ST. LOUIS (KMOX) — Deaths due to colorectal cancer have been falling in older Americans — but increasing in those younger than 50.
A lot of it has to do with screening and colonoscopies.
The numbers are down in older Americans because they are getting their regular colonoscopies but there's a rise in patients especially between the ages of 45 and 50. African American and Hispanic adults under 50 also showed higher rates of colorectal cancer than non-Hispanic whites under 50.
"No one has come up with a specific answer for why younger people are getting more colon cancers," said Dr. Hope Rasque, a colorectal surgeon at SSM Health DePaul Hospital. "We just know that it is happening, the incidence rate is going up. They're not being screened but we don't have anything saying they are more sedentary or eating more."
CBS News chief medical correspondent Dr. Jon LaPook says changes in gastrointestinal bacteria also may be to blame.
"That's the most intriguing possibility to me, it might have something to do with the gut microbiome," Dr. LaPook said. "That's the trillions of bacteria and hundreds of species in our gut. And it turns out that certain species are linked to increased risk of colon polyps and colon cancer. Maybe we are messing up our gut microbiome with antibiotics and our modern diet."
So what are the current guidelines from the American Cancer Society?
"The guidelines start at age 45," Dr. Rasque told KMOX. "And there are various methods of screening. You can have a colonoscopy every ten years if you have no family members with colon cancer or polyps before the age of 60. If you have a family history of colorectal cancer then you should start screening at age 40 or ten years before the youngest person in your immediate family had colorectal cancer."
But Dr. LaPook says other medical organizations haven't followed suit. He said the decision to get screened should be made between a patient and their doctor.
And while a colonoscopy is considered the gold standard for screening, there are other options.
"You can also have a flexible sigmoidoscopy — which looks at not the entire colon — every five years instead of ten," said Dr. Rasque. "There's also a virtual colonoscopy every five years. And there are stool studies out there where you test the stool for blood. You have to do that every single year. But the unfortunate thing with the stool studies is they really only detect colon cancer or high risk polyps right before they become a cancer. And really the point of screening is to prevent cancer, not detect the cancer."
Dr. Rasque says there are several ways to lower our colon cancer risk.
"If you can increase your physical activity, if you can eat more fruits and vegetables and stay away from processed foods then that does make a difference," said Dr. Rasque. "And smoking also increases your risk of colorectal cancer."