Doctors are being urged to look out for iron deficiency as an early warning sign of colon cancer in young people.
A new analysis of CDC data has shown that deaths from the disease have increased by little under 1 percent since 2005 in Americans aged 20 to 54.
It found mortality was highest in younger people whose tumors are often diagnosed in later stages, perhaps because doctors are less likely to suspect cancer.
The researchers behind the report are now urging physicians to keep a ‘low clinical suspicion’ in younger patients who suffer a change in bowel habits, bleeding or an iron deficiency.
Iron deficiency can cause anemia, which is a condition where the body lacks enough healthy blood cells to circulate oxygen.
According to a 2024 study in the Journal of American Medical Association, roughly three in 10 adults may have some form of iron deficiency. British data suggests 3 per cent of men and 8 per cent of women also have an iron deficiency.
Some symptoms of iron deficiency include fatigue, weakness, pale skin, cold hands, cold feet, headache and dizziness.
Iron is found in high amounts in red meat – yet many doctors have been recommending that people cut back on their intake of this food group to reduce their colorectal cancer risk. It’s also found in foods like spinach, beans and sea food.
The above graph shows the rise of colorectal cancer in Americans under 50 over the last two decades
Research has linked a diet too high in iron to cancer – suggesting that it might build up in the liver and become toxic. But on the other hand, having too little iron makes it hard for your bodies immune system to fight cancer, which could also raise your risk for the disease.
All told, researchers from Germany’s Institute of Nutritional Science said: ‘Ideal iron intake must therefore be carefully balanced between iron deficiency and iron excess, since both can have potentially crucial clinical consequences with regard to cancer development.’
This brutal trend is sweeping the United States and has already claimed the lives of some public figures.
The late Chadwick Boseman, the star of Marvel blockbuster Black Panther, was diagnosed with the disease in 2016, when he was just 39 years old.
He died after a four-year battle with the disease in August 2020 – inspiring countless fans to pay attention to the early-onset colorectal cancer crisis.
Increased attention on the disease has lead to more research, like the new study, which was presented by Rutgers doctors at American College of Gastroenterology (ACG) 2024 Annual Scientific Meeting.
Using data from the CDC and National Center of Health Statistics, researchers examined data from 147,026 cancer deaths from 2000 to 2022.
They divided people into two groups – between 20-44 and between 45-54.
They found that each year, the amount of people aged 20-44 dying from cancer increased by .93 percent.
Study author Yazan Abboud, chair of resident research at Rutgers New Jersey Medical School, told Medscape that their findings: ‘prompt tailoring further efforts toward raising awareness of colorectal cancer symptoms.’
Chadwick Boseman kept his diagnosis largely private, which meant his death at just age 43 was a shock to his millions of fans. He’s since become a symbol of the fight against young colorectal cacner
Dr David Johnson, the chief of gastroenterology at Eastern Virginia School of Medicine who was not involved in the research, told Medscape that many young patients get diagnosed when their disease has already taken over the body.
The longer a cancer goes undetected in the body, the more time it has to grow and infiltrate far reaching parts of the body.
The bigger and more widespread a cancer is, the harder it is to treat.
Instead of waiting until it’s too late, there are signs that young people can look out for, Dr Johnson said, that may make them want to get screened earlier, ‘In particular, overt bleeding and iron deficiency need a focused evaluation in these younger cohorts.’
Doctors know that often in the early stages of colorectal cancer, patients will often develop anemia. So the role that iron plays in cancer has been studied for a long time.
Much of the research has focused on the harm that too much iron can do on your body. With studies from the American Association for Cancer Research showing that a lifetime of overconsuming iron can lead to an increased risk of lung and colorectal cancers.
Researchers suggest that tumor cells may use iron as fuel to grow and spread – taking blood from healthy tissues. It can also built up in the liver and become toxic.
The data, which has yet to be posted in a journal, showed that year on year, the number of people aged 20-54 dying of cancer has increased by .87 percent. This increase, they said, was more pronounced in people aged 20-45
But some research also suggests that too little iron could also be a problem.
A 2021 review from researchers at the Institute of Nutritional Science in Germany found that iron deficiency was linked to a greater risk for developing and dying from colorectal cancers.
The researchers said: ‘Just as the effects of excess iron intake can potentially influence both the etiology and prognosis of CRC, so too can the physiological effects of iron deficiency’.
Similarly, a 2001 study from McGill University in Canada found that people with lung, prostate, head and neck cancers were on average 65 percent more likely to die if they were anemic than if they were not.
Researchers suggest that when your body doesn’t have enough iron, it can’t produce white blood cells, which are the front line defense of the immune system.
When cancer begins developing, a healthy immune system can sometimes sniff out the mutated cells and destroy them before they turn into tumors.
Knocking out the immune system by not getting enough iron could therefore make the body more susceptible to cancer, scientists suggest.
The researchers from the Institute of Nutritional Science said: ‘the role of iron deficiency has been largely neglected and—on the evidence of the reviewed preclinical and clinical data—possibly underestimated.
About 45,000 people in the UK are diagnosed with bowel cancer, the general term for both colon and rectal cancer, each year.
Only half of those diagnosed are expected to survive 10 years after learning they have the disease, with just shy of 17,000 Brits killed by the cancer each year.
However, both cases are deaths are predicted to rise by around 4,500 and 2,500 respectively each year between now and 2040 according to experts.
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