If you’ve never given going to the bathroom a second thought, it may be a good idea to start paying a little more attention when you do. How the stool you flush away looks may be the first indication of a potentially life-threatening illness: colorectal cancer.
And while the rate of colon cancer and rectal cancer cases in the United States has been falling for decades, the proportion of cases involving young people has been on the rise.
That national trend is being reflected in Arizona statistics as well, with an uptick in the rate of colorectal cancer cases in the state in individuals under 50 years old.
“There is solid evidence of an increasing risk of colon and rectal cancer in younger individuals,” says Toufic Kachaamy, M.D., chief of medicine at City of Hope® Cancer Center Phoenix. “Any young adult who experiences possible signs or symptoms of colon or rectal cancer should see a health care provider for an evaluation.”
The following symptoms, which may be linked to other conditions as well, shouldn’t be ignored:
- Changes in bowel movement habits, such as more than occasional diarrhea or constipation
- Rectal bleeding or bloody stool
- Narrow or pencil-thin stools over an extended period
- Abdominal pain
- Anemia
In this article, we’ll explore:
If you are interested in getting screened for cancer, or if you have been diagnosed with cancer and are looking for a second opinion or to discuss your options, call us 24/7 at 844-635-8469.
Colorectal Cancer in Arizona
TheArizona Cancer Registry reports that colorectal cancer is the fourth most diagnosed cancer in the state and is Arizona’s second leading cause of cancer death. State officials have been raising concern about the upswing in colorectal cancer cases diagnosed in younger people for more than a decade. Nationally, the U.S. Preventive Services Task Force in 2021 lowered the recommended age to begin cancer-screening colonoscopies from 50 to 45 years old.
The actual number of Arizona cases is still significantly lower in the under-50 population than for those who are at least 50 years old, but the proportion of cases involving younger people is growing.
From 2017 to 2021, an average of 319 cases were reported annually in Arizona among younger individuals versus 2,453 in the older population. That contrasts with roughly a decade earlier (2008-2012), when the average annual number of cases was 175 in the under-50 group and 2,240 in the 50-and-over group. The proportion of Arizona cases involving younger people went from 7.2% in the earlier period to 11.5% in the more recent one.
A University of Arizona study in 2015 found that in the state between 1995 and 2010:
- The most significant increase in colorectal cancer was in the 10-29 age group, in which cases were up 102%
- The highest increase in colon cancer, with cases up 110% , was also observed in the 10-29 age group
- The largest increase in rectal cancer was in the 30-34 age group, in which it was up 225%
Mounting evidence nationally led to a 2020 online “think tank” involving more than 400 scientists from academia, industry and government, along with patient advocates and others, to address concerns about the increasing prevalence of colon and rectal cancers in younger populations.
“Both young people and doctors need to shed the notion that colorectal cancer is an ‘old person’s disease,’ several meeting participants stressed,” a National Cancer Institute article about the event said. “People should get used to looking at their stool and noticing changes, they noted.”
The article also said that half the younger people diagnosed with colorectal cancer also have chronic conditions — irritable bowel syndrome, Crohn’s disease or diabetes — that may cause inflammation in the gut.
Genetic conditions, such as Lynch syndrome and familial adenomatous polyposis, may also increase the risk for early-onset colorectal cancer.
What’s Behind the Numbers?
While increased cases of colon and rectal cancers in younger individuals may have many reasons, Dr. Kachaamy says that one in particular stands.
“It’s lifestyle. There’s no doubt in my mind,” he says. “When did our diet become really horrible? It’s when our diet became industrialized.”
Processed foods fill our grocery stores and are loaded with extra ingredients like sugar, salts, fats and other additives to extend their expiration date and to make them more visually appealing or appetizing. Unfortunately, all those additives may also be making them unhealthy.
Some of the ultra-processed foods that have become staples of the American diet include:
- Potato chips, pretzels and similar snacks
- Cold cuts, breakfast meats
- Sodas and soft drinks
- Packaged cakes, cookies or other pastries
- Some flavored yogurts
- Breakfast cereals
A good step toward decreasing your risk of colorectal cancer is to change your eating habits. Dr. Kachaamy says he’s adopted such a lifestyle, which for him includes family meals cooked at home, exercising six days a week, and avoiding more sedentary things like long hours watching TV.
“That’s the lifestyle that should be taught,” he says. “But many people don’t have the time for that. It’s just a matter of making it a priority, which I know is hard.”
More perplexing are the increases being seen in colorectal cancer in children, who most likely are not heavy drinkers or smokers — two leading risk factors for many cancers — nor have they lived long enough to be exposed to decades of poor eating habits.
“There are thoughts that childhood obesity is contributing,” Dr. Kachaamy says. “We know that traditionally a polyp takes five to 10 years to turn into cancer. The usual risk factors for polyps and cancer typically take years to impact the colon, so the risk for teenagers is puzzling.”
His advice for teens and younger adults: “Increase physical activity, avoid fast food and low-quality food and increase your intake of fiber, fruits and vegetables. Know your risk factors, such as family history of early colorectal cancer, and discuss it with your doctor.”
Colorectal Cancer Screenings in Arizona
Colorectal cancer typically isn’t diagnosed until it reaches more advanced stages because the signs are hard to identify, especially in younger individuals where the disease was far less prevalent in the past.
In addition, getting more people screened for colorectal cancer is challenging. A 2023 American Cancer Society report showed that Arizona was tied for having the fifth-lowest screening rate among adults ages 45 to 54 years old, with only a third receiving the recommended screenings.
The City of Hope Cancer Center Phoenix is a leader in helping detect the disease and treating it. Doctors at City of Hope may also recommend screenings based on an individual’s personal risk factors.
Besides being able to perform colonoscopies, stool DNA tests and genetic screenings, City of Hope has GI Genius®, which is an artificial intelligence-powered diagnostic tool used for identifying precancerous and cancerous lesions, adenomas, and colon polyps.
City of Hope researchers also have developed a blood test that may be used to detect early-onset colorectal cancer in the future. More research is required before this type of liquid biopsy is approved for wider use.
When cancer is detected, City of Hope may apply precise and minimally invasive surgical techniques and testing to find the most optimal drug combinations to treat a specific cancer. City of Hope can also connect patients with appropriate clinical trials, and it offers a full array of support services for patients and their families.
If you are interested in getting screened for cancer, or if you have been diagnosed with cancer and are looking for a second opinion or to discuss your options, call us 24/7 at 844-635-8469.