Tim Henderson | Stateline.org (TNS)
In response to recent research showing an increase in colorectal cancer cases among younger adults, some states are working to raise public awareness of the deadly disease, especially focusing on Black and rural residents.
In 2021, the U.S. Preventive Services Task Force changed the standard screening age for colorectal cancer from 50 to 45, due to the growing number of cases among younger adults. However, many even younger individuals are being diagnosed with life-threatening advanced cancer that could have been prevented with earlier detection. The reasons for the increased susceptibility of new generations are unclear.
Black and rural Americans are more prone to dying from colorectal cancer at any age because they are less likely to undergo timely screenings that could save their lives. Using state and federal funding, healthcare organizations in Colorado, Delaware, Michigan, Mississippi, North Carolina, Texas, Washington state, and West Virginia have made some progress in increasing screening rates.
For example, in Michigan, healthcare groups surveyed Black residents aged 40 and older last year and discovered that many mistakenly believed they didn't need colorectal cancer screenings if they didn't have any symptoms. By providing more information to patients and implementing software to automatically remind providers to schedule screenings, the groups were able to increase the screening rate.
West Virginia is contemplating a state version of a national program to raise more awareness among younger adults and their doctors. This includes enlisting trusted messengers from different communities to help spread the word, as explained by Susan Eason, program director of the West Virginia Program to Increase Colorectal Cancer Screening. She mentioned that it is one of 35 state-level programs supported by federal, state, and local funding.
“With this on the rise, younger people need to be aware of symptoms, and providers also need to be aware, so when a patient presents with something like blood in the stool, they don’t dismiss it as hemorrhoids,” Eason said.
Rural West Virginia residents encounter various obstacles to getting screened, including long distances on mountain roads to reach doctors and a shortage of gastroenterologists and screening clinics, resulting in a wait of six to nine months for an appointment. Additionally, many residents have jobs that don't offer paid time off for seeking medical assistance, according to Eason. To address these challenges, her program is improving access to chemical tests that can be performed at home and sent by mail. However, an in-person colonoscopy is preferred as it can detect precancerous growths that doctors can remove.
Two authors of a December report that discovered an increase in colorectal cancer with each generation informed Stateline that focusing on ensuring people actually undergo screenings is more important than lowering the age for recommended screenings.
“Rather than lowering the age for initial screening, I would like us to intensify our efforts to encourage screening participation,” said Caitlin Murphy, an associate professor at the University of Texas Health Science Center at Houston.
More than one out of every three adults aged 45 or older has not received screening, according to the American Cancer Society. The study’s main writer, Samir Gupta, who is a gastroenterologist and professor at the University of San Diego, agreed..
Gupta stated that individuals under 45 should think about getting a colonoscopy if they have a family history or symptoms such as rectal bleeding, bloody stools, unexplained weight loss, and low iron anemia.
Young survivors who spoke to Stateline said they initially disregarded symptoms, or that the symptoms were misunderstood by medical professionals who did not anticipate cancer in young patients.
Jameelah Mahmoud, a nonprofit worker in Milwaukee, mentioned that she was given an incorrect diagnosis four times before a CT scan revealed a large tumor blocking her colon in 2019 at the age of 33, with stage 3 cancer that had spread to her lymph nodes. She had complained of increasingly sharp abdominal pain for months but was only advised to avoid spicy foods and take antacids.
Currently cancer-free after surgery and eight rounds of chemotherapy, Mahmoud, who is 37 and engaged, remarked that she advises people not to take their symptoms lightly if they feel like their concerns are being dismissed.
“I always tell people, if you feel like someone’s not listening to you, go somewhere else. Because you’re precious. You only have one life,” she said.
The rate of colorectal cancer deaths has been gradually decreasing for all age groups since 1968, when it was around 28 per 100,000, to around 13 in 2023. However, the proportion of colorectal cancer deaths for patients aged 45 and younger has increased from 2.5% in 1976 to 3.8% in 2023, according to a Stateline analysis of federal mortality data kept by the federal Centers for Disease Control and Prevention.
From 2018 to early 2024, colorectal cancer mortality rates for all ages and for those under 45 have been highest in West Virginia and Mississippi, consistent with research indicating that rural residents have a higher likelihood of dying from colorectal cancer. Kentucky, Oklahoma, Arkansas, Maine, Tennessee, and Vermont also had high rates for all ages and for younger individuals. The lowest rates were in Connecticut, Massachusetts, Utah, Colorado, and New York state.
According to the Stateline analysis, rural areas have the highest rates of colorectal cancer deaths: Rates are 42% higher in the most rural areas compared with the most urban areas.
In his mid-20s and residing in rural North Carolina without health insurance, Jacob “JJ” Singleton did not even consider cancer when he experienced painful bowel movements leading up to his 2015 diagnosis of stage 4 cancer that had spread to his liver and lungs.
“In my 20s, you know, I just thought I was invincible,” Singleton said. “I told myself it was a pulled muscle because I was doing CrossFit training.”
His parents eventually convinced him to see a doctor when he could feel a pulsating mass in his abdomen, which turned out to be a tumor.
Later, testing showed that Singleton had a genetic disorder known as Lynch syndrome that made him particularly susceptible to rapidly growing colorectal cancer, although he was unaware or did not suspect it at the time.
“There’s not much medical history in my family,” Singleton said. “In my family, men don’t visit the doctor frequently. You tough it out and don’t complain. If you get sick, you just hope it gets better. It’s like it’s God’s will, is the way they view it.”
But even in large cities where people have easier access to medical care, it’s still possible for early signs of illness to be missed.
David Thau, a political fundraiser in Washington, D.C., was found to have a cancerous mass that had broken through the walls of his colon when he was 34 years old in 2019.
“If there had been some sort of campaign to raise awareness, like posters in my doctor’s office or other places where a 30-year-old might see them, showing the symptoms of colon cancer, I would have gone to get checked much earlier,” Thau said.
States Newsroom
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stateline.org . Distributed by Tribune Content Agency, LLC.In response to new research showing an increase in cases among younger adults, some states are working to raise public awareness of the illness especially among Black and rural residents.
