These 7 risk factors may lead to early-onset colorectal cancer in men

The seven factors that raise your risk of colorectal cancer if you’re under 50, according to major study – and THESE are the hotspots for the disease

  • Researchers at the University of Indiana spotted seven risk factors for disease
  • Study looked at 3,000 men aged 35 to 49 years old, a fifth of whom had cancer
  • READ MORE: The devastating toll of America’s mystery rise in colon cancer 

Scientists have revealed the seven factors that put young men at a higher risk of colon cancer – as experts scramble to find what’s causing a surge in the disease.

Once seen as a disease of the eldery, there has been a mysterious doubling in colon cancer cases among young adults in recent years. 

Researchers from Indiana University analyzed medical records of 3,000 men aged 35 to 49 years old — a fifth of whom were diagnosed with colon cancer.

The study, published recently in the journal Cancer Prevention Research, looked at the electronic health records of men from veteran medical centers and databases. 

To determine who was most at risk for early onset colon cancer — when the cancer occurs before the age of 50 — researchers examined the medical records against 67 factors – including diet, smoking status, and whether the men took over-the-counter medications.

The above graphic shows the seven factors scientists say raise the risk of colon cancer in younger men

Among all of the factors, scientists found seven that significantly raised men’s risk.

They were: being an older age (35 to 49 years old); alcohol use; a high insurance copay; having a first- or second-degree relative, such as a parent, sibling or aunt, with colon cancer; having a high disease burden, such as being a smoker; and not regularly using statins or non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen. 

Dr Thomas Imperiale, a gastroenterologist at the university and lead author on the study said the findings do not suggest all young men start to take NSAIDs or statins regularly because there is a risk of side effects, such as kidney damage.

He told that most men should instead ‘look at the other five factors to see which might increase their risk’.

Dr Imperiale said: ‘This study is important because it puts whether, and possibly how, to screen people who are younger than 45 years old — below the age for recommended colorectal cancer screening — on the table for consideration of screening.

‘We know that colon cancer at younger ages is on the rise, although the absolute risk is still much lower even in the 45- to 54-year-old age group.

‘Nonetheless, that doesn’t mean that we shouldn’t be trying to identify younger people at higher risk to screen them’. 

He added: ‘Clinicians might have a discussion with a patient and say that although screening guidelines don’t kick in until age 45 and you don’t have a family history, you do have some risk factors. Might you consider a noninvasive screening test?’

The above map, published in 2020 in the American Journal of Cancer Research, shows counties with the highest rate of early onset colon cancer in the US between 1999 and 2017 – and they’re mostly concentrated on the east coast and south east

Data from JAMA Surgery showed colon cancer is expected to rise by 90 percent in people ages 20 to 34 by the year 2030. Doctors are not sure what is driving the mystery rise

Researchers found that men with a relative with colon cancer were more than twice as likely as their peers to develop the disease.

Current alcohol use increased the risk 75 percent, and having a high insurance copay increased the likelihood by 61 percent.


Bowel, or colorectal, cancer affects the large bowel, which is made up of the colon and rectum.

Such tumors usually develop from pre-cancerous growths, called polyps.

Symptoms include:

  • Bleeding from the bottom
  • Blood in stools
  • A change in bowel habits lasting at least three weeks
  • Unexplained weight loss
  • Extreme, unexplained tiredness
  • Abdominal pain

Most cases have no clear cause, however, people are more at risk if they: 

  • Are over 50
  • Have a family history of the condition
  • Have a personal history of polyps in their bowel
  • Suffer from inflammatory bowel disease, such as Crohn’s disease
  • Lead an unhealthy lifestyle  

Treatment usually involves surgery, and chemo- and radiotherapy.

More than nine out of ten people with stage 1 bowel cancer survive five years or more after their diagnosis.

Unfortunately, only around a third of all colorectal cancers are diagnosed at this early stage. 

The majority of people come to the doctor when the disease has spread beyond the wall of the colon or rectum or to distant parts of the body, which decreasing the chance of being successfully cured of colon cancer. 

According to Bowel Cancer UK figures, more than 41,200 people are diagnosed with bowel cancer every year in the UK. It affects around 40 per 100,000 adults per year in the US, according to the National Cancer Institute.

A high disease burden raised the risk by 15 percent, while being slightly older raised the risk by nine percent.

The researchers suggested regularly taking NSAIDs and statins may lower the risk of the cancer because they effect the production of prostaglandins — a hormone involved in inflammation — in cells lining the colon.

Drinking alcohol can raise the risk by causing damage to cells in the colon and change in the gut microbiome.

A high insurance copay is a risk factor because it makes people less likely to seek medical attention, they said.

Colon cancer typically begins as a small growth called a polyp on the inner lining of the colon. 

Over time, cells in these polyps begin to grow uncontrollably, leading to the development of colon cancer.

People with colon cancer often don’t show symptoms until later stages — when the disease is more difficult to treat — which is why doctors urge everyone, especially young men, to get screened every decade beginning at 45 years old.

Symptoms of this cancer include rectal bleeding or blood in the stool, losing weight without trying, ongoing abdominal discomfort and a change in bowel habits. 

In the 1990s, just 11 percent of colorectal cancer cases were among people younger than 55 years old. 

But cases have more than doubled, with people in that age group now accounting for a fifth of all new diagnoses, according to the latest data from 2021.

Amid the spike in early onset colon cancer, researchers in a separate 2020 study found that 232 counties in the US were considered hotspots for the cancer. Ninety-two percent of the hotspots were in the south and eight percent were located in the Midwest.

It wasn’t clear why most hotspots were in the south, but scientists said this could be because of a larger African American population — with the disease disproportionately affecting this group — and higher poverty rates leading to less access to healthcare. 

If caught in the early stages, before it spreads to other areas of the body, the charity Fight Colorectal Cancer says nine-in-10 colon cancer patients will live beyond five years from their diagnosis. 

But, should the cancer not be detected until stage three — when it has spread to other areas of the body — this drops to 71 percent. At stage four, just 14 percent of patients live for another five years.

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