Miami is a Hot Spot for Colorectal Cancer Among Younger Women
Colorectal cancers are usually considered a risk for older adults, yet experts have noticed a troubling trend: While rates have dropped among those 50 and older, they’re going up in the younger set.
Reports show that these cancers have inched up 2% every year for the latter age group, with 11% of colon cancers and 18% of rectal cancers diagnosed in younger people.
Now, a study published in the Clinical and Translational Gastroenterology Journal drills down on those statistics by location. It is the first to look at rates by geography, and the news is not good for the South Florida area.
Miami-Dade is considered one of about 190 hot spots for women under 50.
Women diagnosed with early-onset colorectal cancer in Miami-Dade have a higher risk of dying from the disease than in many other counties.
“We really don’t know why,” says Laurence Russell Sands, M.D., a colorectal surgery specialist at Sylvester Comprehensive Cancer Center. “But we also don’t know why we’ve been diagnosing it more in younger patients.”
If you exclude skin cancers, colorectal cancers — the umbrella term for cancers found in the colon, rectum, and anus — are the third most common type of malignancy in America, according to the American Cancer Society. They are also the second most common cause of cancer deaths when the rates for men and women are combined. About 52,980 people are expected to die from these cancers in 2021.
In the new study, researchers examined the medical data of women, aged 15 to 49 years old, diagnosed with colorectal cancer between 1999 and 2016.
They discovered that colorectal cancer mortality rates had increased overall for adults under 50 but especially within specific counties. Of the 3,108 counties examined, 191 — or about one in 16 — qualified as hot spots for women. Some of the more populous counties include Cook County (Chicago), Fulton County (Atlanta), Bergen County (New Jersey suburbs of New York metropolitan area), Queens County (Queens borough of New York), and Mecklenburg County (Charlotte, N.C.) About 53% were southern counties.
The study also revealed that of the 28,790 women with early-onset CRC, 13.7% lived in these counties. What’s more, physical inactivity and low fertility rates were more common in these cities and their environs. (Almost 25% of adults in these hot spots reported a lack of physical activity, and only 5% of women in these counties had experienced live births in the past year.)
The importance of colorectal cancer screening
While the study authors have no ready explanation for this geographic tendency, Dr. Sands points out that it’s not just young women who should be on the lookout for early-onset CRC.
“What we’ve observed [at Sylvester] is that cases [in younger people] are occurring across a cross-section,” Dr. Sands says. “I can’t say that it’s just women more than men or one group over another. But it does give credence to the importance of early screening.”
Younger patients, he adds, tend to present with a more advanced stage of colorectal cancer, too.
This may be because a younger person may not react as readily to telltale symptoms or because their physicians may dismiss complaints too readily. While colorectal cancers can occur at any age, the overwhelming majority are found in older people. After the age of 40, the risk doubles every 10 years.
Nevertheless, the trend among younger people “should make us keep a high suspicion level for all patients, regardless of age,” he adds.
Some common symptoms of colorectal cancer include blood in stool, a change in bowel habits, constipation, passing excessive amounts of gas, anemia or fatigue, and abdominal discomfort or weight loss. Patients should also be aware of their high-risk factors, including a family history of polyps and a personal history of ulcerative colitis, colon polyps, or cancer of other organs.
Not all is doom and gloom, however.
“This is a preventable disease,” Dr. Sands explains, “and early detection is key.”
Colonoscopies spot pre-cancerous polyps, which can be removed immediately by the doctor before they can grow into cancer. Dr. Sands also urges people to practice a healthy lifestyle. This includes a high-fiber, low-fat diet, regular exercise, maintaining a proper weight, avoiding alcohol, and not smoking.
“The take-home message should be that you’re your best healthcare advocate,” he says.
Learn more about colorectal cancer screening at Sylvester.
Update: Medically reviewed and approved by Dr. Laurence Sands in March 2023.