Saturday, January 24, 2015

Colorectal Cancer Increasing In Young Adults

Health & Wellness

Inflatable Colon: Physical models like this internal view of the colon can encourage individuals  to book colonoscopies with their doctors. Now, one of the best cancer-screening methods promises even better results with 360-degree Google-like views of the colon; it will be like taking a walk inside.
Photo Credit: Tim Fraser
Source: NatPost

An article, by Nicholas Bakalar, in the New York Times (November 5, 2014) says that in the United States colorectal cancer rates are increasing in young adults, and so is the severity of the disease. This is taking place while the rates are decreasing for those 50 and older.

Bakalar writes:
The study, published in JAMA Surgery, used a national database of 400,000 patients with colon or rectal cancer. Incidences decreased by about 1 percent a year over all but rose among people 20 to 34, with the largest increase — 1.8 percent a year — in disease that had already progressed to other organs.

Incidence rates today, per 100,000 people, are 3 for ages 20 to 34; 17 for ages 35 to 49; and 300 for people over 50. But by 2030, the researchers estimate, one in 10 colon cancers and one in four rectal cancers will be in people under 50, and rates among those over 50 will be 175 per 100,000.

The study draws no conclusions about whether screening should begin at a younger age. “There are always risks and unintended consequences of screening tests,” said the senior author, Dr. George J. Chang, an associate professor of surgery and health services research at the University of Texas.
Of course, screening costs money. Setting a policy to initiate screening at a younger age (like 20) will require not only agreement among physicians, but also more government funds, not always an easy task. Yet, it might become necessary and normative in a decade or so, since screenings is still less costly than cancer treatment. Early detection not only saves lives, it also reduces substantially the cost of treatment.

While this study was U.S..-based, one wonders if it similar in other nations, notably western nations. The chief unanswered question is what is the root cause of younger people being diagnosed with colorectal cancer. Is it better screenings? Is it lifestyle? Is it genetic? Or is a combination of all such factors, including higher incidences of obesity, poor diet and inactivity. Does alcohol also play a factor in the higher rates for young people? How about the use of laptops, tablets and other electronics?

I am sure that all these questions will eventually be answered. The paper, published in JAMA (November 5, 2014), concludes as follows: “There has been a significant increase in the incidence of CRC diagnosed in young adults, with a decline in older patients. Further studies are needed to determine the cause for these trends and identify potential preventive and early detection strategies.”

For more, go to [NYT]

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