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Bowel cancer rates are increasing in adults aged between 20 and 50, according to data from 2 big studies published this week.

Both studies looked at large numbers of people across several countries, including the UK, providing strong evidence on the number of people developing bowel cancer. And some worrying trends emerged.

In the UK, bowel cancer cases increased on average by up to 7.3% each year in 30 to 39 year olds between 2005 and 2014, according to figures published by the International Cancer Benchmarking Partnership, which is part funded by Cancer Research UK.

But it’s important to put these percentage increases in perspective. As Professor Stephen Duffy, a cancer screening expert at Queen Mary University of London told the Science Media Centre, “Despite the recent increases, the incidence in people under age 50 remains very low in absolute terms.”

To put that into context, the increase amounted to 267 more cases of bowel cancer in 30-39 year olds in 2014 compared to 2005 in the UK.

But even though the numbers are relatively low, the same trend has not been seen in older adults. Which raises the question of just what is driving the increase in under 50s.

Don’t we already have a clear picture of what causes bowel cancer?

Bowel cancer is one of the most common cancers in the UK, so there’s lots of evidence looking at what can cause it to develop. Previous research has shown that regardless of age, overweight and obesity, a diet low in fibre and high in processed and red meat, drinking alcohol and not being active can all increase the risk of bowel cancer.

But while the new studies looked at trends in bowel cancer rates, neither study investigated what might be behind the changes.

“Both papers suggest that sedentary lifestyles, overweight and dietary factors may be partly responsible for this. This is almost certainly the case, but it is probably not the whole story,” says Duffy.

Risk factors like diet aren’t exclusive to under 50s, which suggests there may be something else going on. This could either be another factor contributing to the rise in this particular age group or something helping to stop any potential rise in older age groups.

There’s also some evidence that bowel cancer in younger people may be different to cancer in older people. These differences are visible at a DNA level and in where the cancer develops in the bowel. It’s these differences that scientists are hoping to take a closer look at.

Finding the missing pieces of the puzzle

We don’t yet know exactly what’s behind the increase in under 50s, but it’s likely that there’s more than just one explanation.

Researchers are working to shed light on unique causes that may explain the increase in bowel cancer in younger adults, exploring areas like genetics and our gut bacteria. It’s early days, but some research suggests that certain types of bacteria in our gut could be linked to bowel cancer.

We’re funding research to investigate bowel cancer in younger adults, including a study to understand the genetics of bowel cancer in people under the age of 40. We’re also funding an international team to investigate how the bacteria in our gut might influence both the development and treatment of bowel cancer, which we’ve blogged about before.

What does this mean for screening?

The UK already has a bowel cancer screening programme for older adults. And despite some headlines, these findings alone don’t point to a benefit in including adults under 50 in the screening programme.

Duffy says it’s too early to change the policy on bowel screening, as the number of cases in younger adults is still small. And to consider lowering the bowel screening age in the UK there would need to be evidence that the benefits would outweigh the harms in these younger age groups.

Bowel screening in the UK

The programme aims to detect bowel cancer before symptoms have developed.

It is available for adults between 60 and 74 in England, Wales and Northern Ireland, and adults aged between 50 and 74 in Scotland.

The English and Welsh Governments have committed to reducing the age to 50.

The bottom line

The rise of bowel cancer in younger adults is concerning and it’s vital we find out why it’s happening. But it’s important to remember that bowel cancer remains uncommon in under 50s.

Dr Marco Gerlinger, a scientist at the Institute of Cancer Research in London, told the science media centre: “These results are a call to action to raise awareness among staff in GP practices and hospitals to consider bowel cancer as a diagnosis when young people come to them with pain, changes in bowel habits or blood in their stool.”

It’s important for everyone to see their doctor about any changes to their body or poo habits that don’t go away. It’s likely that these symptoms will be something much less serious than cancer, but it’s best to get it checked out.

And the good news is no matter how old you are, keeping a healthy weight, eating more foods high in fibre, cutting down on alcohol and processed and red meat, and being more active can all reduce your risk of bowel cancer.

Katie Patrick is a health information officer at Cancer Research UK 

Comments

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Jim June 14, 2019

The screening age needs to be lowered I was 43 when I was diagnosed luckily it was caught and treated before it became terminal I had to get second option as doctors fisrt put symptoms down to hemeroids, my surgeon told me that I would of been terminal or worse if I not been diagnosed till screening age

Katie Roberts June 12, 2019

Hi Katharine,

Thanks for your question about finding bowel cancer studies. We have a section on our website where you can find trials happening in the UK, including studies looking at the genetic characteristics of bowel cancer. You can find all the information here: https://www.cancerresearchuk.org/about-cancer/find-a-clinical-trial. And you can also speak to one of our nurses about taking part in clinical studies by calling freephone 0808 800 4040.

