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Colorectal cancer: What Gen X and millennials need to know

March 1, 2024 - Your Health Matters

The group of people born between 1977 and 1983 are sometimes referred to as Xennials, because they straddle Generation X and millennials. They were born in an analog era and came of age in the digital era.

But this group is facing a threat sooner than many of their elders did. Incidences of early onset colorectal cancer — diagnoses in patients younger than 50 — are on the rise. That’s leading medical professionals like C.P. Choudari, M.D., with Meritus Hagerstown Gastroenterology to sound the alarm.

“Both young people and doctors need to shed the notion that colon cancer is an ‘old person’s disease,’” Dr. Choudari said. “They need to know that 45 is the new 50 when it comes to screenings.”

Early onset colorectal cancer now accounts for approximately 10 percent of all new diagnoses of the disease, Dr. Choudari said. And since 1994, cases of early onset colorectal cancer have increased by 51 percent.

In the next decade, it is estimated 25 percent of rectal cancers and 10 to 12 percent of colon cancers will be diagnosed in people younger than 50, he said.

The age-adjusted incidence of early onset colorectal cancer rose from 7.9 cases per 100,000 people in 1988 to 12.9 cases per 100,000 in 2015 — a 63 percent increase, he said.

“The incidence of early onset colorectal cancer is projected to slowly increase and more than double by 2030,” he said.

So what’s the difference between early onset and later onset of the disease?

Patients with early onset colorectal cancer typically have more advanced disease at diagnosis, which is associated with increased incidents of death. Symptoms can include fresh blood from the rectum, abdominal or pelvic pain, bloating and a change in bowel habits.

Dr. Choudari stressed the need to pay attention to what your body is telling you.

“Awareness of symptoms and what they may represent is very important,” he said. “Unfortunately, we see people who have had concerning symptoms that were not addressed for months or even years before seeking medical attention.

“If you have a change in bowel habits, if you have any bleeding, even if you think it’s a hemorrhoid, and it doesn’t go away, just get a colonoscopy,” he said. “It can be life-saving.”

Also just as important is genetics, he said. Talk to your family about cancer history.

First-degree relatives (siblings, parents or children) of people who have been diagnosed with colorectal cancer should start screening 10 years earlier than the age the family member was diagnosed. So if your father was diagnosed with colorectal cancer at age 45, you should be screened at age 35.

And don’t think only men get colorectal cancer. Statistics show that one in 23 men and one in 25 women will be diagnosed.

There are options to get screened, though Dr. Choudari said a colonoscopy is the gold standard for colon cancer detection and polyp detection.  It is the only strategy that provides colon cancer prevention through polyp removal.

“Don’t be fooled by the marketing,” he says of the other tests on the market. Some still require a colonoscopy to verify their results. Others aren’t nearly as effective, even providing false positives and negatives.

A colonoscopy can detect and remove precancerous polyps before they become malignant, he said. And these days, getting the test isn’t as bad. The preparation is usually done with a mix of Miralax and Gatorade, and sedatives are given so most patients won’t even remember the procedure.

The one question that’s still out there: Why is this cancer showing up earlier?

The short answer: Researchers don’t know for sure and are scrambling the answer, Dr. Choudari said.

“Is it diet? Obesity? A sedentary lifestyle? There’s nothing that’s been proven,” he said. “Nobody knows the cause.”

To learn more about colorectal cancer or to schedule a colonoscopy, visit or call 240-513-7072.

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Chintamaneni Choudari, M.D.

Meritus Hagerstown Gastroenterology

Digestive Health