Colorectal cancer is striking younger adults at alarming rates, driven by lifestyle and genetic factors.

Colorectal cancer (CRC) develops when abnormal cells grow uncontrollably in the colon or rectum, forming tumors that can eventually invade nearby tissues or spread to other parts of the body. It typically begins as small, benign growths called polyps, which can take years to become cancerous.

Globally, CRC ranks among the top three most common cancers, affecting millions of people each year.

Traditionally viewed as a condition that primarily affects older adults, it is now emerging in far younger populations, raising growing concern among doctors and researchers.

Surge in Early-Onset CRC

A study published in The Lancet Oncology has revealed a sharp rise in colorectal cancer diagnoses among adults under 50. Between 2013 and 2017, 27 of the 50 countries studied reported growing rates of early-onset cases. While North America and Europe continue to show high incidence, similar trends are now appearing across Eastern Europe, South-Central and Southeastern Asia, and South America.

Experts suggest that this shift may be linked to modern dietary habits, urbanization, and environmental influences. Preventive measures such as earlier screenings, improved nutrition, and greater public awareness are seen as essential to reversing the trend. Without these interventions, researchers warn that cases could continue to climb in the coming decades.

Life Factors Fuel Rise

Multiple studies suggest that modern eating patterns are contributing to the surge. High consumption of ultra-processed foods, red and processed meats, and sugary drinks has been linked to increased inflammation and a greater vulnerability to cancer.

For example, a study from Kazakhstan found that participants consumed nearly twice the World Cancer Research Fund's recommended weekly limit of 500 grams of meat. Moreover, only 8.6% of respondents met the recommended intake for fish, highlighting potential nutritional deficiencies that may further elevate cancer risk.

Obesity, another key risk factor, has also been linked to CRC. Excess body fat promotes chronic inflammation and disrupts metabolic processes, yet the full extent of obesity's role may be underestimated. A review of 18 studies found that many CRC patients experience unintentional weight loss before diagnosis, meaning traditional measures of obesity's impact could be complex.

Genetics Drive Inherited Risk

Early-onset CRC is frequently associated with hereditary cancer syndromes, including Lynch syndrome and familial adenomatous polyposis, according to Dr. Alexei Tsukanov, head of the Laboratory of Genetics at the National Medical Research Center for Radiology. These conditions result from genetic mutations in tumor-suppressor genes, increasing the likelihood of developing CRC at a young age.

Early detection is critical, yet many individuals ignore warning signs such as persistent changes in bowel habits, blood in the stool, unexplained weight loss, and abdominal pain.

Dr. Tsukanov stated the importance of genetic testing for families with a history of CRC. "Identifying a hereditary mutation allows us to implement lifelong clinical monitoring and early intervention, significantly improving survival rates," he explains.

Innovative technologies like BGI Genomics' COLOTECT Stool DNA Methylation Test identifies CRC-related genetic markers (SDC2, ADHFE1, and PPP2R5C) through stool DNA analysis, offer a promising solution for non-invasive early detection.

Public Awareness for Early Screening

In many nations, including those in Eastern Europe and Central Asia, CRC screening programs are inconsistent. Some countries, such as Kazakhstan, Lithuania, Latvia, and Georgia, have structured national screening initiatives, while others rely on opportunistic testing, leading to gaps in early detection.

"To improve early detection, we must educate both healthcare providers and the public about the importance of screening," says Jemma Arakelyan, an advisor at the Immune Oncology Research Institute and CEO of The Institute of Cancer and Crisis in Armenia.

References:

"Colorectal cancer incidence trends in younger versus older adults: an analysis of population-based cancer registry data" by Hyuna Sung, Rebecca L Siegel, Mathieu Laversanne, Chenxi Jiang, Eileen Morgan, Mariam Zahwe, Yin Cao, Freddie Bray and Ahmedin Jemal, 11 December 2024, The Lancet Oncology.
DOI: 10.1016/S1470-2045(24)00600-4

"Self-reported consumption frequency of meat and fish products among young adults in Kazakhstan" by Venera Akhmetova, Yuriy Balji, Yelena Kandalina, Ainara Iskineyeva, Akmaral Mukhamejanova, Akmaral Baspakova, Yassin Uzakov, Kuralay Issayeva and Galia Zamaratskaia, 1 July 2024, Nutrition and Health.
DOI: 10.1177/02601060221114230

Reference: "Is the association of overweight and obesity with colorectal cancer underestimated? An umbrella review of systematic reviews and meta-analyses" by Marko Mandic, Hengjing Li, Fatemeh Safizadeh, Tobias Niedermaier, Michael Hoffmeister and Hermann Brenner, 21 January 2023, European Journal of Epidemiology.
DOI: 10.1007/s10654-022-00954-6

Colorectal cancer is no longer just a disease of the elderly. It is increasingly affecting younger adults, largely due to unhealthy lifestyle choices. This growing trend calls for urgent action from governments, healthcare professionals, and individuals to promote awareness, improve diets, encourage healthier lifestyles, and expand access to early screenings. The time to act is now.

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