Chadwick Boseman, who played the much-loved titular character King T’Challa in Black Panther, proved that it can happen to anyone—even at the prime of one’s life. News of his untimely death shocked many fans in 2020, but what most didn’t know was that he’d been battling colon cancer (a type of colorectal cancer) since 2016. He was only 39 when doctors first detected it.
Manuelle Josephine Mendoza M.D., a general, laparoscopic, and cancer surgeon at St. Luke’s Medical Center, says the trend is true locally, too. “Colorectal cancer is among the top most common cancers and cause of cancer-related deaths in the Philippines,” she shares, adding that among the youngest patients she’s encountered so far are in their late 30s up to 40s, usually with a strong family history.
Colorectal cancer (CRC) is on the rise and is affecting younger people. As opposed to other more common cancers, such as breast and lung, CRC is not much talked about—but should be, especially among the younger generation. While increasing age is still a significant risk factor, the latest research from Yale Medicine has shown an uptick in cases in people in their 20s to 40s in recent years, which means more and more Gen Zs and millennials are getting diagnosed. Other studies go as far as to predict that young-onset CRC could be the leading cause of cancer deaths among people aged 20 to 49 by the year 2030.
Genetic disposition aside, many medical experts are also quick to stress that our current diets and lifestyle habits are putting us at higher risk for this disease, along with many other types of cancers that seem to be affecting younger adults. Case in point: In 2024, Catherine, Princess of Wales, 42, and actress Olivia Munn, 44, both revealed cancer diagnoses. The royal didn’t divulge what type of cancer she had, while Munn said she battled breast cancer in 2023.
Medical experts are also quick to stress that our current diets and lifestyle habits are putting us at higher risk for colorectal cancer, along with many other types of cancers that seem to be affecting younger adults.
The good news? While the onset of such life-threatening diseases may be moving up, scientific and technological advancements are also increasing chances of recovery and survivorship—especially if the cancer is detected early. Do yourself a favor and read on; the next few minutes might just save your life.
What is colorectal cancer, exactly?
The terms colorectal cancer and colon cancer are often used interchangeably, but they have distinct definitions. Colorectal cancer is a broader term that includes cancers that originate in either the colon (hence the term colon cancer) or the rectum (termed rectal cancer). Both the colon and rectum are parts of the large intestine, preceding the anus.
CRC usually starts as small, benign clumps of cells called polyps that form inside the colon or rectum. Over time, some of these polyps can become cancerous.
According to the World Health Organization (WHO), colorectal cancer is the third most common cancer in the world, making up approximately 10 percent of all cancer cases and ranking second as the cause of cancer-related deaths. Locally, CRC has the third highest incidence among cancer types and ranks fourth among the leading causes of cancer-related deaths among Filipinos.
Now here’s the tricky part: What makes it challenging to detect early is the fact that its most common symptoms include typical ailments most adults experience on the reg, such as diarrhea and constipation. Other signs are abdominal pain, blood in the stool, sudden or unexplained weight loss, fatigue or weakness, and persistent changes in bowel habits, including having a feeling that the bowel does not empty completely.
Medical experts are also quick to stress that our current diets and lifestyle habits are putting us at higher risk for this disease, along with many other types of cancers that seem to be affecting younger adults.
But before you panic, these symptoms can also be associated with other less serious conditions such as irritable bowel syndrome (IBS) and hemorrhoids. The latter, characterized by swollen and inflamed veins in the rectum and anus, can be quite common in women in their 20s and 30s, a.k.a. the typical child-rearing years, since pregnancy and childbirth are known to contribute to its development. Says Dr. Mendoza, “Hemorrhoids are not related [to colorectal cancer] and do not increase the risk [of CRC].” But of course, even if you only suspect hemorrhoids, it’s always best to get checked by a doctor.
Who is at risk?
Though CRC is still most frequently diagnosed in people over 65, cancer rates in this age group, curiously, have been declining since 2011. Today’s older population is also less likely than people under 50 to be diagnosed with advanced disease. For the boomers and older Gen Xers, this is good news. Unfortunately, the numbers have shifted to the younger crowd, with 20 percent of cases in 2019 detected in patients under 55, up from 11 percent in 1995—according to a study by the American Cancer Society (ACS).
“We have to address why the rates in young adults continue to trend in the wrong direction,” Ahmedin Jemal, DVM, PhD, senior vice president of surveillance and health equity science at ACS and senior author of the study, says in a report.
