Millennials are now more at risk for colon cancer. But should they be screened for it?

By Brian Clark, MD
Gastroenterology in Stoneham, Mass.

In recent decades, more young people have developed colon and rectal cancers than before. The rate of colon cancer found in those ages 20-29 rose up to 2.4 percent per year from the mid-1980s through 2013, while the rate of rectal cancer among that age group rose 3.2 percent per year since the mid-1970s.

Over time, this steady increase has produced an alarming trend: Millennials are about twice as likely to develop colon cancer and four times as likely to develop rectal cancer compared to people born in 1950. 
Millennials have about 2x the risk for colon cancer compared to those born in 1950 Click To Tweet

This trend has raised a lot of questions about who should be screened for colorectal cancer and when. The number of people younger than 50 who develop these cancers is still relatively low compared to those older than 50, who make up 90 percent of new colon cancer cases.

However, given how common colorectal cancer is, there are still nearly 15,000 cases per year in adults under age 50, which is more than cervical cancer in all age groups combined.

It’s not yet clear why more people younger than 50 are getting colon cancer. That makes prevention and early screening all the more important.

What is colon cancer?

Colorectal cancer, often called colon cancer, refers to the group of cancers that affect the colon and rectum, also known as the large intestine. About one in 20 people will develop colon cancer at some point during their lives, making this one of the most common cancers in the U.S. These diseases usually are caused by the growth of polyps – small masses of cells – in the rectum or colon. Though these growths start as benign (noncancerous), they can develop into cancerous tumors over time.

A rendering of a polyp in the colon

Polyps tend to grow slowly, but after years they can turn into cancer

Not all polyps will grow into cancer. But when they do, they tend to grow slowly – very slowly. Generally, a polyp will take 10 to 15 years to develop into cancer. With regular screenings, we have a window of opportunity to catch polyps while they’re growing and remove them, which makes colon cancer one of the most preventable types of cancer.

Even so, colon cancer is still the second leading cause of cancer deaths among cancers that affect both men and women, with about 50,000 deaths related to the disease in 2016.  The majority of these cases happened because people did not undergo screening.  By increasing the number of people who come in for screenings, we’ll reduce the number of people who die from colon cancer.

Who should get a colon cancer screening, and when?

Because people age 50 and older make up the vast majority of colon cancer cases, they remain our biggest focus in screening. CDC guidelines state that ALL people age 50 and older should be screened for colon cancer.  But the recent rise in colon cancer cases among younger people is worrisome, and speaks to the importance of earlier screening for those who have a higher risk of developing colon cancer – and knowing what symptoms should send you to the doctor’s office.

Younger people can catch colon cancer early by being vigilant for colon cancer symptoms and understanding their risk, and they can prevent it by being screened accordingly. Those under 50 may need to start screenings earlier or come in more frequently depending on their risk and history of polyps or bowel disorders.

Request an appointment to learn when you should start colon cancer screenings.

Colon cancer symptoms and risk factors

Colon cancer can be asymptomatic, meaning it doesn’t show any symptoms until the disease has progressed to later stages. Even then, the symptoms of colon cancer can be vague and similar to symptoms of common gastrointestinal issues such as hemorrhoids, ulcers, or colitis (inflamed colon).

That said, colon cancer symptoms can include:

  • Abdominal pain
  • Bleeding from the rectum
  • Changes in bowel habits (constipation, diarrhea or thinner stool)
  • Decreased appetite
  • Persistent tiredness or fatigue
  • Unexplained weight loss


If you notice these symptoms, visit your doctor to see if you need a colon evaluation. Health insurance may not cover colon cancer screenings before age 50, but most plans cover these procedures for people with the above symptoms, or with certain colon cancer risk factors.  If you have a family history of colon cancer or colon polyps you may need to be screened before 50.

It’s especially important to be aware of colon cancer symptoms if you know you’re at high risk for the disease. Several factors can raise your risk, including:

  • Alcohol: Heavy alcohol use – more than two drinks per day for men and more than one for women – is associated with colon cancer.
  • Diet: Those who eat a lot of red meat (such as beef and pork) and processed meat (such as hot dogs or deli meat) have higher risk, especially if they eat few vegetables, fruits, and whole grain fibers.
  • Family history: People with an immediate family member who has had colon cancer or polyps are two to three times more likely to develop it themselves.
  • Inflammatory bowel disease: Patients with ulcerative colitis or Crohn’s disease should be followed by a gastroenterologist given their increased risk.
  • Obesity: People who are obese are about 30 percent more likely to develop colon cancer than those who aren’t obese.
  • Race: According to the American College of Gastroenterology (ACG) African Americans should begin screening at age 45 given their increased risk of early colon cancer.
  • Tobacco: Smokers are at risk for many cancers, including colon cancer.

Stress-free colon cancer prevention

The biggest barrier to colon cancer prevention is that people who should be getting colonoscopies aren’t getting them.

Colonoscopies are considered the “gold standard” for colon cancer screenings because they can prevent the disease in addition to catching it early when it’s easier to treat. Your doctor may offer other colon cancer screenings, such as stool tests and virtual colonoscopies, which also can detect colon cancer early.

Related reading: What happens during a colonoscopy, and when do I need one?

We strive to actively prevent colon cancer in our community by making that screening process as easy and stress-free as we can.

As part of our Stress-Free Colon Cancer Prevention Program, our patient navigators reach out to those who need screening to help facilitate appointments, arrange special accommodations when necessary, and make the process as easy and stress-free as they can.

Our improvements to the colon cancer screening process include:

  • A variety of anesthetic options to keep patients comfortable
  • Customizable preparation solutions based on patient preference and medical conditions
  • Fast screening results (you will know the outcome the same day and any polyps removed will have results usually within two business days)
  • Private screening environments
  • A patient navigator that can answer any of your questions and walk you through the process step-by step

Schedule a stress-free colon cancer screening today.

Avoiding colon cancer

Maintaining a healthy lifestyle will reduce your risk for colon cancer. That includes avoiding tobacco, keeping a healthy weight, being physically active, and eating a high fiber diet while avoiding too many red or processed meats.

Other than keeping those healthy habits, here are my takeaway recommendations:

  • If you’re 50 or older: Get screened as soon as you can.
  • If you’re younger than 50, but have any risk factors for colon cancer: Talk with your doctor or see a specialist (gastroenterologist) to discuss when you should start screening.
  • If you have any concerning symptoms: Don’t wait to see your doctor or a gastroenterologist. Even younger adults can get colon cancer!



Tags: cancer, cancer prevention, gastroenterology

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