When you think of colon cancer, you probably assume it’s a grandparent’s disease. But alarming new research shows that rates are rapidly rising in younger adults. If you were born in 1990, you have twice the risk of colon cancer and four times the risk of rectal cancer compared to someone born around 1950, according to a 2017 study published in the Journal of the National Cancer Institute.
“We’re all baffled and perplexed by this,” says Mark Pochapin, MD, professor of medicine and director of the division of gastroenterology and hepatology at New York University Langone Health.
Even more concerning, the study found that people younger than 55 are nearly 60 percent more likely to be diagnosed with late-stage disease than older adults. “When a 25-year old complains of blood in their stool or of a sudden change in their bowel habits, their primary care physician rarely thinks it could be cancer and doesn’t offer screening tests that can diagnose the problem, like a colonoscopy,” explains Edith Mitchell, MD, program leader of gastrointestinal oncology at the NCI-designated Sidney Kimmel Cancer Center at Jefferson Health in Philadelphia. “As a result, they’re not diagnosed until a much later stage. But it’s amazing how many young patients we now have. I would say that about 40 percent of my patients now are below age 50.”
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Colon or rectal cancer in younger adults is often attributed to other risk factors such as inflammatory bowel disease (Crohn’s disease or ulcerative colitis) or an inherited genetic syndrome like Lynch syndrome. But experts say that for many of the younger people they see, there’s no clear reason why it occurs.
“The rise in colorectal rates in younger adults has been parallel to the rise in the obesity epidemic, so it’s reasonable to think that that’s a factor,” explains David Liska, MD, a colorectal surgeon at the Cleveland Clinic. “Many of the risk factors for obesity are also risk factors for colon cancer, including a high fat diet that’s high in red meat and low in vegetables, as well as being sedentary. But I’m seeing a lot of younger patients who are at a normal weight and have a healthy lifestyle, so there have to be other reasons.”
One theory is that changes in the microbiome — the bacteria in your digestive tract — may be a factor, too. “Younger adults may have been exposed to a lot of antibiotics as children, and eat more processed foods than their parents did,” notes Pochapin. “That, in turn, may have altered their gut bacteria in ways that encourage cancer cells to grow.”
Here’s what you can do to protect yourself:
Know your family history
Up to 35 percent of people under the age of 35 who are diagnosed with colon cancer have a genetic mutation, compared to about five percent of all colorectal cancer cases, according to a 2015 study published in the Journal of Clinical Oncology. “There’s more and more evidence that colorectal cancer in younger people may be genetically different than colorectal cancer in older adults,” adds Liska. The two main familial conditions that raise risk of colorectal cancer are familial adenomatous polyposis (FAP), where hundreds of polyps cover the inner lining of the colon, and Lynch syndrome. But there may be many other genetic mutations that raise risk of colon cancer that we don’t yet know about, notes Liska.
If you have a family history of either colon cancer or colon polyps, then you should consult with a genetic counselor, advises Joy Larsen Haidle, spokesperson for the National Society of Genetic Counselors. They can determine whether it makes sense for you to have genetic testing to see if you have one of the common colorectal cancer-causing genetic mutations.
RELATED: What your mother's health reveals
12 things your mother's health says about you
12 things your mother's health says about you
Genetics play a big part in health conditions, so looking at your mom’s health can give you a clue what’s to come. This is especially true of complications that affect women more than men, like osteoporosis, a weakening of the bones. According to the CDC, osteoporosis affects 25 percent of women over 65, but only six percent of men—and recent research has found genetic variants predisposing some people to the disease. “There is strong evidence for an increased risk of osteoporosis if your mother had it,” says Todd Sontag, DO, a family medicine specialist with Orlando Health Physician Associates. “Many times this has to do with an inherited body structure of having lower body weight—less than 58kg [128 pounds] in adults or a BMI of less than 22.” Another risk factor is simply having a parental history (mom or dad) of hip fracture, he says. To mitigate these affects, make sure you’re getting enough calcium and vitamin D, and are living a healthy lifestyle. Here are the signs you’re not as healthy as you think.
