Investigation of Colon Cancer in Young Patients Uncovers Three Risk Factors Contributing to Mortality in Individuals Under 35

A groundbreaking global study has provided fresh insights into individuals under 35 years old who have been diagnosed with colon cancer, a trend that is on the rise.

While there is substantial data available for individuals under 50, who are classified as ‘early-onset’ cases, the researchers conducting this extensive new analysis point out the lack of research focused on the ‘very young’ population.

According to the new report, the numbers of cases in individuals under 35 almost doubled from 1990 to 2019, increasing from 21,000 to 41,000, with a corresponding 25 percent rise in fatalities.

In the US, rates among people under 50 have increased by 50 percent in the same time period, suggesting faster growth in younger groups.   

The study also found three risk factors were strongly associated with colon cancer: heavy alcohol use, being obese, and not consuming enough calcium. 

Surprisingly, how much someone exercised, smoking, and fiber had little effect on colon cancer risk, despite studies linking all three to the disease.  

While the team did not look at the US specifically, they found colon cancer cases in North America in under-35s increased from 1,800 to 2,400, a 25 percent increase. 

The research team, writing in the journal Neoplasia this month, said: ‘Until now, the disease burden of very EOCRC has never been reported. 

‘The results of this study might enhance the vigilance of physicians and young adult towards CRC in individuals under 35 years old, also provide a scientific reference for very EOCRC control policy-making and help with effective allocation of medical resources for very EOCRC prevention and management in the world.’

Bailey Hutchins, pictured above, shared in a recent TikTok video that she was diagnosed with stage three colon cancer at age 24. The cancer has since spread to her peritoneum, the lining the abdominal cavity, according to a GoFundMe set up for her

Globally, one in five colon cancer deaths were tied to diets low in calcium, the most significant risk factor. 

Alcohol was the second highest risk factor, accounting for 13 percent of deaths, and obesity accounted for one in 10. 

In North America, meanwhile, 22 percent of colon cancer deaths were tied to alcohol use, followed closely by obesity at 18 percent and low-calcium diets at 12 percent. 

The study follows a newly published report from the American Cancer Society, which estimated over 154,000 Americans will be struck with the colon cancer this year, and just under 53,000 will die.

In the UK, 44,000 Brits are diagnosed each year, and there are roughly 16,800 deaths.

The researchers evaluated colon cancer data from 204 countries and territories, including the US and UK. 

Data was collected from the The Lancet’s 2019 Global Burden of Disease Study, which looked at chronic disease risk and mortality for 369 diseases.

The researchers said that while this data had been analyzed before, a study this large had never focused on patients under 35.  

The researchers looked at five dietary risk factors – diet high in processed meat, diet high in red meat, diet low in calcium, diet low in fiber, and diet low in milk – as well as alcohol use, smoking, low physical activity, and obesity. 

In total, global cases of colon cancer in under-35s surged from 21,874 in 1990 to 41,545 in 2019, doubling over 30 years. 

Just 61 percent of cases were in men, while 39 percent were in women. 

This is a higher percentage of men with the disease than the national average for all groups. According to the American Cancer society, about 51 percent of colon cancer patients overall are men. 

Monica Ackermann of Australia was just 31 when she was diagnosed with colon cancer 

Evan White is pictured above with his fiancée Katie Briggs and their dog Lola. The pair had started dating when Evan had cancer and got engaged when his condition stabilized. However, he passed away after four years fighting the disease at age 29 

Additionally, the rate of very early colon cancers increased from 0.8 per 100,000 people in 1990 to 1.05 per 100,000 people in 2019. 

Alcohol was the second highest risk factor, accounting for 13 percent of deaths, and obesity accounted for one in 10. 

The researchers did not evaluate risk factors for other age groups, though diets high in red and processed meats, diets low in fiber, and smoking are thought to be the most significant risk factors in older adults. 

From 1990 to 2019, deaths also increased from 11,445 to 15,486, a 27 percent jump. 

Meanwhile, in 2023, 13,160 Americans alone ages 50 to 64 died from colon cancer, suggesting the disease is still far more common and deadly in older adults.

The team also looked at risk factors linked to colon cancer deaths.  

Globally, diets low calcium had the greatest link to colon cancer. 

One in five deaths around the world were due to a diets low in milk and other foods rich in calcium such as cheese, salmon, leafy greens, and yogurt. 

Calcium is thought to bind to bile acids and free fatty acids in the colon, therefore lowering their potentially cancer-causing effects. 

Carly Barrett, from Kentucky, was diagnosed with colon cancer at age 24 after detecting blood in her stool and suffering from abdominal pain

Earlier this month, a study published in Nature Communications found an additional 300mg of calcium per day could cut colon cancer risk by 17 percent. That’s roughly the same amount of calcium in a large cup of milk. 

In the new study, alcohol use was responsible for 13 percent of colon cancer deaths around the world.

The researchers did not specify how much alcohol was linked to colon cancer, though recent research suggests two drinks per day for men or 1.5 for women are enough to raise the risk. 

Alcohol has been shown to damage cells in the colon, leaving them more prone to harmful mutations linked to cancer. 

One recent report in Annals of Oncology, for example, found alcohol could increase the risk of colon cancer by up to 50 percent. 

A high body mass index (BMI) was the third most common risk factor for colon cancer deaths but was only responsible for one in 10 deaths. 

A high BMI is one over 30, which is considered the threshold for obesity. 

This suggests obesity is not the leading cause, like many studies have suggested. 

The team said exercise levels may not have been a significant risk factor due to multiple countries, especially less developed ones, being less sedentary and relying more on physical labor. 

While the researchers in the new study did not look at the US specifically, they did examine ‘High-Income North America,’ which includes the US and Canada. 

In this region, alcohol was most strongly related to colon cancer deaths, with the report finding it contributed to 22 percent of deaths. 

However, significantly fewer deaths were linked to diets low in milk. In North America, 12 percent were associated with a low-milk diet, compared to 21.5 percent globally.

This could be due to America’s love of the drink. According to data from World Population Review, the US consumes more milk than any other country except for India. 

Behind alcohol, high BMI was the second most common colon cancer death risk factor in North America, linked to 18 percent of deaths. 

Diets high in red and processed meats also accounted for one in 10 colon cancer deaths in High-Income North America. 

Several recent studies have looked at processed meats specifically and colon cancer. 

A report published last year in NPJ Precision Oncology, for example, suggested processed meats produce metabolites, which researchers said ‘feed’ cancer cells and ‘hijack’ normal cells.

And other recent research suggests eating processed meats more than once a week is associated with an increased risk of colon cancer markers, which show the presence of cancer in bodily fluids like blood and urine.

The researchers in the new study said there were several limitations to the study, including the lack of detail about cancer severity and location of the tumors. 

The team also did not look at other suspected colon cancer risk factors like antibiotic use and gut bacteria. 

The researchers wrote: ‘Nevertheless, these limitations didn’t alter the fact that this study provided an integrated estimate of very EOCRC burden, which was valuable for the control of the disease burden.’