The cancer striking younger and younger

When 36-year-old mum Anika Millington first started noticing changes in her toilet habits, she did what most would do: ignored it and assumed it would go away. But after six months of experiencing symptoms like occasional bleeding from the bowels, she sought help. She ended up receiving a diagnosis of colorectal cancer, also known as bowel cancer.

Anika told us of what she thought at the time – that “this just does not happen to 36-year-old mothers of three, who are healthy and fit and eat well and don’t smoke.”

A young woman with curled blonde hair and wearing a pink floral top, smiling.
Anika, at home.

However, statistics show that increasingly, it does.

Colorectal cancer among people under 45 is on the rise.

And while there are plenty of theories as to why, there is currently no ‘smoking gun’.

Professor Jeanne Tie, a clinician and researcher specialising in colorectal cancer, confirms the trend. “There is definitely a rise in cases in younger people, and this tends to be in affluent countries, like Australia. There’s some research suggesting the use of antibiotics in childhood and lifestyle may play a role in the rise in affluent countries, but we certainly need more research – it’s a fairly new field.”

While younger people are less likely to think of cancer as a cause of their symptoms, clinicians are also less likely to make the connection when their patient is relatively younger.

Rochelle Hutson was just 36 when she began to experience a higher frequency in bowel movements. It seemed very minor but after three months, she spoke to her GP.

“I really struck it lucky with a GP that kept pursuing it,” Rochelle remembered. “She said at the start, ‘it might just be irritable bowel syndrome but I’m not going to give you that diagnosis until we’ve ruled everything else out.”

Even so, Rochelle remarks that getting appointments to explore her symptoms wasn’t easy.

“I was constantly hitting walls because of my age and because I had so few symptoms,” she says. “There were no risk factors that were encouraging people to make prompt appointments.”

When Rochelle’s diagnosis finally came, her surgeon told her it was likely the tumour had been there for about ten years.

Image of a young woman with brown hair, smiling and standing in the middle of a forest.
Rochelle, after cancer treatment.

“Initially I kicked myself that I didn’t respond the first time that things felt more frequent, but since I learned I only had symptoms for three months of that time, I’ve forgiven myself for that.”

Rochelle and Anika are far from alone. A recent study published in BMJ Open found that younger people report an age bias when it comes to colorectal cancer and found that they wait between three months and five years for a diagnosis.

The impact of diagnosis delays for younger people is significant, with one of the most obvious being untreated and progressing disease.

“Fundamentally, the earlier we catch the disease the greater the chances of a successful treatment and cure,” said Prof Tie. “Once it has spread beyond the bowel in Stage 4, it is very unlikely we can cure it. Certainly, in the clinic I see a lot of younger people who are diagnosed very late.”

To Jeanne, the tragedy of a late diagnosis feels worse in a younger patient. “It is sad to say, but the younger they are, the more they have to lose. Their life expectancy is so much shorter.”

She points to apparent biological differences in younger patients. “The latest data coming through suggests that when comparing younger patients at the same stage of diagnosis with a patient whose cancer was diagnosed after age 50, the younger patient’s biology is a bit different and they tend to have worse outcomes.”

Jodie Collins, colorectal cancer survivor, has made it her mission to raise awareness of colorectal cancer risk in younger people. By the time Jodie received her diagnosis, her cancer was already Stage 3. “I wasn’t even very sick, just very tired,” she said.

A blonde woman with sunglasses and a man stand behind their two young daughters at a festival.
Jodie, with her family.

Together with Rochelle, a fellow member of the GI Cancer Institute Community Advisory Panel, Jodie is pushing for more awareness and a lower age for colorectal cancer screening in New Zealand, which starts at 65 years old, compared with Australia’s 50 years old.

In Australia, there are also growing calls for colorectal cancer screening to begin at 45 years old.

“With breast cancer, at 45 you’ve got your first scan and there’s lots of awareness. But colorectal cancer is something that we haven’t highlighted enough,” Jodie says.

“The big pipeline dream is that we catch people before they’re actually at the stage that I was at and worse.”

“There are too many of us getting diagnosed at much later stages, often because our age has been dismissed,” says Rochelle. “Age shouldn’t be a factor in screening, it shouldn’t be a factor in getting investigations done.”

For all three women, the one thing they want everyone to know is to seek help early, no matter how minor their symptoms.

“It’s not the sexiest part of your body, but it’s really important that if you’ve got blood coming out of there you go and get it checked out, or if your toilet habits are changing,” says Anika.

Jodie agrees. “Putting my big girl pants on and going and getting checked out – it saved my life.”

 

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This article was featured in The Digest, Issue 1, 2024.

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