Barry Stein was diagnosed with stage 4 metastatic colon cancer at age 41. Though the biggest risk factor for the condition is turning 50, there’s no guarantee cancer will wait for your birthday.
By the time it was caught, Stein’s cancer had spread to his liver and lungs. Because colorectal cancer is typically seen as a disease of aging, it’s not often considered when you’re younger, making it less likely that harmful polyps are removed before early onset (diagnosed before age 50) colorectal cancer develops.
In Canada, screening for typically doesn’t start until age 50, when you are considered to be at higher risk. As a whole, rates of colorectal cancer are dropping, but we’re seeing a concerning global trend: younger adults are making up an increasing percentage of those who receive the unfortunate diagnosis. Approximately 2,500 younger adults in Canada will be diagnosed in 2025.
Preventable, Treatable, Beatable
Stein, now a 30 year cancer survivor and President and CEO of Colorectal Cancer Canada, confirmed that the fastest growing group are those aged 28-39 years. While older adults remain the most at risk and make up the majority of cases, researchers are uncertain why the demographic is shifting.
Colorectal Cancer Canada is advocating for lowering the screening age for people without a family history from 50 to 45. Canada wouldn’t be the first country to lower the starting age – both the USA and Australia start screening at 45.
Screening occurs when you have no symptoms. It’s meant to catch rectal bleeding and/or polyps that have the potential to be cancerous before they fully develop. The most common screening methods are:
- Fecal Immunochemical Test (FIT or iFOBT): A stool sample is collected and returned to the doctor or lab to examine for small amounts of blood in the stool.
- Colonoscopy: A thin, flexible, lit tube with a small video camera located at its end is inserted through the anus in order to view the inside of the entire colon and rectum for polyps and cancers.
- Flexible Sigmoidoscopy: A thin, flexible, lit tube with a small video camera located at its end is inserted through the anus in order to view the inside of the lower part of the colon and rectum (usually around the lower two feet) for polyps and cancer-related growths.
It’s entirely possible to catch and remove polyps before they develop into cancer. Though colorectal cancer “is the second biggest cancer killer in this country,” according to Stein, even a stage 4 diagnosis isn’t a death sentence. Colorectal cancer is “preventable, treatable, and beatable,” Stein said.
Preventing Colorectal Cancer in Younger Adults
While the exact cause of early onset colorectal cancer remains a mystery, there are some lifestyle changes you can make to reduce your risk.
Food plays a major part in health. Up to 70 per cent of gastrointestinal cancers are directly related to dietary habits.
Ultra-processed foods (i.e. candy, soft drinks, sausage, instant soup) wreak havoc on your system. They’re correlated with a higher risk of developing colorectal cancer, especially in men.
Foods That Fight Cancer recommends a diet high in fruits and vegetables, low in red meat, processed foods/drinks, and alcohol. The initiative provides cancer preventing recipes you can incorporate into your daily life.
Studies have shown that Colbactin, a toxin in your gut produced by E. Coli, could be one culprit behind the rise in early onset cases. Typically, E. Coli was ingested during childhood and the toxin has been maturing since. Cancer may not develop for decades after the initial infection or at all.
Of course, smoking also raises your risk. Not limited to cigarettes, weed and vape smoke are also harmful to your immune system and overall health, though smoking marijuana and vaping have not been directly linked to colorectal cancer. To lower your risk, abstain from smoking in any form as much as possible.
At Home FIT Tests (If Your Doctor Says No)
Family history plays a big role in colorectal cancer. Up to 10 per cent of cases can be attributed to hereditary or inherited factors passed down from parent to child. In up to 25 per cent of cases, multiple family members are impacted, but the genetic link is unknown.
Your doctor can only order genetic testing if you have a family history of colorectal cancer, or if you’re experiencing related symptoms. As a requirement, you’ll first need to attend genetic counselling. Tests are not conclusive. A positive test doesn’t mean you’ll develop colorectal cancer, just that you should be screened more often.
Because colorectal cancer has traditionally been considered a disease of aging, it’s possible for physicians to mistakenly attribute symptoms to something else, especially if you’re under 50. So, if you still believe you should be tested but you cannot get a FIT test through your family doctor, there are options for at home tests. LifeLabs offers a self-collection Colorectal Health (FIT) Kit for $75. Remember, this is a screening tool, not a diagnosis.
Know Your Risk
Awareness is key when it comes to cancer. Ask your family if any members have been diagnosed with colorectal cancer and what age they were at the time. If they were under 50, you have a higher risk of early onset colorectal cancer and should start screening earlier.
Do you have a family history of colorectal cancer? Click here to download the screening recommendations tool from Colorectal Cancer Canada to learn when you should start getting screened.
At the end of our interview, Stein asked me: “Before now, have you ever thought about colorectal cancer?” Being 23 years old, I told him that it’s not something that has ever really crossed my mind.
“Has anyone in your family had colon cancer? Have they been screened for colorectal cancer? Has anybody [in your family] had any genetic testing in the past that you’re aware of? Of course at 23, we generally don’t think about colorectal cancer screening, but that’s because you would be at average risk. You would start to think about it if the answer to some of those questions … were yes,” Stein said.
Though I’m not at immediate risk due to my age, my sister turns 27 this year. She’s entering the fastest growing age group for being at risk. Right after the interview, I called her and we agreed it was time to have a talk with our parents.
“Making younger people aware of [colorectal cancer] is essential,” Stein said. Raised awareness in both the general population and among practitioners could save lives. Visit Colorectal Cancer Canada for more information.
Check out The Health Insider’s other articles regarding health screenings you may want to think about, whether you have a doctor or not.
~ Read more from The Health Insider ~
- Too Young for Cancer? Colorectal Cancer in Adults Under 50
Colorectal cancer is rising fast among adults in their 20s and 30s. Experts don’t know why—but early screening could save your life. - Bleeding Gums May Impact More Than Just Your MouthBleeding gums aren’t normal—they could be the first sign of gum disease, which may impact your heart, lungs, and more.
- Know Your Nuts: The Importance of Testicular Self-Exams
With testicular cancer the most common cancer in Canada in men aged 15-40, it’s time to encourage testicular self-exams.
The information provided on TheHealthInsider.ca is for educational purposes only and does not substitute for professional medical advice. TheHealthInsider.ca advises consulting a medical professional or healthcare provider when seeking medical advice, diagnoses, or treatment.
