Colon Cancer in Teens and Young Adults

I'm Only 19. Could I Have Colon Cancer as a Teenager?

young man concerned about colon cancer
What should you know about colon cancer in teenagers and young adults?. Ghislain & Marie David de Lossy/The Image Bank/Getty Images

It may surprise you, but young adults, teenagers, and even children can develop colon cancer. In fact, the incidence of colon cancer in young people aged 15 to 39 is increasing

Contrary to popular thought, people who develop colon cancer at a young age do not always have a genetic predisposition. In fact, colon cancer is just as likely to be sporadic as it is in older people. It's important to talk to your doctor about any symptoms that you have, no matter your age or family history.

 

Risk Factors for Colorectal Cancer in Teenagers and Young Adults

At first glance, many people would guess that hereditary factors play a large role in colon cancers in young adults, but that does not seem to be the case. It's thought that around 20 percent of colon cancers in this age group are related to genetic factors. This means that eight out of ten colon cancers in teens and young adults are sporadic, and consequently, these people would not expect to develop the disease and would not be on the lookout for symptoms.

Some of the risk factors for colon cancer include:

  • Genetic colon cancer syndromes (see below)
  • Smoking
  • Obesity
  • Diabetes
  • Excess alcohol intake
  • Being African American
  • Having a history of inflammatory bowel disease (such as Crohn's disease or ulcerative colitis)

Genetics and Colon Cancer

As noted, genetic syndromes appear to account for a similar number of colon cancers in young people and older people—roughly 20 to 25 percent of these cancers.

It's important to note that colon cancer runs in families but only some of the time are these cancers related to specific genetic syndromes. Two of these syndromes include:

  • Lynch syndrome (hereditary nonpolyposis colorectal cancer or HNPCC): People with Lynch syndrome have roughly an 80 percent chance of developing colorectal cancer.

  • Familial adenomatous polyposis (FAP): People with FAP have nearly a 100 percent chance of developing colorectal cancer, often by the age of 45.

Some of the risk factors for colon cancer may also run in families, such as inflammatory bowel diseases and diabetes.

Why is Colon Cancer Increasing in Young People?

Nobody is certain why colon cancer is increasing in young people. It's thought that the increase in obesity and diabetes among young people is one important factor. Since calcium appears to have a protective effect against the development of colon cancer, the increased intake of sweetened beverages and decreased consumption of milk may play a role. Though low exercise levels and high consumption of processed meats may raise risk, there is no conclusive evidence that these are responsible.

It's interesting and concerning to note that lung cancer in young adults is increasing also, despite a decrease in the number of people who smoke. It could very well be that we don't yet know the environmental factors responsible for these cancers, and eating a healthy diet and exercising are probably more important than ever.

How is Colon Cancer Different in Young People?

There are many ways in which colon cancer in young people is similar to older adults, but some unique differences exist as well.

Colon cancer in young adults is more likely to appear in the distal (near the end) end of the colon and the rectum. (This finding has surprised some researchers since hereditary cancers often occur high up in the proximal part of the colon.)

It's not surprising to learn that the disease is often diagnosed at a later stage in young people—cancer in young people is often low on a physician's radar screen—but despite a more advanced stage at diagnosis, the survival rate for young people is similar to that of older people. One of the challenges of cancer in this age group is that fewer young adults take part in clinical trials than do children or older adults, and this has been linked with less improvement in cancer survival rates relative to children and older adults.

Misdiagnosis of colon cancer is also common, and thought to occur in at least 15 to 20 percent of young adults with colon cancer.

Symptoms of Colon Cancer

No matter your age, it's important for everyone to become familiar with the symptoms of colon cancer. Colon cancer is currently the third leading cause of cancer-related deaths in men and the third leading cause of cancer-related deaths in women. And just as you've heard that you should be alert for the symptoms of breast cancer or prostate cancer, keeping our eyes open for the symptoms of colon cancer can save lives as well.

Colon Cancer Screening for Young Adults

For adults age 50 and over, screening guidelines for colon cancer are in place, but what about for younger people? Certainly, young people with a family history of colon cancer or colon cancer syndromes will want to begin screening at a younger age, though it is uncertain exactly when. Since there are currently no guidelines in place that will address this disconcerting trend of increasing colon cancer in young adults, it is more important than ever for young people to have a good relationship with their primary care physicians and have a conversation about this topic.

Concern about Colon Cancer in a 19 Year Old Man—An Example

We often hear from readers who have questions about possible conditions. There is a fine balance between being alarmist (raising unneeded concern) and making sure that people have the knowledge necessary to make a difference early on if they should develop a disease. Let's take a look at one question from a young person concerned about colon cancer.