Wonder if you’re going to get wrinkles or skin damage? Take a look at your mom’s face. Research has shown that male and female skin ages differently due to different hormones. “Your mother’s ability to break down collagen and the age when it started breaking down—the age when she got wrinkles—are passed down to you, as well as the pattern of collagen breakdown: Did she get wrinkles around her eyes first, or deeper lines around her mouth?” says dermatologist Purvisha Patel, MD, creator of Visha Skin Care. “Looking at pictures of her as she ages helps you understand how to combat your aging process.” Daily sunscreen and an anti-aging serum with retinol, vitamin C, ferulic acid, and vitamin E work to fight these genetic effects, she says. In addition, your skin type, passed down from your mother and your father, can affect your chances of sun damage and skin cancer. Those with fairer skin are most at risk. This is what dermatologists wish you knew about preventing wrinkles.
If you’re aware of what psychologists wish you knew about depression, you might already know that depression is diagnosed twice as often in women as in men, possibly as a result of hormonal fluctuations and women’s response to trauma and stress. “Another important aspect in gender studies shows that women have a more chronic course of depression than do men,” says psychologist Deborah Serani, PsyD, award-winning author of Living With Depression. “This means that females experience depression more often and for a longer duration of time than males.” Plus, it’s genetically linked, with Harvard Medical School experts noting that certain genetic mutations associated with depression occur only in women. So if your mother had depression, you should be on the lookout for symptoms, and get treatment if needed. “This is why knowing your family medical history is so important to become proactive about your own personal health,” Dr. Serani says. Here are the signs you’re healthy from every type of doctor.
Women are more likely to have the eye condition glaucoma, and are also more likely to be visually impaired or blind from it, says the American Academy of Ophthalmology (AAO). Thanks to menopause, women are also more likely to have dry eye syndrome, which frequently occurs with glaucoma. Plus, glaucoma runs in families—so if your mom (or dad) has it, be sure to let your eye doctor know, and get screened for it regularly. “You are at higher risk for developing glaucoma and [another eye condition] macular degeneration if your mother had it,” says Dr. Sontag. “Just like everything else, there are other lifestyle factors that contribute as well.” The AAO says to also avoid smoking to reduce your risk. Here’s how to improve your eyesight—without eating carrots!
There are multiple reasons you might have a migraine, and your mother is just one of them. According to the Mayo Clinic, women are three times more likely than men to have migraines, likely because of hormonal fluctuations. The National Headache Foundation notes that 70 to 80 percent of migraine sufferers have a relative who gets the debilitating attacks as well. “One of the main risk factors for migraines is family history of migraines,” Dr. Sontag says. “So yes, if your mother has migraines, you are more likely to develop them as well.” Emerging research is identifying how and why genetics play a role, with one large international study suggesting it may have to do with how the blood vessels function in the brain. But until we know more, if your mother suffers from migraines, you can try to reduce your risk by limiting other risk factors, like getting regular exercise and sleep, managing stress, and avoiding caffeine and any individual food triggers.
Nearly two-thirds of those with Alzheimer’s are women, according to the Alzheimer’s Association. The exact reasons why are yet unknown, but seem to go beyond the simple fact that women live longer than men. Researchers have also found genetic links for Alzheimer’s. “There are genetic alleles that have been identified that increase risk of developing Alzheimer’s disease,” Dr. Sontag says. “A maternal history does increase the risk.” The National Institute on Aging reports that if your mother or father has a genetic mutation for early-onset Alzheimer’s (which appears from your thirties to mid-sixties), there’s a 50/50 chance you will inherit it—and if you do, there is a strong possibility of developing the disease. If your mother had Alzheimer’s or other dementia, you can reduce your risk by exercising, eating a heart-healthy diet, maintaining social ties, and staying mentally active. These are the early signs of Alzheimer’s disease every adult should know.
