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Colon cancer often misdiagnosed in younger patients and disease is discovered at an advanced stage

Young patients with colon cancer are often misdiagnosed at first, leading to the disease being detected when it’s at an advanced stage, a new survey finds. 

In fact, more than 70 percent of patients aged 49 and younger are diagnosed when the cancer is at stage III or stage IV.

Previous studies have suggested that those diagnosed with colon cancer before age 50 are delayed in receiving treatment and have poor survival rates.

The team, from the Colorectal Cancer Alliance, says it hopes the findings lead to an awareness of colorectal cancer among young people and that they recognize the signs so they can get tested before it’s too late.

A new survey has found that more than 70 percent of patients aged 49 or younger were diagnosed with colon cancer at stage III or stage IV, while most patients above age 50 are diagnosed at stage I or stage II (file image)

‘Despite declining incidence in older adults, there has been a rapid and alarming rise in colorectal cancer incidence among young adults in recent decades,’ said lead author Dr Ronit Yarden, director of medical affairs at the Colorectal Cancer Alliance.  

‘We do not yet know the cause of the rising incidence in younger patients, and there is little awareness of this trend among health care providers.’

Colon cancer is a cancer of the large intestine, which is the part of the digestive tract where the body separates water and salt from solid waste.

The cancer usually begins with growths called polyps. They are located on the innermost lining of the colon and become cancerous over many years.

A study published in 2017 found that colon cancer cases diagnosed in adults younger than age 55 doubled from 1990 to 2013, although no one is sure why.

In response, the American Cancer Society updated its screening guidelines for colorectal cancer, lowering the age that people at average risk begin regular screenings from 50 to 45.   

For the new survey, the team reached out via social media to recruit young colon cancer patients and survivors.

They received about 1,200 responses. Of those, 57 percent were diagnosed from ages 40 to 49, about 33 percent were diagnosed from 30 to 39, and approximately 10 percent were diagnosed below age 30.

Results showed that about 63 percent waited anywhere from three to 12 months to see a doctor after their symptoms began, often because they didn’t associate them with colon cancer. 

Additionally, more than 70 percent of patients were diagnosed at stage III or stage IV, compared to those above age 50 who were mostly diagnosed at stage I or stage II. 

The five-year relative survival rate for those with stage I colon cancer is 92 percent, according to the National Cancer Institute’s SEER database.

However, once the cancer has spread to other parts of the body such as the liver, it dramatically drops. The five-year relative survival rate for stage IV is about 12 percent.     

According to the American Cancer Society, colorectal cancer is the third most common cancer diagnosed in the US, among both men and women.

It is also the third leading cause of cancer deaths in both American men and women and is estimated to cause more than 51,000 deaths in 2019. 

Researchers also found that 67 percent of patients saw at least two doctors before getting a correct diagnosis, and some saw up to four doctors.

Dr Yarden said getting the right diagnosis can be delayed because symptoms, including constipation, fatigue and abdominal pain, can resemble other health issues such as hemorrhoids or inflammatory bowel syndrome.

But she says that many young people are also unaware that they can be at risk for the life-threatening disease.

‘Young people need to be aware that colorectal cancer can happen at any age and it is not a disease of old people,’ she said. ‘Everybody should listen to their body and, if it doesn’t feel right, go to the doctor to be tested.’

The findings will be presented at the American Association for Cancer Research annual meeting, which will be held between March 29 and April 3 in Atlanta, Georgia.


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