Friday, November 8, 2024

I’m a bowel cancer expert – these are five reasons why the disease is becoming more common in under 50s

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Doctors are concerned about the alarming trend of younger people being diagnosed with bowel cancer – a disease typically associated with older people.

There has been a 266 per cent increase in bowel cancer rates among adolescents and young adults over the past three decades.

The reasons for this worrying surge are unclear despite similar patterns emerging internationally, according to the Royal Australian College of General Practitioners.

As scientists scramble to pinpoint the cause of the mystery early onset cancer ‘epidemic’ – medically defined as the disease striking adults under the age of 50 – bowel cancer expert and colorectal surgeon Dr Haney Youssef explains some of the reasons why the disease might be becoming more common in the under 50s. 

Mum-of-two Melissa Dunmore, from Melbourne, was diagnosed with stage-three bowel cancer a week before her 33rd birthday, despite having no family history of the disease. Surgeons found a 20cm tumour in her colon along with 11 tiny pre-cancerous polyps

Marlene Sardo-Infirri was seven months pregnant when her husband David was diagnosed with stage-four bowel cancer. The then 38-year-old only experienced one symptom - frequent bathroom visits - and didn't experience any abdominal pain or bleeding

Marlene Sardo-Infirri was seven months pregnant when her husband David was diagnosed with stage-four bowel cancer. The then 38-year-old only experienced one symptom – frequent bathroom visits – and didn’t experience any abdominal pain or bleeding

Bowel cancer can cause you to have blood in your poo, a change in bowel habits, a lump inside your bowel which can cause an obstruction. Some people also suffer from weight loss as a result of these symptoms

Bowel cancer can cause you to have blood in your poo, a change in bowel habit, a lump inside your bowel which can cause an obstructions. Some people also suffer with weight loss a s a result of these symptoms

Dietary changes and processed foods

Despite years of research, scientists and doctors remain baffled as to why there is an increase in younger cases of bowel cancer. 

But a diet of junk food and processed meat, like burgers, bacon and fried chicken, is thought to one culprit.

‘The modern diet, particularly in Western countries, has seen a significant increase in the consumption of processed and fast foods,’ Dr Youssef said. 

He added: ‘These foods are often high in unhealthy fats, sugars, and additives, while being low in fibre. 

Dr Haney Youssef, bowel cancer expert and colorectal surgeon at the The Harborne Hospital, in Birmingham, England

Dr Haney Youssef, bowel cancer expert and colorectal surgeon at the The Harborne Hospital, in Birmingham, England

‘A diet low in fibre and high in processed foods can contribute to the development of bowel cancer.’

Younger generations may be relying more on convenient and often unhealthy food options which lack fibre, and it could be putting them more at risk, Dr Youssef explains. 

Fibre in our diet helps us to poo more often, which means harmful chemicals spend less time in the bowel.

In contrast, processed foods are linked to range of dietary harms.

Processed meats, such as sausages, bacon, salami, chorizo, ham and hot dogs, are one of the foods most widely known to increase cancer risk. 

These meats are any animal flesh that has been treated to increase its shelf life or taste better. This is often done by adding chemical preservatives such as nitrates.

The meat could also be processed through curing, smoking or salting. 

When eaten, nitrates can undergo a reaction that turns them into a substance called N-nitroso chemicals (NOCs).

These can damage the cells that line the bowel, the organ that processes food, which, in turn, can lead to the development of cancer, researchers say. 

Tell-tale symptoms of bowel cancer include bleeding from your bottom, bloating, losing weight without trying, tummy pain and changes in poo, such as having softer poo, diarrhoea or constipation that is not usual for you. 

A diet of junk food and processed meat, like burgers, bacon and fried chicken, is thought to increase young people's risk of bowel cancer (stock image)

A diet of junk food and processed meat, like burgers, bacon and fried chicken, is thought to increase young people’s risk of bowel cancer (stock image)

Sedentary lifestyles

Spending too much time sat at a desk or slouched on the sofa watching TV is thought to increase your cancer risk. 

In fact, the more active you are the lower your risk of bowel cancer.

‘With the rise of digital technology and changes in work and leisure activities, sedentary lifestyles have become more common,’ Dr Youssef said.

He added: ‘Many young people spend long hours sitting, whether at a desk, in front of a computer, or using mobile devices.

‘Lack of physical activity is a known risk factor for bowel cancer, as regular exercise helps maintain a healthy digestive system and overall well-being.’

There are several reasons why keeping moving helps reduce your risk. 

Firstly, being active helps you to maintain a healthy weight which in turn helps your immune system to work at its best. 