Weight, body shape and fitness level
As with many other aspects of health, the condition of your body is partly genetic, partly environmental. So if your mother has a certain body type or weight, you may be more likely to have the same one—but that could be the result of learned behaviors, too. “While there is some solid research to support a maternal’s body shape and weight and its influence on her children, this is definitely not the only contributing factor,” Dr. Sontag says. “Many times, the lifestyle of the mother is what is learned and passed down to her kids, which includes the way she eats and exercises.” So if you grow up eating the same way as you mother, it’s not surprising if you develop a similar body. Likewise, the fitness level you can achieve is part hereditary, part lifestyle. “Genetics do play a strong role in our muscle make-up,” Dr. Sontag says. “No matter how much certain people train, they will never be as fast as Usain Bolt or Michael Phelps.” Still, if your mom is overweight, you can help avoid the same fate by eating healthy and exercising, with the goal of being the healthiest you can for your individual body.
Heart disease and diabetes
Women may believe they don’t have to worry about heart disease, but just like men they need to understand their genetic heart disease factors. Given genetic similarities in weight and body shape, you and your mother might also have a similar risk of heart disease, the number one killer of women, as well as type-2 diabetes. A recent study presented at the American Society of Human Genetics found that maternally inherited gene variants of how women store fat can affect their risk of type-2 diabetes. “There is strong evidence that if your mother has heart disease, type-2 diabetes, or strokes, that you are at a higher risk to develop them,” Dr. Sontag says. “The younger the age that the mother developed it tends to correlate with a higher risk in the children.” But again, there are lifestyle factors to consider. “If your mother had a heart attack at 50, but weighed 300 pounds, never exercised, and smoked, the risk may be completely related to her lifestyle,” he says. “You can’t have soda every day and ice cream every night and then use your family history as an excuse when you develop diabetes.” Still, if your mother (or father) had early heart disease, Dr. Sontag recommends a checkup with a cardiologist. These are the physical and emotional ways heart disease is different for women.
Pregnancy and fertility
If you’re looking to see what your pregnancy experience will be like, ask your mother about carrying you. “Gestational diabetes is more common in women who are risk for adult onset diabetes, which does run in families, so if you have a strong family history of diabetes, you are at increased risk for gestational diabetes,” says Pamela Berens, MD, an OBGYN with McGovern Medical School at UTHealth and Children’s Memorial Hermann Hospital. In addition, “preeclampsia is more common in women who have had high blood pressure, and high blood pressure may be inherited.” A Norwegian study showed severe morning sickness, or hyperemesis gravidarum, may be inherited as well. As for issues getting pregnant, most causes of infertility and miscarriage are not genetic—but some may be. “There appears to be an increased risk of endometriosis in first-degree relatives of women with endometriosis,” Dr. Berens says. “Rarely, some women with recurrent miscarriages can have an inherited chromosome issue that makes miscarriage more common, and genetic testing can be done.” For some other infertility conditions, such as PCOS, it’s not clear yet whether genetics are at play.
You should also ask your mom if she suffered from postpartum depression after pregnancy. Like other aspects of mental health, it may be passed from mother to daughter. “Studiesshow that postpartum depression is genetically linked,” Dr. Serani says. “Your risk for PPD increases if your mother, or another family member—sister, aunt—has experienced it.” One small study from Johns Hopkins found specific chemical alterations in two genes that, when they occur during pregnancy, can predict whether a woman will develop postpartum depression with 85 percent accuracy. The researchers hope this will eventually lead to a blood test that can give pregnant women a better indication of their risk—but for now, knowing your family history is important. “Ask your mother about her postpartum experiences,” Dr. Serani says. “This can informally clue you in to whether or not depression is a risk factor for you.” Here are seven dangerous postpartum depression myths.