Best wishes,

Katie, Cancer Research UK

Katie Patrick June 12, 2019

Hi Jeanette,

Thanks for your question about the screening age. Screening can save lives but there are also harms, like finding cancer that never would have caused someone a problem in their lifetime. In older people, it’s less clear that the benefits outweigh these harms. This is why bowel screening isn’t routinely offered to people over the age of 74.

People who are older than 74 in England and Scotland can still be screened if they would like to be. You won’t get an automatic invitation, but you can request a bowel screening kit by calling your national screening programme helpline, which can be found on our website: https://www.cancerresearchuk.org/about-cancer/bowel-cancer/getting-diagnosed/screening.

And no matter what age you are, if you do notice any unusual or lasting changes it’s important to tell your doctor and get it checked out.

Best wishes,

Katie, Cancer Research UK

Katie Patrick June 12, 2019

Hi Judy,

Thanks for your comment about the effects of electronic devices on internal organs. While the use of mobile phones has increased rapidly in recent decades, research so far shows that it’s unlikely mobile phones increase the risk of cancer. You can read more about this research on our website: https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/cancer-controversies/mobile-phones-wifi-and-power-lines.

Best wishes,

Katie, Cancer Research UK

Frank Nicholson June 11, 2019

I had colon cancer 20 years ago I then ate healthy no beef or bacon no processed food ate all the healthy things Turmeric black pepper and Olive oil and loads of fruit and veg and nearly everything was was classed as healthy and then early 2019 had blocked bowel and later we s told it was cancer not the original cancer but a new one at the other end of the bowel the cancer was cleared but one cell stuck to the bowel wall so I am on tablet chemotherapy hoping to stop the can er returning.So all that healthy eating a drinking and exercise did not stop me getting a new cancer in the bowel

Bunny Clapton June 11, 2019

Thanks for this. It looks as if b.c. is a preventable thing so I hope for great success for you. My husband just died of rectal/bowel cancer. It was not nice and has now deprived my of my wonderful devoted life companion. I do donate.

Fiona June 10, 2019

This is all about cost !
Politicians have the power to influence educative adverts on tv for such cancers,or education via media generally to enlighten .Surgery effective as lots of bowel in terms of length to play with .

Lesley abigail June 10, 2019

I was 50 when diagnosed after many months of symptoms being put down to IBS. Never smoked or drank alcohol and only put on weight when pregnant. Had surgery – a ileum rectum anastomosis no chemo or radio. I am now 75 and am very glad to be here. One of my daughters has ulcerative colitis and has colonoscopies regularly. It worries me that she could develop cancer. My surgeon told me to talk about it as much as i could to raise awareness. He said “people dont worry about talking about what they put in their top end but not about what comes out at the other end”

George Hudson June 10, 2019

Very useful information
Thank you

JUDY June 9, 2019

Has any research been done into the effect of electronic devices on our internal organs. Many of the younger generation are carrying mobile phones in their pockets and close to their bowel area, could this be triggering the cancers? Just a thought. I think we need a lot more research is required in this area, especially as younger and younger children are using them.

Sharon June 9, 2019

I am a 47 year old who has recently had surgery for Stage 2 Bowel Cancer. I am not overweight, have never smoked, eat lots of fibre and a largely vegetarian diet. I was also very active. Other young people who I have met through having Bowel cancer also tend largely not to fit the stereotypes so it is hard to read about these risk factors.

Patricia Bowler June 9, 2019

Thank you. Interesting research. Both my husband and I have had bowel cancer and are always concerned about a genetic link for our family.

Mary June 8, 2019

Im female and I’d just turned 39 when I was diagnosed it was the Dec 2017 and looking back I’d had symptoms since March/Apr however my symptoms were pain near my left hip and constipation very much IBS symptoms, I’d not long lost my mum so believed it was IBS due to that. I had bloods done at the Dr’s and my iron was under 4, I was fast tracked for a colonoscopy. I was told at colonoscopy my tumour was 6cm so not small! I have never smoked, rarely drink and am active with young children, I do not eat red meat! I do have a lot of stress though, I truly believe this was the cause. I had chemo/radio followed by a huge resection then more chemo, I’m now on regular checks and I know Im not out of the woods. Im back at work now but since diagnosis also suffer with anxiety, it’s awful, it’s something I just have to learn to live with but it’s not easy. My tumour was tested but was not genetic, I was just very unlucky!

Ava June 8, 2019

My family member took I’ll last april2018 had all the screening , scans but they never screened her small intestine in feb2019 they found she had a rare form of cancer in her small intestine and is now fighting for her life why did they not screen this they should have so I would like people to know when they screen you for bowel cancer they only do your large bowel.Just make sure you get tested for your small bowel too.