Colorectal Cancer News

Rectal Cancer Increasing in Young Adults

Rectal cancer is on the rise in Americans under the age of 40, although it remains uncommon, according to a recent study.

The analysis of data from the Surveillance, Epidemiology, and End Results (SEER) cancer registry among 7,661 patients diagnosed with colon, rectal, or rectosigmoid cancer before age 40, found that rates for colon cancer among this group have remained stable over the past three decades, Joshua E. Meyer, MD, of New York Presbyterian Hospital in New York City, and colleagues reported.

The lack of increase in colon cancer rates among younger adults suggests that the bump in rectal cancer incidence among younger age groups is not due to the increased use of colonoscopy or sigmoidoscopy, Meyer and co-authors commented online in the journal Cancer.

Although the researchers offered no clear explanation for the changing incidence of rectal cancers and didn't recommend a change to screening guidelines, they warned physicians to take symptoms seriously in younger patients rather than dismissing symptoms as hemorrhoidal bleeding. "Patients presenting with rectal bleeding or other alarming signs or symptoms should be evaluated with this finding in mind," Meyer's group wrote in Cancer.

They suggested strong consideration of the endoscopic evaluation of young patients in such cases. "Although colonoscopy may not be warranted, we suggest that flexible sigmoidoscopy, at a minimum, should be performed in this setting to rule out rectal or rectosigmoid cancer," they added in the paper.

The investigators searched the SEER database, which includes population-based cancer registries covering approximately 26% of the U.S. population, from 1973 through 2005 for cancer in individuals under age 40. Roughly half of the cases found were in those age 35 to 39; approximately 75% of the patients were white.

Together, rectal and rectosigmoid cancers appeared to have started to climb in incidence starting in 1984. The rate of increase was identical between males and females and was seen in both black and white populations.

Reference
Phend, Crystal. Rectal Cancer Rates Rising in Younger Adults. Medpage Today. August 23, 2010.

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