Breast and ovarian cancers
Awareness on the genetic link of breast and ovarian cancers may be due in part to Angelina Jolie, whose mother died from breast cancer. After discovering she carried the BRCA1 gene, the actress underwent a preventive mastectomy, reducing her breast cancer risk from 87 percent to under 5. “The gene mutations that are most commonly associated with hereditary breast and ovarian cancer are the BRCA1 and 2 gene mutations,” Dr. Berens says. “If you have a suspicious family history—for example, if you have multiple family members with breast or ovarian cancer, if the breast cancer happened at an early age, or if the same family member had both cancers—it is more suspicious that you could have a genetic tendency.” Talk to your doctor about your individual risk if you mom or other female relatives had one of these cancers, and consider seeing a genetic counselor for genetic testing.
Studies have shown that the age at which your mother went through menopause will be partly responsible for when you do. In addition, if your mother went through menopause early, you should let your doctor know. “Premature ovarian insufficiency, before 40, can be caused by a number of conditions, and some of these conditions can be inherited—for instance women who are fragile X carriers,” Dr. Berens says. Fragile X is a gene mutation linked to the X chromosome, and it can trigger anxiety, hyperactivity, and intellectual disability. As for menopause symptoms such as hot flashes and night sweats, Dr. Berens says scientists are trying to clarify if there’s a genetic link. The first study of its kind in humans, from UCLA, might have found a related gene variant, but more research is needed. Next, check out what your sweat says about your health.
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Stay at a healthy weight
People who are overweight before age 30 have a higher chance of developing colon cancer later in life, according to a 2018 review published in the International Journal of Cancer. Another 2018 study published in JAMA Oncology found that women in their 20s, 30s and 40s who were either overweight or obese had up to twice the risk of developing colorectal cancer before age 50, compared to women of normal weight.
It’s also important to eat a diet rich in fruits, vegetables, and whole grains and one that’s low in red or processed meats, adds Pochapin. These steps have all also been shown to lower colon cancer risk, as well as getting regular exercise, not smoking and limiting alcohol.
Make sure you’re up to date on screenings
The American Cancer Society now recommends all adults begin colon cancer screening at age 45. While the gold standard is a colonoscopy — a test where your doctor uses a flexible, lighted tube to check for polyps in your rectum and colon while you’re under sedation — you can also do an at-home screening test, known as a fecal immunochemical test (FIT), which checks for hidden blood in your stool, on your own. (Just keep in mind that if the test comes back positive, you’ll need to have a colonoscopy.)
But if you have a family history of colon cancer, you may need to start even earlier: “We recommend then beginning at age 40, or 10 years younger than when the youngest person in the family was diagnosed with cancer,” explains Pochapin.
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20 superfoods for weight loss
20 superfoods for weight loss
An apple a day can keep weight gain at bay. People who chomped an apple before a pasta meal ate fewer calories overall than those who had a different snack. Plus, the antioxidants in apples may help prevent metabolic syndrome, a condition marked by excess belly fat or an "apple shape."
Eat more Apples are the ideal on-the-go low-calorie snack. For a pie-like treat, chop up a medium apple and sprinkle with 1/2 tsp allspice and 1/2 tsp cinnamon. Pop in the microwave for 1 1/2 minutes.
Beef has a rep as a diet buster, but eating it may help you peel off pounds. Try to consume local organic beef; it's healthier for you and the environment.
Eat more Grill or broil a 4-ounce serving of top round or sirloin; slice thinly to top a salad, or mix with veggies for fajitas.
Dig in to eggs, yolks and all: They won't harm your heart, but they can help you trim inches.
Eat more Omelets and scrambles are obvious choices, but if you can't cook before work, bake a frittata on Sunday; chill it and nuke slices for up to a week. An easy recipe: Vegetable Frittata
This green has been buzzy lately. One raw chopped cup contains 34 calories and about 1.3 grams of fiber, as well as a hearty helping of iron and calcium.
Eat more Mix chopped raw kale into cooked black beans. Or slice kale into thin strips, sauté it with vegetable broth and top with orange slices. Make it a meal by tossing the mix with quinoa.
All oats are healthful, but the steel-cut and rolled varieties (which are minimally processed) have up to 5 grams of fiber per serving, making them the most filling choice. Instant oats contain 3 to 4 grams per serving.
