institute, DOI: https://doi.
org/10.
1093/ jnci/djw322.

[4] Colon cancer.
Retrieved Aug 31 ,2020, from https:// Alyssa R.
Scott, et al.
, (2020).
Trends in Cancer Incidence in US Adolescents and Young Adults, 1973-2015.
JAMA Network Open, DOI: 10.
1001/jamanetworkopen.
2020.
27738.

[6] Rui Song, et al.
,(2021).
Adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations and colorectal cancer survival.
Cancer Epidemiology, Biomarkers & Prevention, DOI: 10.
1158/1055-9965.