Question:  I was on your site and I'm a little concerned about my risk of colon cancer. I'm only a teenager (19), but I have a family history of diabetes and while I don't smoke, everyone else in my house does. I've been extremely tired recently even though I'm sleeping more often. My stools are thinner than they used to be. I often feel like I have to have a bowel movement but can't. Also, I've noticed a pain in my lower abdomen when bending certain ways. But I've never heard of a teenager getting colon cancer. Is it possible? If so, is there any test other than a colonoscopy that can diagnose colon cancer?

Answer: You are worried about your symptoms and whether they may mean you have colon cancer. When it comes to medicine, nothing's impossible, and as noted earlier, colon cancer in young people is increasing. People get things no one ever thought they would and people recover from things no one ever thought possible.

But let's talk about you, in particular. It's great that you know your family medical history. Diabetes is a risk factor for colon cancer (and many other health conditions), so you should keep an eye on your blood sugar. And you're right to worry about living in a house full of smokers. Smoking has been associated with an increased colon cancer risk (and a bunch of other unpleasant things) so our advice is to limit your secondhand smoke exposure as much as you can. You may have also learned that thin stools can be a symptom of colon cancer.

It's very important that you talk to your doctor about your symptoms. Before your appointment, you can do a few things to prepare for your visit. Just as you've learned that you have a family history of diabetes, ask about your family history of other diseases as well, particularly colon cancer and other cancers. We mention other cancers, because certain cancers can mean an increased risk of other cancers. For example, having an uncle with pancreatic cancer may raise the risk that his niece will develop breast cancer, but this isn't always obvious. Talk to your parents, grandparents, aunts, and uncles and ask about their medical history. Make sure to ask what their age was when they were diagnosed.

Talk to your doctor and make sure you end up with an explanation for your symptoms. Here is an article which discusses some of the tests used to diagnose colon cancer. If you are still concerned after testing, request a second opinion. Not only is it important to make sure that your symptoms aren't alerting you to an undiagnosed colon cancer, but it's clear that your symptoms are lessening your quality of life and that's important as well.

Colon Cancer Prevention for Young Adults

An ounce of prevention is always worth a pound of cure. Regardless of whether or not this 19 year old man has colon cancer, young people are developing colon cancer more frequently. Talk to your family and know your genetic risk for cancer. Review the symptoms of colon cancer above. Try to exercise, eat healthy, and maintain your ideal weight. And check out these top colon cancer prevention tips.

For those who have already been diagnosed, learn to be your own advocate when it comes to cancer. It makes a difference.

Resources for Colon Cancer in Young People

If you have been diagnosed with colon cancer at a young age, or are interested in advocacy, the organization Never Too Young Coalition has combined patients, advocates, and researchers in a united attempt to look at the increase in colon cancer in young adults.

In addition to colon cancer organizations, there are several organizations that now address the cancer needs specific to young adults coping with the disease. The organization Stupid Cancer is but one of these resources for young adults.

Online support groups are also an excellent way for young people with colon cancer to stay on top of the latest research. There is mounting evidence that there are significant molecular differences between colon cancers in younger versus older people which will hopefully lead to more precise treatment of the disease in time.

Bottom Line on Colon Cancer in Teens and Young Adults

It's true that colon cancer not only does occur in teens and young adults, but the incidence is increasing. Most colon cancers in young people are not linked to genetic syndromes and occur sporadically. It's important for anyone of any age to be familiar with the symptoms as well as risk factors for the disease. Symptoms are our body's way of telling us that something is wrong. Whether your symptoms are a sign of cancer or not is important, but there are many other reasons to see your doctor as well. If you have any symptoms or concerns which are lessening your quality of life, speak up. A wise physician once made the comment "when you add up all of the rare diseases they are actually quite common." Be your own advocate in your health care and get the care you deserve.

Sources:

Ballester, V., Rashtak, S., and L. Boardman. Clinical and Molecular Features of Young-Onset Colorectal Cancer. World Journal of Gastroenterology. 2016. 22(5):1736-44.

Connell, L., Mota, J., Braghiroli, M., and P. Hoff. The Rising Incidence of Younger Patients With Colorectal Cancer: Questions About Screening, Biology, and Treatment. Current Treatment Options in Oncology. 2017. 18(4):23.

Hubbard, J., and A. Grothey. Adolescent and Young Adult Colorectal Cancer. Journal of the National Comprehensive Cancer Network. 2013. 11(0):1219-25.

Teng, A., Lee, D., Cai, J., Patel, S., Bilchik, A., and M. Goldfarb. Patterns and Outcomes of Colorectal Cancer in Adolescents and Young Adults. The Journal of Surgical Research. 2016. 205(1):19-27.

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