Colorectal cancer rising in younger adults as calls grow to lower screening age in Canada

Dr. Enrique Sanz Garcia of the Princess Margaret Cancer Centre talks about the most common symptoms of colorectal cancer.

As colorectal cancer diagnoses increase among younger Canadians, advocates are renewing calls to lower the age of routine screening - a move that could catch the disease earlier.

According to the Canadian Cancer Society, people under 50 in Canada have the likelihood of a diagnosis up to 2.5 times higher than previous generations of the same age.

In an interview with CTV Your Morning Thursday, Dr. Enrique Sanz Garcia, a medical oncologist at the Princess Margaret Cancer Centre, said the increase can be linked to several factors, including diet, sedentarism — a type of lifestyle characterized by prolonged, habitual inactivity — and alcohol intake, all of which changes the gut microbiome and impacts bowels.

Several groups, including the Canadian Cancer Society, are urging policymakers to lower the recommended screening age from 50 to 45, citing a growing body of evidence that more cases are being diagnosed earlier in life.

“Colorectal cancer is the fourth-most commonly diagnosed cancer in Canada and the second-leading cause of cancer-related death among Canadians, behind lung cancer,” the charity’s website outlined.

Current Canadian guidelines still recommend average-risk individuals begin screening at 50, typically using the fecal immunochemical test (FIT) which checks for hidden blood in stool samples - the most common symptom. A positive result is then followed by a colonoscopy.

Along with stool bleeding, Garcia said it’s important to look out for unexplained changes in bowel habits, like alternating diarrhea and constipation. Other symptoms include excessive fatigue, abdominal pain and unexplained weight loss.

“If you have a family member that has been diagnosed with an early onset colorectal cancer, which is earlier than 50 years old, you may qualify for an earlier screening,” Garcia said.

Despite the concerning trend, Garcia emphasized that treatment outcomes are improving.

“We are gaining a lot of survival and also we are curing more and more people,” he said pointing to advances in surgery, radiation and targeted therapies.

Nearly 67 per cent of people diagnosed with colorectal cancer will survive for at least five years after their diagnosis, according to the Canadian Cancer Society.

“We are also looking into exercise. We know that if you are diagnosed with a colorectal cancer after your surgery, doing exercise is going to improve your survival,” he added.

Garcia noted that at the Princess Margaret Cancer Centre, the charity is doing research on drugs to help with this type of cancer — many, Garcia said, are in the pipeline.