Bowel cancer on the rise in under 50s over past three decades

Bowel cancer is significantly impacting younger people with 1-in10 new cases in Australia now occurring in people under age 50.

New Australian and international research reveals bowel cancer rates in under 50s has increased considerably over the past three decades. Alarmingly, over the next 10 years worldwide, it is estimated that 25% of rectal cancers and 10-12% of colon cancers will be diagnosed in people under age 50.

A recent South Australian study involving 28,566 patients (7.5% aged 18-50) from 1990-2017, found a disturbing trend in the incidence of young-onset gastrointestinal adenocarcinoma which mirrored international data. The researchers noted the change in incidence rates in younger individuals greatest for bowel cancer and more pronounced in males compared to females.

A 2022 Lancet study noted incidence rates in those younger than 50 years requires vigilance from researchers, clinicians and policy makers and a possible reconsideration of screening guidelines.

“If young-onset bowel cancer is rising in Australia and around the world without an obvious cause, then our approach to screening should be modified,” said Julien Wiggins, Bowel Cancer Australia CEO.

“All major US guidelines now endorse average-risk bowel cancer screening from age 45, yet Australian guidelines continue to lag, despite screening proven to be cost-effective from this age,” he said.

New analysis published in JAMA Oncology provides additional empirical evidence further supporting screening for bowel cancer at age 45.

Researchers found that starting endoscopy in younger women between ages 45-49 lowered the risk of bowel cancer by 57% compared with those who did not receive an endoscopy. They also had a lower risk of bowel cancer when compared to those who started just 5 years later.

Further research from Clinical Gastroenterology and Hepatology showed similar advanced adenoma detection rates at first-time screening colonoscopy for the 45-49 and 50-54 age groups.

Bowel Cancer Australia spokesperson, gastroenterologist A/Prof John Ding said, Screening is the process of looking for cancer or pre-cancer in healthy people, those with no symptoms of the disease.

“With regular screening, most polyps can be found and removed before they have the chance to turn into cancer, and cancers are detected earlier when they are easier to treat.

“While specific causes underlying the increase in young-onset bowel cancer cases remain elusive, there may be an overlap with older-onset risk factors, including a Western-style diet, which can alter the gut microbiome, as well as obesity and physical inactivity.

“Delayed diagnosis in younger patients and advanced disease upon presentation, underscores the need for greater awareness of bowel cancer in younger people and health professionals,” Dr Ding added.

In Australia, over 15,000 people are diagnosed with bowel cancer each year, 1,542 of whom are aged under 50.

Bowel cancer is the deadliest cancer and the fifth leading cause of death overall for Australians aged 25-44.

June is Bowel Cancer Awareness Month â€“ Bowel Cancer Australia’s signature event to raise awareness of Australia’s second deadliest cancer and funds for the leading community-funded charity dedicated to prevention, early diagnosis, research, quality treatment and the best care for everyone affected by bowel cancer.

For more information visit – bowelcanceraustralia.org or call 1800 555 494.

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