The five people gathered around the restaurant table do not fit the profile of colon cancer patients. They’re female, and they’re young. Two were diagnosed in their 20s, one in her 30s, two in their early 40s.
Their colon cancer support group gathers about once a month to share stories, such as the one about the doctor who said you just need a laxative, the one about the oncologist who said there’s nothing we can do for you but give you chemotherapy the rest of your life, the one about friends saying, “You don’t look sick,” without realizing that isn’t helpful.
“It’s making themselves feel better,” said Carly Brown, 29, a schoolteacher diagnosed with Stage 4 colon cancer five years ago.
These women know all too painfully well that something strange is happening in the United States in the long war on cancer. Although progress has been substantial in lowering the overall death rate from cancer, deaths due to some types of cancer have increased among people younger than 50.
Colorectal cancer is one of the drivers of this trend. In the past three decades, incidence of the disease has risen significantly among people younger than 50, many of whom have no obvious risk factors, such as having a genetic predisposition. No one knows why.
American life expectancy trails that of similarly developed nations, and the gap is widening. The dismaying reality is that multiple factors are taking the lives of people who have not yet reached a ripe old age. Colorectal cancer is a tiny element in that complex story, but the recent rise in the disease among seemingly healthy young people is a reminder that the health landscape is constantly evolving in ways not readily understood by medical science.
A report released early this year by the American Cancer Society found that people younger than 55 went from accounting for 11 percent of all colorectal cancer in 1995 to 20 percent in 2019. About 3,750 people younger than 50 will die of colorectal cancer in 2023, according to the report.
The rise in early-onset colorectal cancer is driven primarily by cancer forming on the patient’s left side, in the lowest portion of the colon or the adjacent rectum, said Rebecca Siegel, senior scientific director of surveillance research for the American Cancer Society. These cases tend to be more advanced than cancers detected in older people.
Siegel first spotted statistical evidence of the phenomenon in early 2008 and wrote a report published in 2009. Further studies showed that, contrary to what some experts suspected, this is not just a case of increased screening and earlier diagnosis, Siegel said. Mortality rates have been increasing alongside disease incidence, she said.
“This is a dramatic increase. And the trends are not going away,” said Whitney Jones, a gastroenterologist who founded the Colon Cancer Prevention Project in Louisville and now is a consultant for Grail, the liquid biopsy company. “We need to educate all people around colorectal cancer, similar to how we educate women around breast cancer.”
ADVERTISING
Colorectal cancer remains a relatively uncommon disease among young people. But that creates a diagnostic hurdle: When a young woman, for example, tells a doctor that she’s experiencing severe pain in her lower abdomen, or blood in her stool, or unexplained weight loss, the doctor probably isn’t going to think “colon cancer.”
A common symptom among patients with colorectal cancer is rectal bleeding, and such patients are usually diagnosed with hemorrhoids, Siegel said. Doctors “are thinking horses, not zebras.”
The coronavirus pandemic eased its grip slowly. Data released in November by the Centers for Disease Control and Prevention showed life expectancy rising to 77.5 in 2022, which restored less than half of what was lost during the first two years of the pandemic.
http://www.washingtonpost.com/healt...id=mc_magnet-anearlydeath_inline_collection_9
That data supports The Washington Post’s year-long investigation of America’s life expectancy crisis, which found that, although drug overdoses and gun violence take a horrific toll, the greatest corrosion of life spans comes from chronic conditions such as heart disease, obesity, diabetes and cancer.
The United States for many years had lower death rates from cancer among people younger than 65 compared with peer countries, according to a Post analysis of data standardized by cause of death across countries. But other nations are closing that gap, The Post found. Positive health trends in the United States, including improvements in cancer survival, have lost some momentum, even as chronic diseases such as obesity have risen among people younger than 65.
One way to track the society-wide effects of a disease such as cancer is to measure “years of life lost” — in other words, how many years patients fell short of an average life span. The United States used to have a large advantage among cancer patients younger than 65, in aggregate, compared with peer countries. That advantage has shrunk to one-eighth of its extent 25 years ago, and is now almost gone, The Post found.
Amid this broader phenomenon are puzzling developments such as the rise in colorectal cancer among young people, which has been seen in many highly developed countries, according to Siegel.
One suspected factor is obesity, which has soared among children and young people. Lifestyle changes that increase the risk of being overweight, such as increased consumption of highly processed, low-fiber foods and a lack of exercise, could be boosting the risk of colorectal cancer.
Researchers note, however, that many young colorectal cancer patients have no history of obesity. That suggests that more subtle, systemic factors could be at work, such as changes in gut bacteria — the microbiome — according to medical experts.
Skip to end of carousel
Life expectancy series
The Washington Post’s examination of U.S. life expectancy, published in a series of stories this fall, found that chronic diseases play an outsize role in eroding life spans. This spring, while reporting a comprehensive story about the mortality crisis, staff writers Joel Achenbach and Laurie McGinley contacted a support group in Louisville for colorectal cancer patients.
A medical mystery
As the patients shared their stories, the reporters decided to make this a separate narrative, focusing on a medical mystery — the rise of colorectal cancer rates among people younger than 50. Achenbach traveled to Louisville this spring and met five members of the cancer support group and followed their trials and triumphs during the past year.
The reporters
Since 2008, Joel has been on The Post’s Health and Science team. Laurie, former editor of the team, covers the Food and Drug Administration and has extensive experience writing about cancer. Reporter Dan Keating contributed to this report, analyzing U.S. cancer rates compared with peer nations.
1/3
End of carousel
For now, this is a medical mystery.
