Study: Colorectal Cancer Patients Diagnosed Before 50 Have Better Survival Odds

New research has found that younger patients who are diagnosed with colorectal cancer have high rates of survival if they’re diagnosed with the disease early.

The study analyzed data from 769,871 people diagnosed with colorectal cancer. The results showed that the people diagnosed with colorectal cancer when they were younger than 50 had a “survival advantage” over the people who were diagnosed between the ages of 51 and 55.

People who were diagnosed at ages 35 through 39, and with stages I and II, had the best outcomes.

The authors concluded that the study's findings clearly showed the potentially life-saving benefit of early screening for colorectal cancer. The study's findings are timely, coming just a month after the United States Preventive Services Task Force (USPSTF) lowered the recommended age to start colorectal cancer screenings from 50 to 45.

Colorectal Cancer

Colorectal cancer is cancer in the colon (the large intestine or rectum—the last several inches of the large intestine closest to the anus). It occurs when abnormal growths called polyps form in the colon or rectum. Over time, some of the polyps can turn into cancer.

If a polyp becomes cancerous, it can grow into the wall of the colon or rectum. It can also grow outward through several layers of the gastrointestinal tract.

When cancer cells get into the wall of the colon or rectum, they can make their way into blood vessels or lymph vessels (which carry away waste and fluid) and spread to other parts of the body.

Risk Factors

Colorectal cancer is the third-leading cause of cancer-related deaths in men and women and is expected to cause about 52,980 deaths in 2021. The lifetime risk of getting colorectal cancer is about 4% for men and women.

Risk factors for colorectal cancer include:

• Older age
• Having a family history of colorectal cancer
• Having type 2 diabetes
• Being overweight or obese
• Not being physically active
• Eating a diet high in red and processed meats
• Smoking
• Moderate to heavy alcohol use

Symptoms

According to the American Cancer Society, colorectal cancer may not cause symptoms at first. When symptoms do occur, they can include:

• A change in bowel habits (like diarrhea, constipation, or narrowing of the stool) that lasts for more than a few days
• A feeling that you need to have a bowel movement that is not relieved by having one
• Rectal bleeding with bright red blood
• Blood in the stool (which can make it look dark brown or black)
• Stomach cramps or pain
• Weakness and fatigue
• Unintended weight loss

Colorectal Cancer Screenings

The USPSTF, the leading panel for medical guidance in the U.S., released a final recommendation statement on colorectal cancer screenings in May 2021.

The Task Force recommends screening for people who

• Have an average risk of colorectal cancer
• Do not have symptoms of colorectal cancer
• Do not have a previous diagnosis of colorectal cancer
• Do not have a family history of colorectal cancer

The USPSTF also recommends that some adults between the ages of 76 and 85 be screened based on their current health and previous screening history.

Screenings for colorectal cancer include a stool test to look for signs of cancer or a visual exam like a colonoscopy to look for polyps inside the colon and rectum.

What Doctors Say 

Anton Bilchik, MD, PhD, a surgical oncologist, professor of surgery, chief of gastrointestinal research, and chief of medicine at Saint John’s Cancer Institute at Providence Saint John’s Health Center in Santa Monica, California, tells Verywell that the study's findings are “fascinating.”

“We know that there is a rapid increase among young people under age 50 who are presenting with colon cancer,” says Bilchik, “and it’s logical to think that, if you present at a younger age, you will have a worse outcome.”

Bilchik adds that because younger patients usually are not screened, colorectal cancers are often more advanced and aggressive when they are detected.

“What this study suggests is that, if you present at a younger age, if it’s detected at an early stage, your survival is actually better,” says Bilchik, adding that this finding "reinforces the need to screen at a younger age.”

Joshua Meyer, MD, vice-chair of translational research in the Department of Radiation Oncology at Fox Chase Cancer Center, tells Verywell that younger people are still at risk of developing colorectal cancer, even if the official recommendations do not currently suggest that they be screened for the disease.

"Just because the screening age may start at 45 does not mean that younger people are not at risk," says Meyer. "Even if that risk does not rise to the level that makes screening an appropriate step."

Meyer says that people of all ages pay attention to unusual symptoms, and that "if a person in their 20s or 30s or 40s has persistent rectal bleeding, change in bowel habits, or abdominal/pelvic pain that persists, they should discuss further workup with their doctor, including a possible colonoscopy."

Bilchik says that while the latest data supports the recommendations that the screening age for colorectal cancer be lowered to age 45, now, "the question is whether it should be even younger."