A shocking and worrying trend has emerged in recent years: the rise of colon cancer among young adults. This alarming development has left researchers and medical professionals scrambling for answers.
Imagine the shock and disbelief Umanita felt when, just two weeks after a minor belly pain, she received a colon cancer diagnosis. She became an unwilling member of a growing club, a club no one wants to join, of young adults facing a disease once considered an elderly person's concern.
"It felt like a nightmare, an unreal experience," Umanita shared, capturing the surreal nature of her journey.
The statistics are eye-opening: in 2019, one in five new colorectal cancer diagnoses, a staggering 145,000 cases, were in people under 55. This is a significant increase from 1995, where the rate was only half as high. By 2024, colon cancer had become the leading cause of cancer deaths in men under 50 and the second-leading cause for women in the same age group.
Scientists are now turning their attention to potential causes, with diet and ultra-processed foods emerging as key suspects.
Health Secretary Robert F. Kennedy Jr. has been vocal about the dangers of these foods, describing them as "poison" and a major contributor to health issues in the country. In a recent move, Kennedy issued new dietary guidelines, advocating for a significant reduction in highly processed foods loaded with salt and sugar.
Boston's academic medical centers are leading the charge in understanding the role of these foods. Researchers are utilizing data from patients like Umanita to investigate why seemingly healthy young adults are developing such devastating cancers.
A recent study by MGB researchers has found a link between the consumption of ultra-processed foods - those pre-made, high-sugar, high-salt, high-fat, and additive-laden foods - and the development of precancerous polyps.
"We've been looking at known risk factors for older adults, but we know that's not the whole story," said Dr. Andrew Chan, one of the study's authors from Mass. General. "There's still so much more to uncover."
As promising as this research is, experts are still baffled by the high numbers of colorectal cancer in young adults. While some cancers have clear causes, like smoking and lung cancer or HPV and cervical cancer, colorectal cancers are likely a complex interplay of multiple factors.
Everyone close to Umanita seems to have a theory, given her lack of obvious genetic predisposition. Some blame her diet, others microplastics, and a few even point to the COVID-19 vaccine, despite the lack of evidence.
"Of course, that's not true," Umanita clarified. "They're just searching for an answer, trying to understand why a girl my age would get cancer, but I don't have that answer either."
Umanita's journey took an emotional turn when she returned home from her initial hospital stay. The hospital, with its constant tests and blood draws, had been a distraction. She dreamed of simple pleasures - grilled cheese, tomato soup, and special lemon Twizzlers - while being fed through a tube.
Once home, Umanita began her cancer treatment, opting to continue her studies and work as a teaching assistant rather than taking time off. She wanted to keep her mind occupied, refusing to let her diagnosis define her days.
As a psychology major, Umanita had learned about cancer in her science classes, but now the disease had a new, personal meaning. Her life continued as normally as possible, balancing chemotherapy and her academic workload. Every other week, she traveled to her parents' home on the North Shore and then to Boston for her classes and chemotherapy infusions.
She consulted a dietitian, wrote a paper on the links between cancer and diet, and swore off red and processed meats. She found purpose in participating in research at a top academic medical center, contributing surveys and tissue samples.
Dr. Andrew Chan, the MGH physician and co-author of the ultra-processed foods study, remembers a patient who came in with severe abdominal pain about 20 years ago. She was under 40 and had colon cancer. She was caring for young children and an aging mother, a network of people depending on her.
"When a young person faces a disease like cancer, it hits you harder," Chan said.
Other doctors also noticed an increase in colon cancer among middle-aged and young adults around that time, but the reasons were unclear.
Some of the increased diagnoses can be attributed to screening. An American Cancer Society study found that screening in the 45 to 49 age group increased by 62% from 2019 to 2023 after the group lowered its age recommendation. However, this doesn't account for the rise in colon cancer among those under 45. Younger patients often ignore subtle symptoms like pain, irregular bowel movements, and bloody stool, and by the time they seek help, they are sicker than their older counterparts with the same disease.
Established risk factors for colon cancer include being overweight or physically inactive, and in older adults, diets high in red meat and sugar. But do these factors also apply to younger adults?
Chan and other researchers are working tirelessly to find answers, studying healthy individuals over time and those like Umanita who are diagnosed with early-onset colon cancer.
In a recently published study in JAMA Oncology, Chan's team found that soda, chips, and other ultra-processed foods could be partially responsible for the polyps that lead to colon cancer. They analyzed the diets of nearly 30,000 women under 50 and found that those with the highest intake of ultra-processed foods had a 45% higher risk of developing precancerous polyps in the colon compared to those with the lowest intake.
Dr. Lilian Chen, chief of colorectal surgery at Tufts Medical Center, referred to herself as a "surgical plumber" and was not surprised by the food-cancer connection. "Whatever goes into our body, our colon processes it," she said.
However, ultra-processed foods alone cannot explain the rise in colon cancer. Chan sees many patients with healthy diets and active lifestyles who still develop the disease.
"These standard risk factors don't apply to everyone," Chan emphasized.
The next big question is whether years of unhealthy eating can be reversed. This is what Chan plans to investigate next.
In March, after surgery and 12 rounds of chemo, Umanita rang the bell at Mass. General, a symbol of completing cancer treatment. She thought the hard part was over, but the transition back to normal life caught her off guard.
Dr. Aparna Parikh, Umanita's oncologist, described their most emotionally challenging visit as being in October, more than six months after her last chemo cycle.
"We need to keep a close eye on her and support her mental health because she's not okay, even though she's been strong and resilient this whole time," Parikh reflected.
During treatment, Umanita's life was moving at a rapid pace, but then it suddenly stopped. She no longer had her diagnosis to focus on, and her youth meant few around her could truly understand her experience.
She faced her fears and survived, but the worry of cancer's return lingers. Umanita sees her life now as divided into two parts: before cancer and after.
"For me, it's not the end of a journey," Umanita said. "It's the beginning of something else."
Umanita may never know why she got cancer, but she has made changes to lower her future risk. She exercises regularly, eats more fiber, and avoids red meat, except for the occasional Beef Wellington. She understands that there are likely other factors beyond her control.
"It's complicated and multifaceted. Everything is, if you really examine it closely," Umanita said. "It doesn't bring me solace, but it's the truth."
What do you think? Are there other factors we should consider? Share your thoughts and experiences in the comments below.