Eat more Instead of using breadcrumbs, add oats to meat loaf—about 1 cup for a recipe that serves eight. Or try this recipe for turkey and oatmeal meatballs.
Lentils are a bona fide belly flattener. Eating them helps prevent insulin spikes that cause your body to create excess fat, especially in the abdominal area.
Eat more There are many varieties of lentils, but red and yellow cook fastest (in about 15 to 20 minutes). Add cooked lentils to pasta sauce for a heartier dish. Their mild flavor blends right in, and because they're high in protein, you can skip meat altogether.
These chewy, tart berries have a hunger-curbing edge over other fruit: 18 amino acids, which make them a surprising source of protein. Snack on them mid-afternoon to stay satisfied until dinner. The calorie cost? Only 35 per tablespoon.
Eat more Mix 1/4 cup of the dried berries (from health food stores) with 1/4 cup raisins and 1/4 cup walnuts for a nourishing trail mix. Or for dessert, pour 1/4 cup boiling water into a bowl with 2 tbsp dried berries; let sit 10 minutes. Drain, then spoon over 1/2 cup lowfat vanilla frozen yogurt.
Not only do fish fats keep your heart healthy, but they shrink your waist, too. Omega-3 fatty acids improve insulin sensitivity—which helps build muscle and decrease belly fat. And the more muscle you have, the more calories your body burns. Opt for wild salmon; it may contain fewer pollutants.
Eat more You don't need to do much to enhance salmon's taste, says Sidra Forman, a chef and writer in Washington, D.C. "Simple is best. Season a fillet with salt and pepper, then cook it in a hot pan with 2 tsp oil for 1 to 3 minutes on each side."
Swap plain noodles for this hearty variety; you'll slip into your favorite jeans in no time. Buckwheat is high in fiber and, unlike most carbs, contains protein, so it's harder to overeat buckwheat pasta than the regular stuff.
Eat more Cook this pasta as you do rice: Simmer it, covered, over low heat. For a light meal, toss cooked buckwheat pasta with broccoli, carrots, mushrooms and onions. Or make buckwheat crepes using our tasty recipe.
All berries are good for you, but those with a blue hue are among the best of the bunch. They have the highest antioxidant level of all commonly consumed fruit. They also deliver 3.6 grams of fiber per cup.
Eat more Instead of topping your cereal with fruit, fill your bowl with blueberries, then sprinkle cereal on top and add milk or yogurt.
Adding this spread may lower bread's glycemic index (a measure of a food's effect on blood sugar). A study from the University of Toronto found that people who ate almonds with white bread didn't experience the same blood sugar surges as those who ate only the slice.
Eat more Try it for a change from peanut butter in sandwiches, or make a veggie dip: Mix 1 tbsp almond butter with 2 tbsp fat-free plain yogurt. Or add a dollop to oatmeal for flavor and protein.
The juice gets all the hype for being healthy, but pomegranate seeds deserve their own spotlight. In addition to being loaded with folate and disease-fighting antioxidants, they're low in calories and high in fiber, so they satisfy your sweet tooth without blowing your diet.
Eat more Pop the raw seeds on their own (many grocery stores sell them preshucked) as a snack at your desk. Use them in salads instead of nuts. They're especially delicious on raw baby spinach with lemon-poppy seed dressing. For another take on the seeds, use our easy recipe for sweet and spicy pomegranate salsa.
One reason to spice up your meals: You'll crank up your metabolism. A compound in chiles called capsaicin has a thermogenic effect, meaning it causes the body to burn extra calories for 20 minutes after you eat the chiles.
Eat more Stuff chiles with cooked quinoa and marinara sauce, then roast them. To mellow a chile's heat, grill it until it's almost black, peel off charred skin and puree the flesh. Add the puree to pasta sauces for a one-alarm kick. Or stir red pepper flakes into any dish you enjoy.
Dietitians often refer to plain yogurt as the perfect food, and for good reason: With its trifecta of carbs, protein and fat, it can stave off hunger by keeping blood sugar levels steady.