Is it the Flamin’ Hot Cheetos? Our generation’s samgyeopsal obsession? Or basically everything from the supermarket nowadays? TikTok is rife with all sorts of theories, and they’re not all wrong. Our lifestyle and diet play a key role in our gastrointestinal health, after all—and our overall health, period.
It’s all the more important for young adults to know their family history.
Dr. Mendoza cites “consuming a high-fat or highly processed food diet, excessive alcohol intake, smoking, lack of physical activity, and obesity” as primary factors that can up your risk for CRC. She also asserts that “genetics or family history of colorectal cancer and the presence of inflammatory bowel disease or genetic mutations” are strong indicators of increased risk.
That said, it’s all the more important for young adults to know their family history. “In general, screening should start at age 45 for average-risk, and earlier for high-risk individuals,” says Dr. Mendoza. High-risk people include those with a family member who’s had colorectal cancer before or a personal history of genetic conditions, such as Lynch syndrome, and genetic mutations, such as polyposis syndrome. She adds, “There are studies that indicate men are at greater risk for advanced colorectal cancer.”
A quick and non-invasive screening method is via a stool exam, the most common of which is the fecal occult blood test (FOBT). You simply have to poop in a cup and have it sent to the lab. This test detects the presence of hidden blood in the stool, which can be an indicator of CRC or polyps. If any blood or abnormalities are detected, a more comprehensive test such as a colonoscopy is usually recommended. In this procedure, a flexible tube with a camera is inserted through the rectum to examine the colon.
Can you lower your risk for colorectal cancer?
Yes, you can—but you have to start today. “Colorectal cancer can be prevented by early detection,” says Dr. Mendoza, who adds that surgical treatment is widely available for CRC patients. This includes “minimally invasive surgery (laparoscopic and robotic-assisted).” Surgery is often used in the early stages of CRC, especially if it has not spread to other areas of the body. Chemotherapy and radiation therapy are different methods utilized to help shrink the tumor.
But though it’s often highly treatable, a CRC diagnosis can no doubt be a daunting ordeal for anyone, especially Gen Zs and millennials who are in “peak adulthood,” so to speak. Cancer at this age can significantly damage finances and interrupt life—from careers to relationships and family plans—especially since more advanced cancer treatment may impact fertility.
It goes without saying that the best approach, as with any type of disease, is the proactive approach. Here are some strategic and practical measures you can take (read: doable) to lower your risk for colorectal cancer:
Add more fiber to your diet.
Consume plenty of fruits, vegetables, and whole grains. Yale Medicine recommends taking in 25 grams of fiber a day to maintain a healthy colon. You can easily achieve this by adding a serving of fruit or vegetable to every meal (a medium pear, for example, has about 5.5 grams of fiber).
Limit red and processed meats.
Pork, beef, and lamb have been associated with increased risk for cancer, as well as processed food items, such as hotdogs, bacon, and sausages. The same goes for fried and high-fat food.
Keep your weight in check.
Being overweight or obese ups your chances of getting CRC as well as dying from it.
Stay physically active.
Living a sedentary lifestyle not only ages you faster, it can make your life quicker, too. Aim for at least 150 minutes of moderate-intensity or 75 minutes of high-intensity exercise each week.
Drink responsibly and quit smoking.
It’s recommended to limit alcohol to no more than one drink per day for women and two for men. As for smoking, it is no secret that it greatly deteriorates one’s health. Smoking increases the risk not just of lung cancer, but of colorectal cancer and other types as well. Did you know that next to the sun, smoking is the second top cause of aging?
Get screened.
Adults at average risk should start screening at age 45, but those with higher risk factors might need to start earlier. Ask your doctor about it—and don’t skip the stool exam during your annual physical exam!
The truth about early-onset cancer
Not a scare tactic, just facts: CRC is not the only type of cancer that’s on the rise in the younger population. “Other than colon cancer, lung cancer, breast cancer, and cervical cancer are also becoming prevalent in the young,” says Dr. Mendoza. “In addition to cancer screening, it really is best to live a healthy lifestyle.” That or at least strive to make small, healthy changes every day.
But what if you do get colorectal cancer? (Knock on wood.)
Thankfully, CRC survival rates are encouragingly high, with over 91 percent of patients with stage 1 colon cancer living for over five years after diagnosis. The rates for those with advanced stages are also improving, largely due to continuous medical advancements and research. Those being diagnosed now may in fact have a better outlook than what current stats show.
Again, early detection is crucial. If you have any symptoms—specifically rectal bleeding, unusual stools, or perpetually low energy—get checked. Even if it turns out to be nothing, it will be worth the trip.
Young woman with stomachache by © Lifestock via canva.com
