In other words, in young adults, a diagnosis of colorectal cancer has a higher impact for different reasons: young adults with colon cancer are generally diagnosed at a later stage and with a more aggressive type of the disease. Then, the treatments heavier consequences also in terms of fertility, family planning, career aspirations and financial security.
If there are common factors and signs of this cancer in young people, including obesity, family history, inflammatory bowel disease (IBD) and symptoms, such as abdominal pain or bleeding rectal, this cancer is generally diagnosed later in young adults.
Young patients living with colorectal cancer have long-term consequences on their lives,
and these consequences are different from the impact of the disease on older people.
The first study seeks to understand why colon cancer affects more young adults. The analysis of the National Cancer Data Base which includes approximately 3 quarters of cancers diagnosed in the United States and the comparison of the results of young adults (18-44 years) and older adults (45 years and older) diagnosed with a colon cancer between 2015 and 2021, reveals that:
- a higher proportion of young adults suffer from advanced disease with more aggressive tumor types;
- a higher proportion of young adults with colon cancer is found in minorities and particularly among non-Hispanic black patients;
- the incidence of this cancer is strongly associated with obesity, family history of colon cancer, inflammatory bowel disease, prevalence of abdominal doubles and rectal bleeding, after accounting for sociodemographic factors and pre-existing illnesses.
The lead author of this first study, Dr. Kelley Chan, a cancer researcher and surgeon at Loyola University Medical Center in Chicago, concludes: “We know that over the past 20 years, colon cancer diagnosis rates have decreased by 20% among patients aged 66 and over but that rates have increased by 15% among people aged 18 to 44 years old. Therefore, our findings highlight the need for more research to understand the development of colon cancer in young adults and to improve prevention and screening of these cancers before they reach more advanced stages.”
A second study highlights the significance of colorectal cancer diagnosis in younger adults and the need for more holistic ways to address the concerns of these patients. The more qualitative study was conducted through interviews with 35 patients who had been diagnosed with colorectal cancer before the age of 50. Participants described the influence of the cancer diagnosis on their lives, their daily challenges, and their worries about the future.
4 areas of concern emerge, in terms of health and well-being:
- physical health,
- mental health,
- family planning,
- the career.
- More precisely, infertility, anxiety and uncertainty surrounding diagnosis and long-term survival, the inability to build assets, pursue higher education or achieve professional security are the main concerns of these patients;
- these concerns do not appear to be gender specific.
Better measuring the concerns of younger patients who are diagnosed with colorectal cancer may inspire new interventions, such as fertility counseling, financial support programs and mental health.
“These aspects of cancer care are too rarely addressed, so it is important to recognize that younger patients are concerned about their fertility and family planning, their career aspirations, building their assets – all of which are life plans to be put on hold due to the cancer diagnosis.
This goes well beyond colorectal cancer.
“Most young patients with all types of cancer experience similar challenges, so these data should help promote much more holistic management of the disease.”
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