Colorectal cancer: Why are rates doubling among the young?

March is Colorectal Cancer Awareness Month. As we end the month, let’s continue raising awareness for this number one killer in Singapore. Did you know that colorectal cancer is one of the three leading cancers in Singapore, regardless of gender or ethnicity? Everyday, approximately 5 Singaporeans are diagnosed with colon cancer, and to date, we have more than 1,200 cases each year. 

At first thought to be more prevalent amongst middle aged individuals, colon cancer is on a steady rise among young adults. About 1 in 10 cases these days are patients between the ages 20-50. As it is, we don’t know exactly what causes colorectal cancer, what more find an explanation for the rising trend among young adults. 

While more research needs to be done, what we can do to reduce colorectal cancer rates is to undergo regular colorectal cancer screening and find out more about the condition, including its symptoms and risk factors.

What causes colorectal cancer?

Colorectal cancer usually develops from small, non-cancerous polyps that grow in the lining of the large intestine. They are often present for years without symptoms and stay in the colon with the chance of developing into invasive cancer. Why these polyps form is an area still currently studied by doctors. It is hence important to practice prudence and arrange for regular screenings where necessary, as procedures like an endoscopy can detect precancerous polyps. If discovered, we can remove them before they turn cancerous, thus 100% preventing colorectal cancer. 

In some cases, colorectal cancer develops for no reason at all. This is usually linked to a family history of the condition. If you have a family history of colon cancer, all the more you should go for regular screening.

What are the symptoms of colorectal cancer?

Colorectal cancer often has no symptoms in the early stages, but warning signs include: 

  • Bloody stools
  • Changes in stool shape or colour
  • Constipation
  • Diarrhoea
  • Abdominal pain or discomfort
  • Anaemia
  • Lump in the abdomen
  • Fatigue
  • Unexplained weight loss

These symptoms are commonly associated with other conditions, such as Crohn’s disease or irritable bowel syndrome (IBS). If you are at all concerned or find that your symptoms persist or get worse, please do not hesitate to get them checked out by a specialist.

Who is at risk of colorectal cancer?

The risk factors of colorectal cancer include:

Age
While men and women aged 50 and above have an increased risk of colorectal cancer, as mentioned we’re finding that the prevalence of colorectal cancer in younger patients is increasing, so please do not overlook any symptoms. 

Ethnicity
Out of all the races in Singapore, the Chinese have a higher risk of colon cancer. 

Personal history
If you have been diagnosed with colorectal cancer or colorectal polyps in the past, you may be at risk of experiencing a recurrence and are advised to go for regular screening. 

Family history
Some individuals have familial adenomatous polyposis, a genetic syndrome that causes many polyps to develop in the large intestine at a young age. The risk of developing colorectal cancer for such individuals is extremely high — about 80-100%. If you have this condition, do consider removing your colon before the age of 40. In addition, individuals with a family history of polyps or colorectal cancer are at a high risk of developing the cancer — though the risk is still lower compared to one with familial polyposis. 

Ulcerative Colitis
Ulcerative colitis is a disease which affects the bowels and in the long term can lead to inflammation and colorectal cancer. 

A sedentary lifestyle and obesity
Being obese and having a sedentary lifestyle increase the risk of colorectal cancer. Engaging in regular physical activity improves movement of faeces in the colon and can reduce your risk. 

A diet low in fibre
Research has found that a diet low in dietary fibre and high in fat, processed food and alcohol affect the risk of developing colorectal cancer.

How can I protect myself from colorectal cancer?

Apart from going for regular screenings, thankfully there are a few simple ways to take control of your lifestyle and reduce your risk of colorectal cancer and other serious conditions. 

1. Quit smoking
Cigarette smoke contains carcinogens, which are cancer-causing substances. To date, smoking is linked to 14 types of cancer as well as other medical conditions like heart disease and chronic obstructive pulmonary disease. 

2. Consume a healthy, balanced diet
Aim for a balanced diet consisting of plenty of fruits, vegetables, foods high in fibre and lean meat. And don’t forget to drink lots of water! 

3. Reduce or cut out alcohol consumption
Alcohol forms into acetaldehyde, a toxic chemical that triggers fast growing cell development, which can lead to gene mutations responsible for cancerous growths. 

4. Increase your physical activity
Living an active lifestyle helps digest and pass out cancer-causing chemicals faster, reduce inflammation in your intestines and keeps your body fitter and healthier. You can start by walking more; I recommend aiming for at least 10k steps a day. 

References 

  1. Patel, S. G., & Ahnen, D. J. (2018). Colorectal Cancer in the Young. Current gastroenterology reports, 20(4), 15. https://doi.org/10.1007/s11894-018-0618-9
  2. Patel, S. G., & Boland, C. R. (2020). Colorectal Cancer in Persons Under Age 50: Seeking Causes and Solutions. Gastrointestinal endoscopy clinics of North America, 30(3), 441–455. https://doi.org/10.1016/j.giec.2020.03.001

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