Introduction
Like the majority of cancers, colorectal cancer is primarily a disease of the elderly. In about 25% of cases, however, risk groups are affected, in some cases the disease can occur much earlier. Therefore, it is important to think of bowel cancer at a younger age if symptoms occur and to rule it out if necessary.
It should also be remembered that although colorectal cancer usually does not make itself felt until old age, it usually develops over a period of years or even decades, i.e. it exists long before the first symptoms or even the diagnosis is made, and can also be detected in the bowel. This is why colorectal cancer screening is of great importance here. By means of colonoscopy and other preventive examinations, serious progressions can be avoided and, if detected early, healing successes can be achieved.
At what age does colorectal cancer typically occur?
According to statistics, 90% of patients are over 50 years old when they are diagnosed with colorectal cancer, the majority of them even significantly older. However, this does not mean that colorectal cancer cannot also occur at a younger age. This is the case, for example, with cases of bowel cancer in close relatives or with certain diseases that increase the risk of bowel cancer.
These include ulcerative colitis, a chronic inflammatory bowel disease, intestinal polyps and various genetic diseases such as familial adenomatous polyposis (FAP), hereditary non-polyposis colon cancer (HNPCC), Peutz-Jeghers syndrome and others. The mean age of onset varies with the disease. In HNPCC, for example, patients are on average only 45 years old when the colon cancer first manifests itself, and rarely younger than 25 years. In Peutz-Jeghers syndrome, the mean age of onset is 35 years.
Is colon cancer also present in adolescence?
Unfortunately, there are also cases of colorectal cancer in adolescence, although rare. These can occur in connection with the genetic disease FAP (familial adenomatous polyposis). FAP occurs with a frequency of 1:10.
000 inhabitants in Germany and accounts for about 1% of all colorectal cancer cases. In this disease, a genetic modification of the genetic make-up leads to the formation of >100 polyps in the colon during childhood. These then lead to the development of colon cancer in almost 100% of cases, whereby this usually develops from the age of 15. Therefore, the large intestine is often removed prophylactically in affected children and adolescents, usually between the ages of 10 and 15. You can find out more about the various polyposis of the colon at Symptoms of intestinal polyps
What are risk factors for colon cancer at a younger age?
There are several known risk factors that favour the development of colon cancer at a younger age. First of all, there are the genetic diseases that lead to an early incidence of colorectal cancer. These include hereditary non-polyposis colon cancer (HNPCC) and the group of familial polyposis syndromes.
Also, a high incidence of colorectal cancer in the family and close relatives who have early onset of colorectal cancer increases the risk of developing the disease even before the age of 50. In addition, polyps in the intestine increase the risk of cancer, which is why affected persons and close relatives of affected persons have an increased risk of developing the disease at a younger age if the polyps are not removed in time. You can find out more about the various polyp-related intestinal diseases at Chronic inflammatory bowel diseases also favour the occurrence of bowel cancer at a younger age; especially ulcerative colitis, more rarely Crohn’s disease.
Lifestyle factors are currently being discussed as further circumstances that may favour early disease. It is certain that a diet rich in meat and fat and low in fibre, lack of exercise, overweight and long-term nicotine and alcohol consumption increase the risk of developing colon cancer. However, it is currently unclear whether they also cause the disease to occur earlier. – Symptoms of intestinal polyps
- Lynch syndrome
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