Rising Colorectal Cancer in Young Indians
Colorectal cancer has traditionally been seen as a disease that affects older individuals, typically those over 50. However, a disturbing trend has emerged in India, where oncologists are observing a significant rise in colorectal cancer patients who are under 40. At Tata Memorial Hospital, one of India's premier cancer treatment centers, the average age of patients is just 47.2, with a shocking 35% of them being younger than 40. This shift is alarming, as some patients are as young as 19.
Doctors are particularly concerned about the rise in aggressive subtypes of colorectal cancer, such as signet-ring cell carcinoma, which is linked to poorer outcomes. In the Tata Memorial Hospital audit, around 13.4% of patients presented with signet-ring tumors, a figure much higher than the 1% typically seen in Western countries. This indicates that younger patients are increasingly harboring aggressive cancer variants that progress rapidly and are often diagnosed late.
Common early symptoms of colorectal cancer, like rectal bleeding or unexplained weight loss, are often dismissed as minor issues such as piles, fissures, or mere acidity. This leads to delays in diagnosis, with patients often waiting an average of four months before seeking medical help. By the time they see a specialist, nearly 29% of these patients already have metastatic disease, complicating their treatment options.
While genetics can play a role in colorectal cancer, inherited syndromes account for only a small percentage of cases. Environmental factors, which reflect changes in lifestyle and diet, are believed to be significant contributors to the rising incidence of this disease in a younger population. Unlike in the US and UK, where routine screenings start at ages 45-50, India lacks a national screening program, resulting in only 3.8% of patients being diagnosed at Stage I.
Dr. Avanish Saklani emphasizes that any sign of rectal bleeding, unexplained anemia, or persistent changes in bowel habits should warrant a colonoscopy, even for individuals under 30. The Indian healthcare system faces the challenge of adapting to two distinct groups of colorectal cancer patients: the traditionally older demographic and the growing younger population.
In summary, the message from oncologists is clear: do not ignore any warning signs, regardless of your age. The latest data shows that young age offers no protection against colorectal cancer, making awareness, early detection, and lifestyle changes crucial in combating this silent epidemic.
