Younger patients are often diagnosed at a later stage than older adults, Hanna says, because patients and even their doctors don’t think about the possibility of colon cancer. Because it is considered a cancer affecting older adults, many younger people may brush off the symptoms or delay getting medical attention, Hanna says.
In a survey of 885 colorectal cancer patients conducted by Colorectal Cancer Alliance earlier this year, 75% said they visited two or more doctors before getting their diagnosis, and 11% went to 10 or more before finding out.
If found early, colon cancer is curable, Hanna says. About 50% of those with colon cancer will be diagnosed at stage I or II, which is considered localized disease, he says. “The majority have a very good prognosis.” The 5-year survival rate is about 90% for both stage I and II.
But when it progresses to stage III, the cancer has begun to grow into surrounding tissues and the lymph nodes, Hanna says, and the survival rate for 5 years drops to 75%. About 25% of patients are diagnosed at stage III, he says.
If the diagnosis is made at stage IV, the 5-year survival rate drops to about 10% or 15%, he says.
“Unfortunately, African Americans are more likely to develop colorectal cancer at a younger age and to be at a more advanced stage when diagnosed,” says Elena Ivanina, DO, a gastroenterologist at Lenox HIll Hospital, New York, according to the National Cancer Institute and the Colon Cancer Coalition. “Even when African Americans are diagnosed with early stage disease, they have significantly worse survival rates.”
Overall, ”colorectal cancer remains a condition that on one hand can be prevented with screening colonoscopy, but on the other a lethal progressive cancer if not caught early.”
Experts have been trying to figure out why more young adults are getting colon cancer and why some do so poorly. “Traditionally we thought that patients who are older would have a worse outlook,” Hanna says, partly because they tend to have other medical conditions too.
Some experts say that younger patients might have more ”genetically aggressive disease,” Hanna says. “Our understanding of colorectal cancer is becoming more nuanced, and we know that not all forms are the same.” For instance, he says, testing is done for specific genetic mutations that have been tied to colon cancer. “It’s not just about finding the mutations, but finding the drug that targets [that form] best.”