Study: Young adults could be screened for colon cancer

Janelle Hill (left) who chairs the Arizona chapter of Colon Cancer Alliance, and Kim Newcomer, who volunteers with the alliance, both were diagnosed with colon cancer at age 35. (Photo by Alexis Dominguez/Cronkite News)

Kim Newcomer knew something was wrong.

She had just returned home to Arizona from a trip abroad and was exhausted.

Then a doctor found tumors in her breasts. But she didn’t have breast cancer. Another doctor found tumors in a lung. She didn’t have lung cancer. Multiple tests every month, for four months, before she got the answer.

She had Stage 4 colon cancer. And she was given six months to live.

“By the time they had found my cancer it had spread to my lungs and my liver,” said Newcomer.

She was 35 years old.

A new study in Cancer journal proposes colon cancer screenings could begin at age 40 or 45.

Colon cancer screening guidelines recommend initiating screenings at 50 years old, but the percentage of cancer cases in younger patients is increasing. In less than fifteen years, the colon cancer rate will increase by 90 percent in people 20 to 34 years old, according to a study published in JAMA Surgery.

Young adults were more likely to be diagnosed with an advanced-stage of the disease, according to Cancer journal. Several surgeons who conducted the study said that shows the recommended age for screening needs to be younger than current guidelines.

Newcomer agrees. She said she kept telling doctors to examine her for possible colon cancer.

She told them her father was diagnosed with colon cancer when he was 46.

Doctors told her she was too young to get colon cancer. Screenings for those with a family history of colon cancer, like Newcomer, is recommended at age 40, a decade younger than those without a family history.

“I let my doctors tell me that I was fine,” Newcomer said. “They kept saying I was crazy and there was nothing wrong with me.”

Dr. Suryakanth Gurudu, a gastroenterologist at Mayo Clinic in Scottsdale, while not specifically addressing Newcomer’s case, said getting tested early is recommended if patients have colon cancer in their family history.

“Patients with first degree family members, that includes, parents, sisters and brothers, should undergo a colonoscopy at age 40.”

But he does not agree with a proposal by a group of surgeons writing in Cancer journal to lower the age for a colon screening to age 40 or 45.

“We still don’t have large population-based studies that show cost effectiveness by decreasing the age to 40 years,” Dr. Gurudu said. “It may hurt or it may benefit people between 40 to 50 years of age.”

He suggests that a less invasive approach, such as stool DNA, may be an option instead of an expensive procedure like a colonoscopy. Insurance does not always cover the full cost of a colonoscopy if the patient is younger than 40, is not considered high risk or does not have symptoms, according to Colon Cancer Alliance.

Like many cancers, colon cancer can strike with or without a family history.

Janelle Hill, a cancer survivor who chairs the Phoenix chapter of Colon Cancer Alliance, was diagnosed at 35 years old.

Hill believes the recommended age for screenings should be lowered.

“It is a very silent disease. However, it is one of the only preventable cancers. A lot of younger people are passing from this disease. So we need to make a change,” Hill said.

Colon cancer is the second leading cause of cancer death in the U.S., according to the Colon Cancer Alliance website.

Symptoms include chronic abdominal pain, blood in stool, a change in bowel habits, constipation, narrow stools, passing excessive amounts of gas, anemia or fatigue, according to Mayo Clinic’s website.

A colonoscopy includes a restricted diet one to three days before the procedure to help cleanse the colon, and a device threaded through the body to check for polyps. If polyps are found, they can be removed and tested to see if they are benign or cancerous.

Newcomer is now 42 years old.

She volunteers with the local chapter of the Colon Cancer Alliance, chairing its annual Undy Run/Walk to raise awareness.

She says it is important to ask questions and demand answers of medical professionals.

“I have alone known six people in the last two years under 40 who have died, with small children,” said Newcomer. “I just think we need to take the time to take care of ourselves and look out for our best interests.”

Colon cancer by the numbersInfographic