With colorectal cancer cases rising among younger adults, physicians are warning the public about screening guidelines, access to care and persistent disparities.
Four gastroenterologists recently weighed in on their concerns with Becker’s.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What colorectal cancer trend is concerning you the most right now, and why?
Brett Bernstein, MD. Mount Sinai Beth Israel (New York City): The increase in colorectal cancer incidence among younger people is very concerning. While the screening age was appropriately decreased to 45, unfortunately we are seeing many cancers in patients even younger. Studies need to be done to support lowering the screening age further, as I am concerned we are missing an opportunity to prevent this disease in younger populations.
Rajiv Bhuta, MD. Temple Health (Philadelphia): The trend that concerns me most is the rising incidence among young people, combined with a lack of hard data on its cause. Some data suggest obesity, an overly processed diet or early antibiotic exposure may contribute, but we’re far from a clear understanding. Is lowering the screening age by five years enough? Or is it overly broad and non-specific, with some being screened too early and others too late?
Shakeel Ahmed, MD. Atlas Surgical Group (Fairview Heights, Ill.): The most concerning trend is the increasing incidence of colon cancer in younger populations. As a practicing gastroenterologist with 25 years of experience, I find it a rising issue that needs serious attention. Clinicians must increase outreach and awareness for younger patients and emphasize that this is not just a disease of the elderly — it can strike at any age.
Linda Lee, MD. Brigham and Women’s Hospital (Boston): I’m concerned about the rise in incidence and mortality in younger patients, as well as the ongoing higher mortality rates in Black individuals. Lowering the screening age to 45 may help, but we also face a shortage of gastroenterologists to handle the added volume. We need to work closely with primary care providers, expand stool-based screening options and use patient navigators to ensure equitable access, especially in underserved communities.
