Experts urge routine care to intercept colon cancer before it starts From the cover
The big picture
Colorectal cancer incidence rates While the total number of colorectal cases in the U.S. has decreased, new cases among people ages 20-49 has risen.
Due to changes in lifestyle and a greater emphasis on screenings, the overall rate of people in the U.S. who are diagnosed with colon or rectal cancer has dropped each year since the 1980s, according to ACS. Despite the overall decrease, colorectal cancer is now the leading cause of cancer deaths in men under 50, and the second-leading cause of cancer deaths in women under 50, according to a 2024 report by the ACS. Dr. Andrew Miller, a surgeon for Texas Colon & Rectal Specialists’ Austin North and Round Rock locations, said this is a trend that is still being explored. However, it is something medical experts across the board are seeing. “We are catching younger and younger people,” Miller said. “At this point in my practice, probably a third of my patients with colorectal cancer are under the age of 50. We’re not exactly sure why that is … but it is a trend that is startling.” Meanwhile, Texas has one of the lowest rates for colon screenings in the U.S., according to data from the National Cancer Institute—another trend local health experts are hoping to reverse. On average, 223 incidents of colon or rectal cancer are reported annually for people of all ages in Travis County, with an average age of 61.9, according to NCI.
Men Women
15 12
Men: +36.6% Women: +32.2%
9 6 0
1998 2000 2002 2004 2006 2008 2010 2012 2014 2016 2018 Year
Average rate of new colon and rectum cancer cases, between 2016-2020, in ages 50 and under.
The lifetime risk of developing colorectal cancer is about 1 in 23 for men and 1 in 25 for women.
Estimated colon & rectum cancer cases in 2024
Estimated colorectal cancer deaths in 2024
Location
Incident rates *
Travis County 7.9 Williamson County 9.0 Texas 8.1 United States 8.7
Men
81,540
28,700
Women 71,270
24,310
Between 2016-2020, Travis County averaged 49 new colorectal cancer cases in people under 50 annually.
Total
152,810
53,010
SOURCES: AMERICAN CANCER SOCIETY, NATIONAL CANCER INSTITUTE/ COMMUNITY IMPACT
*CASES PER 100,000 POPULATION PER YEAR
Diving in deeper
A change in bowel habits Blood in or on your stool Diarrhea, constipation or feeling that the bowel does not empty all the way Abdominal pain, aches or cramps that don’t go away Unexplained weight loss Fatigue Vomiting Colorectal cancer warning signs
then cancer takes about 10 years, Solis said. “It really is a simple exam that has very minimal complication rates,” Solis said. “Usually, [patients are] in and out of any facility within two hours from the time they walk in to the time they walk out.” Alongside colonoscopies, there are alternative methods of testing for colon cancer such as fecal tests. A colonoscopy is better than a fecal test, but a fecal test is better than nothing, Luther said, as fecal tests run the risk of showing false results and they do not include any preventative actions. “All these other kinds of tests are either checking people for symptoms of cancer and polyps or for cancer, but remember, with a colonoscopy we actually want to prevent cancer,” Solis said. According to a 2021 report by the U.S. Preventive Services Task Force, the estimated number of colorectal cancer cases averted per 1,000 individ- uals who begin screening at age 45 ranges from 42-61 cases.
Colorectal cancer, called colon or rectal cancer depending on where it occurs within the large intes- tine, is one of the most common types of cancer but also one of the most preventable, Luther said. One preventive option is called a colonoscopy, which is a sedated procedure where a thin, flexible scope is inserted through the anus to observe the lower intestinal tract. Taking on average 15-30 minutes, the procedure finds and removes polyps, or abnormal tissue growths, Luther said. Though one-third of people are estimated to have polyps, there is only a 1 in 200-300 chance of those polyps being cancerous, said Dr. Ricardo Solis, a member of the Texas Colon & Rectal Specialists group within cancer treatment and research organi- zation Texas Oncology. Although not all polyps are cancerous, removal helps reduce the risk of colon cancer from devel- oping, Luther said. The time it takes from a patient having a normal colon to developing polyps and
SOURCE: NATIONAL CANCER INSTITUTE/COMMUNITY IMPACT
“Prevention is really what I would advocate for … because that’s where it all starts. By the time you turn 45, you really want to do a colonoscopy versus any other modality there is.” DR. RICARDO SOLIS, TEXAS COLON & RECTAL SPECIALISTS GROUP WITHIN TEXAS ONCOLOGY
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