Physicians advocate early diagnosis as teenage colon cancer cases rise

Paediatric surgeons and pathologists have called for enhanced efforts in early diagnosis and awareness of colon cancer across all age groups following a worrying increase in cases among teenagers.

Health experts are concerned that colon cancer, traditionally considered a disease of older adults, is now occurring with alarming frequency in younger age groups.

Speaking exclusively with PUNCH Healthwise, the physicians emphasised the need for increased health education to promote awareness of potential warning signs, such as persistent abdominal pain, changes in bowel habits, unexplained weight loss, and rectal bleeding.

According to the World Health Organisation, colorectal or colon cancer is the third most common cancer worldwide, accounting for approximately 10 per cent of all cancer cases and is the second leading cause of cancer-related deaths worldwide.

The global health organisation said the disease predominantly affects older individuals, with the majority of cases occurring in people aged 50 and above.

However, a recent study indicated a noticeable surge in colon cancer diagnoses among adolescents and young adults, challenging conventional assumptions about the age brackets susceptible to the disease.

The study, which was presented in May at the Digestive Disease Week 2024 conference, found that incidence rates of colorectal cancer in people aged 10 to 44, increased between 1999 and 2020, with the biggest jumps seen in those between the ages of 10 and 24.

In carrying out the study, the researchers analysed data from the Centers for Disease Control and Prevention Wonder database, which offers publicly available data on mortality, cancer incidence, census data, vaccinations, and more.

They also tracked colorectal cancer incidence rates between 1999 and 2020 among people in seven different age cohorts, spanning from ages 10 to 44.

The researchers found that rates rose across the board in all age groups during this time, but that younger demographics saw a sharper uptick in cases.

Though the percentage increases were steepest in those between the ages of 10 and 24, it’s important to note that middle-aged and older adults were still more likely to get colorectal cancer—incidence rates in this age group were noted to just rise at a slightly slower pace.

Speaking with our correspondent, the physicians said shifting dietary habits and environmental factors are potential contributors to this unexpected, alarming trend.

Both experts stressed the importance of early diagnosis, saying that symptoms of colon cancer in teenagers can be subtle and easily mistaken for other conditions.

A researcher in Congenital Paediatric Oncology and Infections, Professor Aminu Mohammed, said modern lifestyles, characterised by diets low in fibre and high in processed foods, may play a significant role in the disease’s emergence among teenagers.

The don, who is also the President of the Medical and Dental Consultants Association of Nigeria, explained that these dietary changes may be linked to the development of colon cancer in teenagers, as reduced fibre intake prolongs the contact of carcinogenic agents with the bowel lining, potentially leading to malignancy.

Aminu, who is also a Professor of Paediatric Surgery at Bayero University, Kano State, said environmental factors such as chemical pollutants in water sources and genetic predispositions play crucial roles in the early onset of colon cancer among young individuals.

He noted that these factors collectively emphasise the urgency of early detection and heightened awareness.

He stressed the importance of recognising early symptoms like abdominal discomfort, changes in bowel patterns, and rectal bleeding.

According to the professor, early identification of these signs could lead to timely medical intervention and significantly improve treatment outcomes.

Reflecting on his clinical experience, the physician affirmed a notable increase in colon cancer cases among individuals under 20, adding that he records more than three colon cancer cases in teenagers annually.

While stressing that this phenomenon was previously unheard of, the paediatric surgeon advocated for comprehensive health education campaigns to raise awareness of the early signs and symptoms of colon cancer.

Speaking on early presentation and symptoms, Aminu said tumours in different parts of the colon manifest distinctively.

He added, “Cancer rates are rising due to advancements in diagnostic technology, which enables earlier detection. Additionally, dietary changes, like reduced fibre intake, contribute to increased colon cancer risk. Modern diets often lack the fibre found in traditional foods, potentially promoting bowel abnormalities and malignancy.

“We’re witnessing a notable increase in colon cancer cases among individuals under 30, which was uncommon in the past. As a pediatric surgeon, I now encounter two to three cases of colon cancer annually in teenagers under 20, a trend previously unheard of.

“Several factors drive this increase, including refined diets, food preservatives, and environmental pollutants. Genetic predisposition also plays a significant role, exacerbating the risk of developing malignancies from early-stage conditions.

“Different parts of the colon present varying symptoms of cancer. Tumours on the right side may manifest subtly with symptoms like anaemia, whereas those on the left can cause visible bleeding or changes in stool appearance.”

The surgeon, however, said socioeconomic challenges influence late-stage diagnosis, and that dietary habits influenced by affordability often lead individuals to delay seeking medical attention.

He added that lack of awareness and initial misdiagnosis further compound these delays, limiting access to timely and effective treatment.

To address these issues, the professor underscored the importance of timely medical evaluation for persistent symptoms like unexplained weight loss, chronic fatigue, and changes in bowel habits.

He urged individuals not to dismiss such signs as inconsequential.

The don further said there is a need for accessible screening programmes, including physical examinations and stool tests to detect occult blood, which is an indication of hidden colon cancer.

These measures, he emphasised are essential for identifying colon cancer at its earliest stages, thereby improving prognosis and reducing the overall burden of the disease.

On his part, an Atomic Pathologist at the University of Ilorin Teaching Hospital, Kwara State, Dr Olaleke Folaranmi emphasised the important role of dietary habits low in fibre and high in processed foods, which are often devoid of the essential nutrients needed for gut health.

While saying that his centre has not seen a surge in teenage colon cancer cases, he highlighted the significant impact of familial genetic factors in predisposing some individuals to the disease early in life.

The specialist noted that the adoption of urban lifestyles has led to increased fast food consumption, raising concerns about the uncertain effects of additives and preservatives in such modern diets.

The physician noted that these factors, while not directly linked to colon cancer, contribute to a broader conversation on preventive health measures and public health policies aimed at early detection and intervention.

Folaranmi also stressed the importance of genetic counselling and regular screenings for individuals with a family history of colon cancer.

He said screening protocols, including colonoscopy procedures, are crucial for detecting precancerous conditions early, adding that this would enable timely intervention and treatment.

The expert added, “In our medical centre, we haven’t seen an increase in cases of colon cancer among teenagers. However, when it does occur at a young age, familial genetic factors often play a role, such as inherited conditions that lead to the early development of colon polyps.

“However, the majority of colon cancer cases we encounter still affect individuals aged 50 and older, which is why we recommend that screening typically start around ages 45 to 50.

“Family history remains a significant indicator. Individuals with relatives who have had colon cancer should consider genetic counselling and early screening. A colonoscopy is crucial for detecting and monitoring precancerous conditions, especially among families with a history of the disease.

“Implementing policies that promote routine screenings through workplace programmes or insurance coverage can greatly improve early detection efforts.

“While colon cancer may not receive as much attention as breast or prostate cancers in Africa, its impact on affected individuals is profound. Preventive measures such as regular screenings and increased awareness of risk factors are essential. Government initiatives mandating screenings at specific ages could help increase early detection rates and improve outcomes.”

“Taking proactive steps and timely interventions are crucial. Establishing screening protocols similar to those for prostate-specific antigen (PSA) tests could standardise screening practices across adult populations aiming to identify and manage potential cancerous developments promptly.”