director of medical oncology

The alarm sounded in the United States a few years ago: is from 2022in fact, that experts have highlighted an increase in cancer cases among young people, before the age of 50. Since then, numerous studies have been published confirming the growing trend especially for the breast cancer and for that to colorectal. Llatest report from the American Cancer Societyhowever, adds a new, worrying piece: for colorectal cancer, it is not only new diagnoses that are increasing, but also deaths. Indeed, to be precise, this is thethe only neoplasm among young people for which deaths among those under 50 are increasingas he points out study just published in the scientific journal Jama. «It is now clear that colorectal cancer can no longer be defined as “a disease of the elderly” – he says Ahmedin Jemal, senior vice president of the American Cancer Society -. We must redouble our efforts to identify the cause of this tsunami of cancers in generations born after 1950.”

The latest statistics in America and the UK

In the most recent survey, researchers examined cancer mortality in the US between 1990 and 2023 and focused on most lethal pathologies in the population under 50 years of age: leukemia, brain, breast, lung and colorectal tumors.
In the time period taken into consideration (33 years), 1.27 million Americans under 50 died from cancer and, in general, mortality dropped by 44%. However, by analyzing the various tumors individually it emerged that i deaths decreased for all types of cancer except one, colorectal cancer, whose mortality has grown by 1.1% every year from 2005 onwards. While it fell annually by 0.3% for the brain, 1.4% for the breast, 2.3% for leukemia and 5.7% for the lung.
Breaking down the cases by sex, in 2023 colorectal cancer was the first in the ranking (as a cause of death from cancer under the age of 50) among men and second (after breast cancer) among women.
A a similar situation was recorded in the United Kingdomwhere data collected by Cancer Research UK indicates the colorectal cancer as the second most common cause of cancer death in Britainwith approximately 17,400 deaths per year (between 2021 and 2023 it accounted for 10% of all cancer deaths).
A research published in the British Medical Journal in 2024 had also highlighted a decline in cancer deaths among people aged 35-69 in the UKassuming that the credit should be distributed among various advances: the dissemination of smoking cessation programsl’increase in early diagnoses through screening programs el’arrival of new therapies.

The Italian situation

«The one in the colorectum which, with almost 49 thousand (48.706) new cases registered every yearAnd the second most frequent type of tumor in Italy and it is also second in the little coveted ranking of the most lethal, causing approximately 20 thousand deaths per year – remember Carmine Pinto, director of Medical Oncology at the Comprehensive Cancer Center of the AUSL-IRCCS of Reggio Emilia –. And if mortality is decreasing (thanks to early diagnosis programs, improvements in surgery and advances in therapies) and At the moment we have not noticed the increase in mortality emerging in Americathe number of cases is unfortunately growing, even in young people, before the age of 50despite well 9 out of 10 cases could be avoided only thanks to a simple and painless test which millions of Italians choose not to do.”

The life-saving test that too many Italians don’t take

In fact, almost 90% of colorectal cancers develop from adenomas that take years, on average about ten, to transform into malignant forms. It is in this time window that screening with the fecal occult blood test allows for an early diagnosis ed eliminate intestinal polyps before they have acquired dangerous characteristics and evolve into a malignant tumor. But over half of Italians do not take the opportunity. The exam is offered by the National Health Service to all citizens between the ages of 50 and 70 who receive, every two years, a letter from their local health authority with the invitation to go to the nearest pharmacy to collect a small container in which collect a stool sampleand then return it and receive the letter with the report at home within a couple of weeks.
“If he test for occult blood in feces (Sof) tests positive, the patient is sent for treatment colonoscopy which allows you to highlight and remove any precancerous lesion or to perform a biopsy – continues Mario Scartozzi, full professor at the University of Cagliari and director of medical oncology at the University Hospital of the Sardinian capital -. Screening allows us to intervene when the person does not yet have symptoms. The advantage is clear and so are the numbers: participating in screening reduces mortality from colorectal cancer by 20-30%, thanks to early diagnosis and the possibility of intervening immediately on lesions in the initial stage.”

Problems and solutions: symptoms not to be overlooked

What could be due to this increase in colon cancer mortality among those under 50 in America? «Various factors can have an influence – replies Pinto -: meanwhile, screening with the Sof test only involves the population from the age of 50, which makes early diagnosis more difficult. And then there is the question of lifestyles: the bad eating habitsthe sedentary lifestyle e obesity are on the rise among young Americans and this has a great impact, while in Italy we still enjoy a protective effect of the Mediterranean diet.” Protective effect increasingly threatened by overweight, by lack of physical activity and incorrect nutrition which are increasingly widespread in Italy too. “Furthermore colorectal cancer appears to have more aggressive characteristics at a young age and this makes it more difficult to treat – he concludes Scartozzi -. Making matters worse is the fact that those under 50 they often arrive late at the diagnosis Why they ignore the first signs such as for example frequent and persistent diarrhea, blood loss (bright red, together with feces or not), continuous abdominal pain and which persist for long periods.”