May 16, 2019

expert reaction to two studies on the rise of bowel cancer among young adults

Research published in The Lancet Gastroenterology & Hepatology and Gut both describe an increase in the rate of bowel cancer among adults aged 20-49.

Prof Stephen Duffy, Professor of Cancer Screening, Queen Mary University of London, said:

“Both publications show a clear increase in recent incidence of colorectal cancer in people under age 50 in several developed countries. Both papers suggest that sedentary lifestyles, overweight and dietary factors may be partly responsible for this. This is almost certainly the case, but it is probably not the whole story. Again, both publications indicate that there is a need for research to discover the likely multiple causes of the increased incidence. In terms of screening or prevention, it is probably too early to change policy, since despite the recent increases, the incidence in people under age 50 remains very low in absolute terms. What is reassuring is that while incidence is rising, mortality from the disease is falling, probably due to a combination of earlier diagnosis and improved treatment.”

Mr Andrew Beggs, Consultant Colorectal Surgeon and Cancer Research UK Advanced Clinician Scientist, University of Birmingham, said:

“The authors of both papers have carried out a very important study into bowel cancer. Surgeons have anecdotally reported that more and more young patients (under the age of 50 years) are being diagnosed with bowel cancer. The authors of these studies looked at records of patients with bowel cancer from across Europe, Australia and Canada and found that the numbers of young patients being diagnosed with bowel cancer has increased significantly over the last 10-15 years. The reasons why this is happening aren’t clear, but it must be urgently investigated. This means the age at which bowel cancer screening needs to start may have to change to screen people at a younger age, and people under the age of 50 with any “red flag” symptoms (bleeding, a change in bowel habit, weight loss or tummy pain) should get it checked out as soon as possible.

“The studies are high quality, as they use data from large population registries. These are centrally held databases that governments keep of all the cancers within that particular country and means that the data within them is very reliable. Patients are followed up over a long time and so we can be confident from this that the conclusions the authors have reached are correct.”

Dr Marco Gerlinger, Team Leader in Translational Oncogenomics, The Institute of Cancer Research, London, said:

“We have noticed increasing numbers of young patients with bowel cancer for some time now, and these large and high-quality studies provide solid data to support this trend.

“These results are a call to action to raise awareness among staff in GP practices and hospitals to consider bowel cancer as a diagnosis when young people come to them with pain, changes in bowel habits or blood in their stool.

“The new studies show a clear need to dedicate more efforts to understanding the lifestyle factors that trigger bowel cancers in young people and to re-think how screening may need to be adjusted to prevent such devastating cancers.”

‘Changes in colorectal cancer incidence in seven high-income countries: a population-based study’ by Araghi et al. was published in The Lancet Gastroenterology & Hepatology at 23:30 UK time on Thursday 16th May.

 ‘Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years’ by Vuik et al. was published in Gut at 23:30 UK time on Thursday 16th May.

Declared interests

Prof Stephen Duffy: ‘No’

Mr Andrew Beggs: “None.”

Dr Marco Gerlinger: “No relevant COIs.”