People born after 1990 have a higher risk of colon cancer. Here's how to catch it early

CATHY WURZER: March is Colorectal Cancer Awareness Month. Now, if you were born after 1990 and decided to tune out after hearing "colorectal cancer," thinking it's an old person's disease, well, think again. Research shows people born in 1990 have a higher risk of colon cancer than those born in 1980. That's significant for millennials and Gen Z.

Doctors are still trying to figure out why this is the case. Here to break it down for us Dr. Jay-Sheree Allen. She's a family medicine doctor from Mayo Clinic. Hey, welcome back.

JAY-SHEREE ALLEN: Hey, Cathy. Thank you so much for having me.

CATHY WURZER: You know, when I saw that figure, I just stopped cold in my tracks, and I thought, what? Are you kidding me? This is just-- that sounds just crazy. What factors make folks born in 1990 have a higher risk of colon cancer?

JAY-SHEREE ALLEN: Yeah, so this is like the million-dollar question, right? There's so much research going on in this area at this point in time. Some of the factors we're finding and looking into are things like sedentary lifestyles.

So some things have changed with generations, with time. So we call that a cohort effect. So looking at lifestyle, a little more sedentary, overweight, smoking, heavy alcohol use, and then processed meats-- diets that are high in processed meats, as well as low fiber and high fat, and then seeing some environmental factors as well. But the research is ongoing.

CATHY WURZER: Environmental factors? That's interesting. What do researchers think might be in the water, in a sense, or air?

JAY-SHEREE ALLEN: That's so funny you put it that way. So, no, we're actually looking more so at some of the lifestyle areas, you know, some of the diets, as mentioned before, the activities, or physical inactivity that we've mentioned before-- so not necessarily a geographic place or an environment, as we've kind seen with some other cancers. It's more some of those factors related to the habits of daily living.

CATHY WURZER: OK. So remind us, how common is colon cancer in general?

JAY-SHEREE ALLEN: Very common. So it's actually the third-most diagnosed cancer in men and women in the United States. It's also the third-leading cause of cancer related deaths in the United States, so quite common. One in 23 men, one in 24 women will have a diagnosis of colon cancer in their lifetime.

CATHY WURZER: Wow. And it can be dangerous, obviously, especially if you don't catch it in time.

JAY-SHEREE ALLEN: Mm-hmm. Absolutely. You know, as I was preparing for this segment, I was doing quite a bit of reading. And someone put it in a way that I really loved. It was an article from Yale. And she said, "Cancer is almost like an intruder in your house. It's that level of threat."

So it really is a dangerous condition. But it starts out by just growth of polyps, so small masses of cells. And they usually start out being pretty benign. But then they continue to grow and can develop into cancerous tumors over time.

CATHY WURZER: So since we're talking about an increased incidence of colon cancer among younger people, and most of us, when we turn 50, you're told to get a colonoscopy, and people go, oh, my gosh, it is just part of getting older, right? But should younger people now be getting colonoscopies.

JAY-SHEREE ALLEN: Yes, yes. And 45 is the new 50. So it's not 50 anymore. An average individual, average-risk individual, should start screening for colon cancer at age 45. So that's the new number.

But younger people who have increased risk should also consider earlier screening. So some of those things that put you at increased risk, if you have a first-degree family member who was diagnosed with colon cancer, you would actually start your screening 10 years before the age of their diagnosis. So it's important to keep in touch with your doctor regarding your family history.

CATHY WURZER: So can folks do anything to prevent colon cancer? Better diet? I mean, obviously, you were talking about dietary effects. And I'm wondering, if people had a more of a plant-based diet, perhaps, or something like that, would that be helpful?

JAY-SHEREE ALLEN: Yes. It definitely will be. And there's nothing that's 100%, but ways to lower your risk, as you mentioned, the diet. And specifically, when we talk about diet, it's consuming adequate fiber in your diet-- so the fresh fruit, the veggies, the whole grains, beans, all of that, adding that extra amount of fiber. You want to look at least 25 grams of fiber per day, so just getting specific.

But other things-- if you smoke, quit, drinking responsibly, exercising, just really trying not to have that sedentary lifestyle, and if you're overweight or obese, losing weight.

CATHY WURZER: OK. The exercise part of it is hard for some of us. So--

JAY-SHEREE ALLEN: Oh--

CATHY WURZER: --to try to get going--

JAY-SHEREE ALLEN: --I get it.

CATHY WURZER: Yeah I'm wondering, just on a broader look here at millennial health, because that's what you specialize in, there was this study by Blue Cross and Blue Shield, which I also thought was interesting. Millennials had 11% more total adverse health effects than did Gen Xers when they were the same age.

JAY-SHEREE ALLEN: Yeah.

CATHY WURZER: So what's going on there?

JAY-SHEREE ALLEN: Interesting, right? So, yes, as everyone knows, I'm really interested in the health of millennials. We are now the largest living adult population in the United States. And so I think the state of our health has a significant impact on every area of our economy.

You talk about the workforce of the future, health care consumers of the future. I think it's important. So there's still a lot of work to be done in this area to figure out exactly what's taking place here.

And I know we started the segment talking about colon cancer. But this report was a little more broad, bringing in behavioral health, cardiovascular health. So it looked at more diseases outside of just colorectal cancer.

And we're not quite sure of the reasons why. But I think it's important for us to recognize that we are seeing these trends, that at this same age, millennials are sicker and have more health problems than the generation did before them, and use that, if only as a stepping stone to getting in with your primary care provider and establishing care so you can understand your risk and your current baseline of health.

CATHY WURZER: Oh, gosh, because you don't think-- millennials are, in my mind, we're still young. You don't consider any-- you don't consider your health being terribly bad at this point, you know?

JAY-SHEREE ALLEN: We don't. We don't. But the truth is the numbers are starting to show something a little different, you know? Going back to colon cancer for a second, so the rates have actually been decreasing quite steadily in older adults. But it's increasing by 1 to 2% a year in younger adults. So 20%, that is, one in five, colorectal cancer diagnoses in 2019 were in people less than age 54.

CATHY WURZER: Wow.

JAY-SHEREE ALLEN: So something is definitely in the water, as you said.

CATHY WURZER: OK. And so for those who are of age and they're listening, again, going back to the colon cancer that we talked about earlier, so if-- do you suggest, if someone's really worried, do they have to get a colonoscopy, the full colonoscopy? Could you get the fecal tests or just--

JAY-SHEREE ALLEN: Yes.

CATHY WURZER: --talk to your doctor, your doctors?

JAY-SHEREE ALLEN: Yes. So if you're really worried and you have some signs you're concerned about, things like rectal bleeding, so, like, bright red blood, either in the toilet or in your stool, unusual stool patterns, change in your bowel movements, or even just unexplained low energy or tiredness-- you're losing weight that you're not trying to lose, those sorts of things-- it's important to talk to your doctor about your options.

I always tell my patients, Cathy, the best screening test for colon cancer is the one that you're actually going to do.

CATHY WURZER: Mm-hmm.

JAY-SHEREE ALLEN: So a colonoscopy is absolutely the gold standard. But you do have other options that you can discuss with your doctor as well.

CATHY WURZER: All right, interesting information, always a pleasure talking to you. Thank you so much, Dr. J.

JAY-SHEREE ALLEN: Thank you for having me again.

CATHY WURZER: Family medicine physician Dr. Jay-Sheree Allen, she's the host of the podcast Millennial Health.