Many people think of colorectal cancer as an older person’s disease, but an alarming spike in the number of younger Americans being diagnosed is prompting calls to start screening earlier.
Chadwick Boseman was 43 when he died of colon cancer, according to a statement his family shared Friday.
“Chadwick was diagnosed with stage III colon cancer in 2016, and battled with it these last 4 years as it progressed to stage IV,” the statement read, in part.
Every day, 49 new cases of colorectal cancer — which starts in the colon or the rectum — will be diagnosed in people under 50 and 10 of them will die.
"The most striking thing is that this comes after a period of steady decline. All of a sudden, there has been a steady rise and it's expected to continue. So this is not an isolated phenomenon,” said Dr. Kimmie Ng, founding director of the Young-Onset Colorectal Cancer Center at the Dana-Farber Cancer Institute in Boston.
The facility is one of the few places in the world dedicated to figuring out why colorectal cancer is suddenly skyrocketing in younger people.
TODAY's Craig Melvin revealed in 2017 that his brother, Lawrence Meadows, had been diagnosed with colon cancer. He tweeted Saturday, "Waking up to the Chadwick Boseman news is perhaps the starkest warning yet. Colon cancer is absolutely ravaging the community of young Black men in our country and researchers are having a hard time figuring out why."
April Kastura MacDonald was part of the mystery. The Michigan mother was diagnosed with stage 3 colon cancer at age 43.
"She had no symptoms up until she had symptoms ... She had a normal life,” said Joe Kastura, her brother.
“Then she started having stomach problems, some blood in the stool. Went to the doctor's, had a colonoscopy and the rest is history. Nothing leading up to that."
MacDonald fought the disease for seven years, dedicating her time to raising awareness and discussing a cancer many people don't want to talk about. She died two years ago after the cancer spread and treatments stopped working.
"She didn't want other people to go through that,” her brother said. “So she wanted to get the word out there.”
One of the leading hypotheses about why colorectal cancer is striking younger people is obesity, but it doesn’t apply to the vast majority of patients Ng sees at her clinic. Most exercise, eat a healthy diet and are at a healthy body weight, she said.
"It is the one question in cancer research that honestly keeps me up at night," Ng noted.
For years, 50 was the recommended age to start getting colonoscopies. But in response to the alarming statistics, the American Cancer Society lowered its screening guidelines to start at age 45.
Ng believed the change would catch more young-onset colorectal cancers at an earlier stage, which would presumably be associated with improvements and survival.
A recent study predicted screening at age 45 could identify 30,000 cases of cancer and prevent 11,000 deaths over the next five years.
But most insurance still won't cover the cost of screening before age 50 and patients are being forced to pay out of pocket.
The U.S. Preventive Services Task Force — which sets guidelines followed by most insurance companies — said there isn't enough evidence to lower the screening age.
As with any cancer, early detection is key so it's important to be aware of the symptoms. Colorectal cancer might not cause symptoms right away, but if you notice any of the signs below from the American Cancer Society, it's worth a visit to the doctor:
- Change in bowel habits (diarrhea, constipation or narrowing of the stool that lasts more than a few days)
- Feeling that you need to have a bowel movement, but once you have one you don't feel relieved
- Rectal bleeding with bright red blood
- Blood in stool
- Abdominal cramping or pain
- Weakness or fatigue
- Weight loss
Jim Nauen isn’t sure if he’d be alive today had he waited longer for the screening.
Diagnosed with stage 3 colorectal cancer at 49, Nauen's doctors found a tumor the size of a baseball. He now wonders if his prognosis would be different if he were screened four years earlier.
"Would it have been stage 2 instead of 3? Would it have been stage 1? Would it have been just a polyp that was caught in the screening and zapped and never given another thought to, right?” he said.
Now 53, the Massachusetts father of two is undergoing treatment. He’s sharing his story hoping to change policy that he believes could save lives.
"It's too late to change the start of my battle. But we can certainly change the start of other people's,” Nauen said.