This means the body can be better at spotting, and dealing with, cells which could go on to become cancer.

Like eating fibre, exercise also helps to move food through our bowel faster, meaning anything harmful we eat spend less time in the bowel. 

The more active you are the lower your risk of bowel cancer, according to research

The more active you are the lower your risk of bowel cancer, according to research

Obesity

It’s not just eating too much junk food and not exercising enough that puts you at an increased risk, but also one of the consequences: putting on too much weight. 

‘Obesity rates have been climbing globally, and younger age groups are not immune to this trend, Dr Youssef said.

He added: ‘Excess body fat can lead to inflammation and changes in hormone levels, which may promote cancer development. 

‘The rising prevalence of obesity in younger individuals is a contributing factor to the increased incidence of bowel cancer in this demographic.’

Being too fat causes the level of growth hormones in the body to rise, which then causes cells to divide more often. 

Each of these additional divisions represents another potential chance for cancer cells to appear, increasing the odds of getting the disease. 

Another factor increasing risk is that immune cells are attracted to areas of the body where there are lots of fat cells.

This can then cause an inflammation spike in these areas which causes cells to divide quicker, again increasing the risk of cancer forming.

Genetic factors

But it’s not all diet and exercise; genetics can also be putting you at a higher risk of the disease. 

‘Research has not unveiled a conclusive a connection between genetics and the increase in diagnosis. However, having a first-degree relative under 50 who has had bowel cancer could suggest a higher risk for younger people,’ Dr Youssef said. 

But there are also some rare inherited conditions associated with an increased risk of bowel cancer. 

He added: ‘While most cases of bowel cancer are sporadic, a portion of younger patients may have a genetic predisposition to the disease. 

‘Conditions such as Lynch syndrome and familial adenomatous polyposis (FAP) significantly increase the risk of developing bowel cancer at a young age – however, this only accounts for five per cent of all bowel cancer cases.’

Delayed diagnosis and ongoing misdiagnosis

Non-biological factors could also be playing a part in a rise in bowel cancer diagnoses. 

Increased awareness of the disease and improved diagnostic techniques are thought to have played a role in increasing the number of young people getting diagnosed. 

Logically, the more young people know the symptoms of bowel cancer the more likely they to getting checked out as a result. 

‘Younger people are more aware of the importance of getting medical advice for symptoms such as ongoing bowel habit changes and rectal bleeding,’ Dr Youssef said.

‘As a result, this could be having a knock-on effect of the number of younger people getting diagnosed.’

While this increased awareness is a positive, Dr Youssef added there still too many cases where cancer patients face delays or problems getting a diagnosis. 

‘Symptoms such as abdominal pain, changes in bowel habits, and rectal bleeding can be attributed to less serious conditions like irritable bowel syndrome (IBS) or haemorrhoids,’ Dr Youssef said.

‘For a small minority, this delay in accurate diagnosis allows the cancer to progress to more advanced stages before it is detected.’

It’s for this reason that Dr Youssef believes bowel cancer awareness is important amongst all age groups.

‘By addressing the controllable factors, such as dietary habits, promoting physical activity, and managing obesity, individuals can help reduce their risk of bowel cancer,’ he added. 

COLON CANCER: WHAT ARE THE WARNING SIGNS?

Bowel, or colorectal, cancer affects the large bowel, which is made up of the colon and rectum.

Such tumors usually develop from pre-cancerous growths, called polyps.

Symptoms include:

  • Bleeding from the bottom
  • Blood in stools
  • A change in bowel habits lasting at least three weeks
  • Unexplained weight loss
  • Extreme, unexplained tiredness
  • Abdominal pain

Most cases have no clear cause, however, people are more at risk if they: 

  • Are over 50
  • Have a family history of the condition
  • Have a personal history of polyps in their bowel
  • Suffer from inflammatory bowel disease, such as Crohn’s disease
  • Lead an unhealthy lifestyle  

Treatment usually involves surgery, and chemo- and radiotherapy.

More than nine out of ten people with stage 1 bowel cancer survive five years or more after their diagnosis.

Unfortunately, only around a third of all colorectal cancers are diagnosed at this early stage. 

The majority of people come to the doctor when the disease has spread beyond the wall of the colon or rectum or to distant parts of the body, which decreasing the chance of being successfully cured of colon cancer. 

According to Bowel Cancer UK figures, more than 41,200 people are diagnosed with bowel cancer every year in the UK. 

It affects around 40 per 100,000 adults per year in the US, according to the National Cancer Institute.

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