Colorectal cancer rates have been falling among older adults in the U.S. but rising among younger adults, National Cancer Institute statistics show.
Researchers can point to some risk factors -- obesity, physical inactivity, and smoking, for example – but those alone don’t explain why so many Americans under 50 are being stricken with the disease.
One of those affected is Luzerne County resident Aimee Kearney, who was diagnosed last year at the age of 44.
“I couldn't believe it. At first, I was shocked. I thought this can't be happening to me like it was an out of body experience. But then I immediately, like went into survival mode. I have two daughters, I had to show them that it's not the end,” Kearney said.
March is National Colorectal Cancer Awareness Month, and Kearney shared her story before an audience at King’s College in Wilkes-Barre last week. She was joined by a panel of doctors who discussed the causes and treatment of colorectal cancer, with a heavy emphasis on testing and prevention.
Kearney is the daughter of Wilkes-Barre Mayor George Brown, who worked with academic and health care experts to put together the event.
"What I did was I reached out to every college in the area. And we also reached out to the guys from School of Medicine, General Hospital, everyone overwhelmingly said we want to be part of this program, mayor," Brown said.
The panel was moderated by Dr. Thomas Mangan, a Wyoming Valley native and emeritus gastrointerologist at the Mayo Clinic in Rochester, Minn.
Participating were physicians Julie Jiang, Thomas Erchinger, Ahmad Hanif and Duane Deivert from Geisinger; and from Commonwealth Health, physicians Karthik Penumetsa and Essam Almeky.
About 100 people attended the event, which included a question-and-answer session.
Sobering statistics
One in 24 Americans are at risk for colon cancer, the panelists explained, with 150,000 new cases diagnosed each year and 50,000 deaths. In Pennsylvania, the risk is 1 in 22.
For the U.S. as a whole, that translates into 36.6 cases per 100,000 people, the presentation stated. For Pennsylvania, it's 40.7 cases per 100,000. In Luzerne County, where Aimee lives, it's 47 cases per 100,000 people.
Since 2000, the cases and deaths have decreased overall nationwide and in Pennsylvania — but not for those age 20 to 44. In that group, the doctors said, the rate of cases has increased from 6.6 to 10.1 per 100,000 people nationwide.
The panelist doctors explained that there are not yet any definitive answers for the increase in younger Americans. While behaviors such as smoking, drinking alcohol and eating processed meats may be contributing factors, what is emerging may also be a different biologically from the cancers seen in older adults.
The key to beating colon cancer, they said, is prevention.
"At the end of the day, just get the colonoscopy," Commonwealth's Penumetsa said.
Screening for colorectal cancer typically is recommended for those 45 and older, the doctors said, unless there are "alarming symptoms" or risk factors.
Those risk factors can include age, family history, genetic cancer syndrome, inflammatory bowel disease, abdominopelvic radiation, co-morbid medical conditions, and diet/lifestyle.
Symptoms can include persistent abdominal pain, bloating, rectal or abdominal masses, rectal bleeding, and iron deficiency anemia, the doctors said.
Kearney's experience
In the summer of 2022, Kearney developed an unexplained inability to swallow. Bloodwork revealed low hemoglobin levels, and her doctor sent Kearney for an emergency blood transfusion. That was followed by an endoscopy and colonoscopy.
The tests revealed a rectal tumor.
“I was sad, but I wasn't angry. I wasn't questioning why me,” she said.
While there was some family history, Kearney said testing showed her cancer was not DNA-related.
Kearney’s treatment included intensive surgery, resulting in a permanent colostomy, as well as oral and IV chemotherapy and radiation.
The doctors on the panel explained that most surgeries for colon and rectal cancer do not require a colostomy, and such surgeries increasingly can be performed with minimally invasive techniques. They also pointed out that newer treatment forms, including immunotherapy, are under development.
"I'm doing really great. I'm still recovering from surgery," Kearney said. "So I didn't get my all clear yet. But I'm back to work. And I'm feeling great. So yeah, I'm getting there a little by little, every day is a little easier."
The doctors also stressed that the purpose of screening is to detect polyps in the early stages so they can be removed before they become cancerous.
Kearney and her dad have a simple message for anyone who will listen.
"Don't be afraid, get tested. And that's the main thing here. Get tested," Brown said after the panel discussion. "Our goal was to save one life or to at least help someone as they go through what Amy went through."
To learn more
You can learn more about Aimee's story, the presentation, and hear from the doctors at https://www.wilkes-barre.city/colorectalcancerawareness.
