In the month to fight colon cancer, the American Cancer Society published a study that shows an
increase in this oncological pathology in people under 50 years of age
.
The data is from the United States and the question that arises in this regard is whether this incidence
could be extrapolated to our country
.
Also, what are the possible causes associated with this change.
The work cited by
The New York Times
states that researchers estimated that
in 2023, 153,000 people in the United States would be diagnosed with colorectal cancer
.
Of these cases, around 13% would correspond to people under 50 years of age, which represents an
increase of 9% in this age group since 2020
.
"While diagnoses of this type of cancer are declining among those older than 50,
the trend for younger people is in the opposite direction
," said Steven Itzkowitz, professor of cancer medicine and sciences at the Icahn School of Medicine at Mount Sinai. New York, to the American newspaper.
The other detail to keep in mind is that, according to the study authors, cancers diagnosed in people under 50 years of age
tend to be more aggressive
.
"We live in a time when young people in their prime get colon cancer," Itzkowitz added.
A colorectal cancer organoid, with the cells responsible for the metastasis marked in red.
Photo: IRB Barcelona
In the same article, Nancy Baxter, a colorectal surgeon and director of the Melbourne School of Population and Global Health at the University of Melbourne, said that the rising rates of early-onset colorectal cancer are concerning, but the risk of a person under the age of 50 will develop colon cancer is still extremely low.
"I don't want to panic," Baxter said, adding that "age continues to be the biggest risk factor."
According to The New York Times
publication
, a major study published in 2022 concluded that obesity in your 20s or 30s can
more than double the risk of early-onset colorectal cancer
.
It is also believed that excessive alcohol consumption may be a determining factor.
For Baxter, the issue is likely to be even more complex.
Researchers don't yet know how certain childhood risk factors—being born by C-section, taking antibiotics, and exposure to certain environmental events—might play a role.
In turn, they refer to the consumption of sugary drinks and ultra-processed foods, among other possible reasons.
Another fact to consider is that people of African descent and American Indian origin are most at risk, which many studies attribute to
social inequalities and barriers to health care
.
With all this information, two local specialists tried to give answers about the
Argentine scene
.
Federico Esteso, deputy head of the area of digestive tumors at the Alexander Fleming Institute, explains that "
there are no personal data
to confirm what is happening in Argentina with colon cancer."
However, "
historically, we replicate what happens in the United States a few years later
, so it is a phenomenon to take into account since it can affect us."
Meanwhile, he clarifies that
the health framework is different
from that of that country.
"While there they are evaluating, based on these results, the possibility of starting to track this type of cancer at 45 instead of 50,
in our country less than 30% of those over 50 are tested
," he tells her. to
Clarin
Esteso.
It is based on data from the 4th National Survey of Risk Factors of 2019 and warns that the situation worsened with the pandemic: "I am not saying that it is not an issue to consider, but the reality is that we must first improve the situation of the
elderly of 50
”.
He comments that there are two screening procedures,
colonoscopy
, which in patients with low risk and without the presence of polyps should be performed after the age of 50 every 5 or 10 years, and
fecal occult blood,
which is a non-invasive analysis technique. to detect microscopic bleeding that should be repeated every year.
High chances of cure
“
Early detected tumors have more than a 90% chance of cure
.
Hence the importance of finding polyps on time, which have a benign onset”, remarks Esteso.
Regarding the causes of the increase in cases among younger people, he assures that “it is not clear.”
“It is believed that it may have to do with diet, with the
intake of ultra-processed foods, red meat and alcohol
.
Also with the lack of physical activity, smoking and there are even hypotheses linked to the
use of antibiotics
.
It is necessary to continue investigating ”, he maintains.
Lisandro Pereyra, gastroenterologist and endoscopist at the German Hospital in Buenos Aires and consultant for the Colorectal Cancer Program of the National Ministry of Health, says that it is an issue that "scientific communities are paying attention to."
In this sense, he ensures that it is key to detect benign polyps that are
lesions prior to cancer
and that, in general, do not give symptoms.
Although it clarifies that
the results of the United States are not fully representative at the local level
.
"On the SEER basis, the United States Epidemiological Surveillance Registry, we found
some biases
," he warns.
"Most of the cases of children under 50 are registered
in the vicinity of the Mississippi River
, an area in which it is being investigated whether they may be suffering from
contamination by pesticides
," Pereyra points out.
And he adds: "Furthermore, there are people with lower purchasing power who, consequently, tend to
consume poorer quality food and, in some cases, are obese.
In turn, there are Afro-descendant communities that are more predisposed to presenting high blood pressure and polyps that can lead to colon cancer.
He says that, in addition, half of this group has a family history and that in cases with a history,
tests must be started earlier because the risk increases
.
These elements make you think that
another population sample would have to be analyzed to see if it yields similar results.
"Argentina has special characteristics since only 29% of those over 50 are tested and because we do not have good quality data," highlights Pereyra, who shares that the latest information available is from 2020 and that 12,482 new ones were diagnosed that year
. cases and 7,458 people died
from this disease.
He says that he cannot talk about the reasons why the cases increased in the United States, but that
the risk factors for suffering from this type of cancer
are known .
It refers to
habits and diet
.
"It is not advisable to eat red meat more than three times a week, consume little vegetables and many sausages, ultra-processed, sugar, alcohol and lead a sedentary life", he details and affirms that "antibiotics can modify the microbiota of the colon" and that " Evidence is still lacking and we must continue investigating its effects”.
Beyond the need to have medical follow-up throughout life and comply with screenings from the age of 50 or earlier, depending on the characteristics of the patient, Pereyra says that there is a website called "Check your colon", it offers Useful information and help raise awareness.
"It is supervised by the Buenos Aires Endoscopy Society. Each person can upload personal data on the subject and possible symptoms and receive recommendations regarding when to visit a specialist. Arriving on time to consult and be tested is essential ", contributes Pereyra.
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