Eat more Use lowfat plain yogurt instead of mayonnaise in chicken or potato salad, or top a baked potato with a bit of yogurt and a squeeze of lemon juice. You'll save 4.7 grams of fat per tablespoon. Look for Greek yogurt, which has more protein than other versions.
Curbing hunger is as easy as piling your plate with this whole grain. It packs both fiber (2.6 grams per 1/2 cup) and protein, a stellar nutrient combo that can keep you satisfied for hours.
Eat more Serve quinoa instead of rice with stir-fries, or try this take on a scrumptious hot breakfast: Cook 1/2 cup quinoa in 2/3 cup water and 1/3 cup orange juice for 15 minutes. Top with 1 tbsp each of raisins and chopped walnuts.
These tiny fish are the unsung stars of the sea. They are high in protein and loaded with omega-3s, which also help the body maintain muscle. And they're low in mercury and high in calcium, making them a smart fish pick for pregnant women. If the flavor doesn't appeal to you, soak them in milk for an hour; it will remove any trace of fishiness.
Eat more Use sardines in recipes you like that call for anchovies, including Caesar salad and stuffing. Or make a sardine melt: Toss whole sardines with chopped onions, fresh herbs and diced bell peppers. Put the mixture on top of a slice of pumpernickel or rye bread, cover with a slice of cheddar and broil.
You can use this herb, a staple in French cooking, in place of salt in marinades and salad dressings. Plus, tarragon lends a sweet, licorice-like flavor to bland foods.
Eat more Rub 2 tbsp dried tarragon on chicken before baking or grilling. Or make a tasty dip by mixing 1 tsp chopped fresh tarragon into 4 oz lowfat plain yogurt and 1 tsp Dijon mustard, recommends Jacquelyn Buchanan, director of culinary development at Laura Chenel's Chèvre, afromagerie in Sonoma, California.
Drop that rubbery lowfat cheese and pick up the real stuff. Women who had one serving of whole milk or cheese daily were less likely to gain weight over time, a study in The American Journal of Clinical Nutrition finds.
Eat more Grate Parmesan over roasted vegetables. Or snack on a 1-ounce portion with an apple or a pear.
Don't let the fat content of an avocado (29 grams) scare you—that's what makes it a top weight loss food. The heart-healthy monounsaturated fat it contains increases satiety. And it's terrific party food.
Eat more Add avocado to your sandwich instead of mayo for a creamy texture and a shot of flavor. Avocados do contain a lot of calories, so it's best to watch your portions. One easy way to do it: Try Wholly Guacamole's 100-calorie fresh guacamole packs (WhollyGuac.com). They're easy to pack in your lunch and pair with chopped vegetables.
Like avocados, olive oil has healthy fat that increases satiety, taming your appetite. But that's hardly its only slimming feature. Research shows it also has anti-inflammatory properties. Chronic inflammation in the body is linked to metabolic syndrome.
Eat more Drizzle your salad with olive oil and you'll increase the antioxidant power of your veggies, a study published in the British Journal of Nutrition notes. Or toss pasta with a few teaspoons of olive oil, fresh basil and sautéeed garlic.
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Listen to your body
Most younger adults diagnosed with colon cancer have it first develop in the lower part of the bowel, which usually presents as rectal bleeding, notes Pochapin. “Any rectal bleeding should be taken seriously and requires a colonoscopy,” he stresses.
But you should also be alert for any changes in bowel function — that means diarrhea or constipation that lingers for more than a few days. “One of the most common signs is stool getting thinner and narrower, almost like a pencil caliber,” adds Pochapin. “This is because the colon cancer starts narrowing down the inside of the bowel.”
If you feel like your doctor is ignoring your concerns, get a second opinion. “My 15-year-old patient complained of symptoms for months and was told repeatedly that they were just due to her starting menstruation,” says Mitchell. “It wasn’t until she ended up in the ER requiring immediate surgery that she was properly diagnosed.”