Colorectal cancer cases have increased in kids over the last 2 decades. Here’s what you need to know.

Colorectal cancer cases in children have been on the rise over the past two decades. Recent research has shown that not only are younger adults being affected by this type of cancer, but now cases are also increasing in children.

A comprehensive analysis of data from the Centers for Disease Control and Prevention spanning 22 years revealed a significant surge in colorectal cancer cases in children between 1999 and 2020. The study found that the rate of colorectal cancers increased by 500% in children aged 10 to 14, 333% in teenagers aged 15 to 19, and 185% in young adults aged 20 to 24. These findings will be presented at the upcoming Digestive Disease Week later this month.

It is important to note that the overall number of cases remains relatively low. For instance, in 2020, only 0.6 children aged 10 to 14 per 100,000 were diagnosed with colorectal cancer, compared to 0.1 per 100,000 in 1999. In teenagers, the number increased from 0.3 to 1.3 per 100,000, and in young adults, cases increased from 0.7 to 2 per 100,000.

Nevertheless, doctors emphasize the significance of these increases. “These findings are definitely alarming,” says Dr. Tiago Biachi, a medical oncologist in the Gastrointestinal Oncology Department at Moffitt Cancer Center. It is crucial for parents to be aware of these trends.

The reasons behind the increase in cases among younger individuals are not yet fully understood. However, Dr. Biachi suggests a few factors to consider.

“It is well known that the process of developing ‘non-inherited’ colorectal cancer takes time, and the typical interval between a polyp and cancer is five to 10 years,” explains Dr. Biachi. “This means that children developing colorectal cancer were likely exposed to risk factors from a very young age.”
Dr. Jacqueline Casillas, a pediatric hematologist/oncologist and medical director at MemorialCare Miller Children’s & Women’s Hospital Long Beach, explains that lifestyle factors such as obesity, unhealthy diets, sedentary living, and antibiotic use that alters a child’s gut microbiome may contribute to the development of colorectal cancer in young people. However, she emphasizes that the reasons for this trend are still unclear and further investigation is needed.

On the other hand, Dr. Jeffrey Hyams, a pediatric gastroenterologist at Connecticut Children’s Medical Center, reassures that colorectal cancer in teenagers is extremely rare. In his 40 years of medical practice, he has only encountered one case of this cancer in a teenager, and even that case had predisposing risk factors. Risk factors for colorectal cancer include inflammatory bowel disease, family history of the disease, and inherited syndromes, according to the American Cancer Society.

Dr. Anton Bilchik, a surgical oncologist and director of the Gastrointestinal and Hepatobiliary Program at Providence Saint John’s Cancer Institute, echoes the rarity of this phenomenon, cautioning that the numbers should be interpreted carefully. He stresses the importance of considering family history and other factors before drawing any conclusions.

While this information is not a reason to initiate colonoscopy screenings in children, it does highlight the need to understand the underlying causes of this trend, says Dr. Bilchik.

What symptoms should parents be aware of?
According to the study, the most common symptoms experienced by patients with colorectal cancer were identified as signs of iron deficiency anemia. It is important to distinguish these symptoms from less serious stomach issues. Although the presence of these symptoms in children does not automatically indicate colorectal cancer, it is crucial to have them evaluated by a doctor if they persist for more than a month or two. Tests such as stool testing, blood work, and abdominal X-rays are typically conducted before considering a colonoscopy. Parents should prioritize their child’s gut health and continue seeking answers if something seems abnormal. The study also serves as a reminder to establish healthy habits early in life, such as maintaining a nutritious diet and engaging in regular physical activity. However, doctors emphasize that parents should not panic, as colorectal cancer is still extremely rare in children.