One in nine bowel cancer patients in Australia is now aged under 50, with early research suggesting this may be linked to modern diets and lifestyle.

Susie Burrell

Once considered a disease affecting “old people”, and one to pay attention to only when you reach the age of 50, bowel cancer has emerged as the deadliest cancer for Australians aged 25-44.

One in nine bowel cancer diagnoses in Australia is in a patient aged under 50, data from Bowel Cancer Australia shows.

According to the Royal Australian College of General Practitioners, global rates have been rising over the past few decades. Of particular concern is the incidence in earlier years, with a 266 per cent increase in rates among adolescents and young adults over the past 30 years.

Such dramatic rises suggest that lifestyle rather than genetic disposition can be a cause. Slowly, researchers are coming to understand how diet and lifestyle can cause such profound issues in the gut.

Most Australians do not get anywhere near the optimal intake of 30g of dietary fibre each day.
Most Australians do not get anywhere near the optimal intake of 30g of dietary fibre each day.Edwina Pickles

What is bowel cancer?

Bowel or colorectal cancer develops when the wall of the large intestine grows abnormal cells. It can be found in the lining or mucosa of the intestine wall, or from growths known as polyps on the bowel wall that turn into cancerous cells, which can then spread to other parts of the body.

Bowel cancer was previously regarded as relatively slow-growing type. In recent years, however, specialists have observed faster growing cancers presenting more frequently in younger people.

What can increase the risk of bowel cancer?

As with many different types of cancer, bowel cancer has a strong genetic component. A family history of bowel cancer, especially on both sides, significantly increases the likelihood of developing the disease. But lifestyle is a factor too: being overweight or obese, having low vitamin D levels, excessive alcohol consumption and having type 2 diabetes all increase the risk.

From a diet perspective, a high intake of red meat and processed meats such as ham and bacon, which contain nitrates, can damage intestinal walls. The World Health Organisation has highlighted these as foods to actively limit in the diet.

Miso salmon, soba noodle and avocado salad.
Miso salmon, soba noodle and avocado salad.Sarah Pound

The latest on diet and bowel cancer risk

Consuming adequate amounts of dietary fibre has a protective effect on the health of the bowel. Getting enough fibre means that waste is more efficiently moved through the digestive tract, leaving less time for mutant cells to grow and infiltrate.

Researchers from Ohio State University have noted that up to 70 per cent of presenting colon cancers in young people occur in the left side of the colon.

“In those over age 50, colon cancer can occur equally on the right or left side. This could indicate that the cause [of cancers in younger people] is something in the microbiome — the bacterial content of the colon. Species located in different areas of the digestive system vary,” Ohio State colorectal surgeon Matthew Kalady says.

At the American Society of Clinical Oncology meeting this month, the Ohio researchers noted an association between the low-fibre and high-sugar diets of younger patients with colon cancer.

Stressing the research was in its early stages, they said a bacteria associated with such a diet pattern had an inflammatory effect in the digestive tract, potentially increasing the risk of cancer cells growing.

TheNutrients journal published data showing more than 80 per cent of Australians do not get anywhere near the optimal daily intake of 30g of dietary fibre.

Do you get enough fibre?

To get 30g of dietary fibre, we need to consume five serves of vegetables and two pieces of fresh fruit as well as wholegrain breads and cereals. Breads and wraps bought as take-aways are generally white or sourdough, so swapping to wholegrain breads and increasing daily vegetable intake is one of the simplest ways to reduce the risk of developing colon cancer, regardless of age.

Signs and symptoms

For prevention and early management of bowel cancer, it is essential to pay more attention to what is going into, and on with, your gut. Most importantly, pay attention to changes in your bowel habits.

Any unexplained gut pain, weight loss, constipation or diarrhoea should be thoroughly investigated, at any age. With early detection, bowel cancer has one of the highest rates of full recovery.

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