Yosune Baraibar, oncologist at Val d’Hebron Hospital: “The trend is an increase in the incidence of colorectal cancer in people under 50 years of age”

Colon and rectal cancer is the second cause of death in our country after lung cancer and breast cancer. Until now, the incidence of this disease has been associated primarily with old age, and experts recommend appropriate screening tests starting at age 50, but lately we’ve seen the trend change. “Although in recent years we have seen how in in people over 50 the incidence decreases or supported, we observe significant increase in cases in younger patients (up to 50 years),” says Dr. José Ignacio Martín Valadez, director of the multidisciplinary department of digestive tumors and peritoneal oncology at the MD Anderson Cancer Center in Madrid, in an article from the MD Anderson Cancer Center.

If we take a magnifying glass closer to the data on colorectal cancer in Spain, “in 2022, these figures amounted to 28,706 cases of colon cancer and 14,664 cases of rectal cancer,” Yosune Baraibar Argota, oncologist at the oncology department of Colón, tells us. Val d’Hebron Hospital and Val d’Hebron Hospital Institute of Oncology (VHIO). According to the study, data will emerge showing that rising incidence among young people is a global trend in countries such as Europe, North America and Oceania, where the rebound in incidence at this age begins in the middle 90s; a trend that has continued to accelerate in recent years.

The question arises: why did this happen? “The reasons for the increase in the incidence of colorectal cancer among the young population, by young we mean age under 50 years, unknown, although there is indeed an increase in the incidence of colorectal cancer in this population group throughout the world. This is something we are currently looking into and it may be related to life habitssuch as food and sedentary lifestyle, but the reason is still not exactly known. Currently, the screening program starts at age 50, which means younger segments of the population are excluded,” explains Dr. Baraibar.

But, in addition, when we talk about the possible reasons for its occurrence, we cannot fail to mention the possible microbiome changea discovery that Dr. Josep Tabernero, director of the Vall d’Hebron Institute of Oncology (VHIO) and head of the medical oncology service of the Vall d’Hebron Hospital in Barcelona, ​​explains in an interview with the publication World: “The mechanisms involved have not yet been established, but we do know that early-onset colorectal cancer has a microbiome that is different from that of the normal population and from colorectal cancer that occurs later in life.” And he adds: “We know that factors such as diet, obesity, breastfeeding or antibiotic use influence the composition of the microbiome. It is important that these medications are taken only when needed.”

What are the symptoms?

Symptoms that typically cause colorectal cancer, determined after a global review of 55 studies, are typically abdominal pain in 55% of cases, rectal bleeding in 46%, weight loss in 35% and changes in bowel rhythm in 46%. 32% of cases.

People under 50 years of age are not included in early detection campaigns, which can lead to late diagnosis and therefore progression of tumors when they are detected at a younger age. “It causes diagnostic delay“Either because the patient takes a long time to seek advice, or because it is not suspected that someone young can have this disease,” the doctor explains to us.

What can we do to prevent? At the same time, expert recommendations for the general population, according to the oncologist, are to “lead a healthy lifestyle and Consult your doctor if any of the symptoms appear. (abdominal pain, change in bowel rhythm, blood in stool, etc.),” as well as any of the above. The message can be summed up as follows: “Just because you are younger, it is possible that you have colon cancer, and the risk of getting it at a younger age is not zero,” the oncologist adds.

Early detection saves lives

However, if we look at the numbers again, the survival rate for colorectal cancer can be as high as multiply by six, thanks early detection, and it is expected that before 90% of patients can be cured if they are diagnosed at an early stage, according to data provided by the health services of the Community of Madrid.

And what are these reviews and screening tests? “Currently in Spain there is a population-based screening program for colorectal cancer, which is carried out in total population 50 to 69 years old and it consists of a stool occult blood test that is done at home,” the doctor tells us. This is a test that is very easy to do at home, and the result is obtained in a few days. If the result is positive, “a colonoscopy is performed to determine the presence of a malignant or precancerous lesion. This eliminates injuries that could become serious in the long term and can be repaired. discovered in early stages“

Is it expected that the age for this early detection population screening may vary? The truth is that in countries like the US or Canada, due to the increasing number of cases among people under 50, they are already being implemented. tests from 45 years, as Dr. Tabernero explains in the same interview, “and probably at the rate we are going, in 10 years we will have to reduce it even more. But these changes must always be driven by the belief that you will make an impact and that lives will be saved,” he adds.

As the doctor told us, the possible causes of colon cancer are currently being studied, but there is an opinion that its appearance may be multifactorial. On the one hand, due to an unhealthy lifestyle, and on the other, the possible influence of environmental factors, including. “The main recommendation is to lead a healthy lifestyle with a balanced diet, high in fiber and low in inflammatory or ultra-processed foods; and habitual exercise practice, an attempt to avoid a sedentary lifestyle. It’s also very important adherence to population screening program in the target population,” warns the oncologist.

Moreover, the treatment of colon cancer in young people does not differ from the treatment of older patients, but it is important to take it into account based on the diagnosis, psychosocial impact and consequences that this disease can cause in the patient. The goal, of course, is to provide a higher quality of life in general and, in particular, to offer help for conditions associated with subsequent depression, uncertainty, sexual dysfunction or fertility problems or other possible problems caused by this cancer.

Photos | Edward Jenner Carolina Grabowska Anastasia Shuraeva

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