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Decoding colorectal cancer: the importance of prevention in younger populations

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March 2024 is Colorectal Cancer (CRC) Awareness Month and it shines a spotlight on a disease that affects millions worldwide. Throughout this dedicated month, individuals, healthcare professionals and organisations join forces to raise awareness about the importance of early detection through screening and implementing preventative measures. With a focus on education and advocacy, this month-long campaign aims to empower communities to take charge of their health, understand risk factors and embrace screening as a crucial tool in the fight against CRC.

Recent studies have shown the incidence of CRC in people under 50. In the US, incident cases have increased by 22% from 2000 to 2013 while incidence rates for people over the age of 50 declined by 32%. Death rates from CRC have decreased by 34% in people over 50 years old and increased by 13% in those under 50. In 2023, the American Cancer Society saw a 20% increase in CRC diagnosis in 2019 in patients under 55, which is double the rate in 1995. The dropping mortality rate in older populations is predominantly due to catching CRC in its early, and thus more treatable, stages. Similar trends are also being seen in Europe, Asia, Australia, Canada, and New Zealand.

40% of all cancer diagnoses in the US are linked to obesity

Many countries start screening for CRC at 50 or older, thus missing a growing population of at-risk individuals. However, responses to this are mixed: the US Preventative Services Task Force has recommended that the screening age be dropped to 45, but Ontario, Canada noted that despite increased incidence in younger populations, screening ages would not be lowered.

Healthcare professionals and scientists are not sure why the incidence of CRC has increased substantially over recent years in younger populations. It could be due to lifestyle reasons such as obesity, physical inactivity, smoking, lack of fibre in modern Western diets or to chemicals in the environment.

Younger populations at a further heightened risk for CRC, such as those with a family history of CRC, should take extra precautions as screening options in their age groups are limited. According to the Centers for Disease Control and Prevention, 40% of all cancer diagnoses in the US are linked to obesity, making increased weight a prominent risk factor. Globally, cancer organisations recommend living a healthy lifestyle with an adequate intake of fruits, vegetables, and whole grains, and consistent exercise. Younger populations also need to be educated on the signs of CRC, such as blood in the stool, persistent abdominal pain and unexplained weight loss.

Younger demographics must exercise vigilance and raise awareness

Health departments globally need to re-evaluate CRC screening programmes as more people under the age of 50 are diagnosed with CRC. If more countries follow in the US’s footsteps and drop screening ages to 45 or younger, the CRC test market will expand to accommodate a larger test population. In 2022, CRC ranked as the third most common cancer globally in terms of incidence and the second highest in terms of mortality.

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According to World Health Organisation forecasts, CRC rates will continue to rise until 2050; thus, screening tests will continue to be vital in the future. As younger demographics face rising incidence of CRC over the next two decades, they must exercise increased vigilance and adopt preventive measures. This involves embracing healthier lifestyles and enhancing awareness of CRC and its indicators.


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