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Rectal Cancer Rate Increasing in Young Adults

HeartofSoul's picture
HeartofSoul
Posts: 732
Joined: Dec 2009

(Since there is no rectal cancer board, i chose to post this article here instead)

http://abcnews.go.com/Health/CancerPreventionAndTreatment/rectal-cancer-rates-rising-young-adults/story?id=11463628

Using data from the Surveillance, Epidemiology, and End Results (SEER) cancer registry, Dr. Joshua E. Meyer of New York Presbyterian Hospital in New York City and colleagues found that the incidence of colon cancer among this group has remained stable over the past three decades, suggesting that the bump in rectal cancer diagnoses among young adults is not due to increased screening. The study was published online in the journal Cancer
Rectal cancer is considered to be rare among young individuals in the U.S., but a recent analysis shows rates to be rising.

By conducting a study using data from the Surveillance Epidemiology and End Results cancer registry, they calculated that between 1984 and 2005, the rate of rectal cancer diagnosis rose 3.8% per year.

The incidence of colon cancer excluding the rectum was stable at 1.11 per 100,000 over this period. Rectal cancer occurred at a rate of 0.42 per 100,000 over the study period, but rose at a rate of 2.6 percent per year. Cancer of the rectosigmoid junction before age 40 was even less common with an incidence of 0.13 per 100,000, but also 2.2 percent per year.

Together, rectal and rectosigmoid cancers appeared to have started to climb in incidence starting in 1984. The rate of increase was identical between males and females and was seen in both black and white populations.

Although uncommon, cancer of the rectum and anus gained significant attention with the death of American actress Farrah Fawcett in 2009 after a three-year battle with anal cancer. Anal cancer is rare compared to rectal cancer; the American Cancer Society estimates 39,670 new cases of rectal cancer and 5,260 new cases of anal cancer in 2010.
Current guidelines for colorectal cancer screening from the American College of

Gastroenterology recommend that screening begin at age 50 for average-risk individuals and at age 45 years for African Americans, who are at higher risk. An earlier start for screening is suggested only for those with a positive family history of colorectal cancer or certain types of polyps.

Although the researchers offered no clear explanation for the changing incidence of rectal cancers and didn't recommend a change to screening guidelines, they warned physicians to take symptoms seriously in younger patients.

Patients presenting with rectal bleeding or other alarming signs or symptoms should be evaluated with this finding in mind," they wrote. "Although colonoscopy may not be warranted, we suggest that flexible sigmoidoscopy, at a minimum, should be performed in this setting to rule out rectal or rectosigmoid cancer."

mp327's picture
mp327
Posts: 2819
Joined: Jan 2010

This should be a wake-up call to doctors and the public alike. Rectal bleeding should never be assumed to be bleeding hemorrhoids, but sadly patients AND doctors are making this unfortunate error in judgement. I tell anyone and everyone I know when discussing this topic that a DRE does not give a doctor enough information to make a diagnosis. Any rectal bleeding needs to be looked at by a specialist using anoscope, at the very least.

SueRelays
Posts: 489
Joined: Dec 2009

Hey Heart....nice to see you again :)
Thanks for the info. Hope you are doing well!!!

Kenny H.'s picture
Kenny H.
Posts: 503
Joined: Aug 2010

Pardon my ignorance, but whats the difference between Rectal cancer and Anal cancer?

z's picture
z
Posts: 1250
Joined: May 2009

Hi Kenny,

My understanding is that the rectal cancer is above the dentae line. The anal cancer is below it. Anal cancer is usually squamous cell, and I believe rectal is another type. I'm sure some others will chime in. The standard tx for anal is 5FU and myto or cispan, along with radiation. Lori

mp327's picture
mp327
Posts: 2819
Joined: Jan 2010

This is a good question because I don't think a lot of people understand the difference. Rectal cancer occurs above the dentate line and is typically adenocarcinoma, which differs from squamous cell cancer. Anal cancer is almost always squamous cell. Different types of cancer cells mean different chemo drugs and a different protocol. I get a little peeved when I get a copy of a scan and the diagnosis on it says "history of colorectal cancer" or "rectal cancer." That's incorrect and healthcare professionals should know the difference, even if the general population does not!

HeartofSoul's picture
HeartofSoul
Posts: 732
Joined: Dec 2009

thank you sue, good to be back. how are you doing?

SueRelays
Posts: 489
Joined: Dec 2009

Feeling great! Just got the 6 month scan since my liver resec and it is stable so WOOHOO and Cheers for that! I'm moving to Central Oregon....Bend area in 2 weeks. Life is just better over there and it's time to make those decisions as to what/where makes you happy right?

How are things for you? do you go in to the "chat" rooms much anymore? I haven't been in months!

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