Their colon cancer support group gathers about once a month to share stories, such as the one about the doctor who said you just need a laxative, the one about the oncologist who said there’s nothing we can do for you but give you chemotherapy the rest of your life, the one about friends saying, “You don’t look sick,” without realizing that isn’t helpful.
“It’s making themselves feel better,” said Carly Brown, 29, a schoolteacher diagnosed with Stage 4 colon cancer five years ago.
These women know all too painfully well that something strange is happening in the United States in the long war on cancer. Although progress has been substantial in lowering the overall death rate from cancer, deaths due to some types of cancer have increased among people younger than 50.
Colorectal cancer is one of the drivers of this trend. In the past three decades, incidence of the disease has risen significantly among people younger than 50, many of whom have no obvious risk factors, such as having a genetic predisposition. No one knows why.
American life expectancy trails that of similarly developed nations, and the gap is widening. The dismaying reality is that multiple factors are taking the lives of people who have not yet reached a ripe old age. Colorectal cancer is a tiny element in that complex story, but the recent rise in the disease among seemingly healthy young people is a reminder that the health landscape is constantly evolving in ways not readily understood by medical science.
A report released early this year by the American Cancer Society found that people younger than 55 went from accounting for 11 percent of all colorectal cancer in 1995 to 20 percent in 2019. About 3,750 people younger than 50 will die of colorectal cancer in 2023, according to the report.
The rise in early-onset colorectal cancer is driven primarily by cancer forming on the patient’s left side, in the lowest portion of the colon or the adjacent rectum, said Rebecca Siegel, senior scientific director of surveillance research for the American Cancer Society. These cases tend to be more advanced than cancers detected in older people.
Siegel first spotted statistical evidence of the phenomenon in early 2008 and wrote a report published in 2009. Further studies showed that, contrary to what some experts suspected, this is not just a case of increased screening and earlier diagnosis, Siegel said. Mortality rates have been increasing alongside disease incidence, she said.
“This is a dramatic increase. And the trends are not going away,” said Whitney Jones, a gastroenterologist who founded the Colon Cancer Prevention Project in Louisville and now is a consultant for Grail, the liquid biopsy company. “We need to educate all people around colorectal cancer, similar to how we educate women around breast cancer.”
ADVERTISING
Colorectal cancer remains a relatively uncommon disease among young people. But that creates a diagnostic hurdle: When a young woman, for example, tells a doctor that she’s experiencing severe pain in her lower abdomen, or blood in her stool, or unexplained weight loss, the doctor probably isn’t going to think “colon cancer.”
A common symptom among patients with colorectal cancer is rectal bleeding, and such patients are usually diagnosed with hemorrhoids, Siegel said. Doctors “are thinking horses, not zebras.”
A medical mystery
American life expectancy at birth, steadily rising during the 20th century and once seemingly destined to reach the milestone of 80, began stagnating around 2010. It peaked at 78.9 years in 2014. After a few down years, it edged back to 78.8 in 2019, then the pandemic hit. Life expectancy plunged to 76.4 in 2021.The coronavirus pandemic eased its grip slowly. Data released in November by the Centers for Disease Control and Prevention showed life expectancy rising to 77.5 in 2022, which restored less than half of what was lost during the first two years of the pandemic.
http://www.washingtonpost.com/healt...id=mc_magnet-anearlydeath_inline_collection_9
That data supports The Washington Post’s year-long investigation of America’s life expectancy crisis, which found that, although drug overdoses and gun violence take a horrific toll, the greatest corrosion of life spans comes from chronic conditions such as heart disease, obesity, diabetes and cancer.
The United States for many years had lower death rates from cancer among people younger than 65 compared with peer countries, according to a Post analysis of data standardized by cause of death across countries. But other nations are closing that gap, The Post found. Positive health trends in the United States, including improvements in cancer survival, have lost some momentum, even as chronic diseases such as obesity have risen among people younger than 65.
One way to track the society-wide effects of a disease such as cancer is to measure “years of life lost” — in other words, how many years patients fell short of an average life span. The United States used to have a large advantage among cancer patients younger than 65, in aggregate, compared with peer countries. That advantage has shrunk to one-eighth of its extent 25 years ago, and is now almost gone, The Post found.
Amid this broader phenomenon are puzzling developments such as the rise in colorectal cancer among young people, which has been seen in many highly developed countries, according to Siegel.
One suspected factor is obesity, which has soared among children and young people. Lifestyle changes that increase the risk of being overweight, such as increased consumption of highly processed, low-fiber foods and a lack of exercise, could be boosting the risk of colorectal cancer.
Researchers note, however, that many young colorectal cancer patients have no history of obesity. That suggests that more subtle, systemic factors could be at work, such as changes in gut bacteria — the microbiome — according to medical experts.
Skip to end of carousel
About this story
Life expectancy series
The Washington Post’s examination of U.S. life expectancy, published in a series of stories this fall, found that chronic diseases play an outsize role in eroding life spans. This spring, while reporting a comprehensive story about the mortality crisis, staff writers Joel Achenbach and Laurie McGinley contacted a support group in Louisville for colorectal cancer patients.
A medical mystery
As the patients shared their stories, the reporters decided to make this a separate narrative, focusing on a medical mystery — the rise of colorectal cancer rates among people younger than 50. Achenbach traveled to Louisville this spring and met five members of the cancer support group and followed their trials and triumphs during the past year.
The reporters
Since 2008, Joel has been on The Post’s Health and Science team. Laurie, former editor of the team, covers the Food and Drug Administration and has extensive experience writing about cancer. Reporter Dan Keating contributed to this report, analyzing U.S. cancer rates compared with peer nations.
1/3
End of carousel
For now, this is a medical mystery.
