Like most cancers, colon cancer is primarily a disease of the elderly. In about 25% of the cases, however, risk groups are affected, in which the disease can sometimes occur much earlier. It is therefore important to think about colon cancer at a younger age if you have any symptoms and to rule it out if necessary. It should also be borne in mind that although bowel cancer usually only becomes noticeable in old age, it usually develops over a period of years to decades, i.e. it exists long before the first symptoms or even the diagnosis and can also be recognized in the intestine. Therefore, colon cancer prevention is of great importance here. With a colonoscopy and other preventive examinations, serious courses can be avoided and, with early detection, healing results can be achieved.
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According to statistics, 90% of patients are over 50 years old when they are diagnosed with colon cancer, and the majority of them are significantly older. However, that does not mean that colon cancer cannot occur at a younger age. This is the case, for example, in cases of intestinal cancer in close relatives or in certain diseases that increase the risk of colon cancer. These include ulcerative colitis, a chronic inflammatory bowel disease, intestinal polyps and various genetic diseases such as familial adenomatous polyposis (FAP), hereditary non-polypous colon carcinoma (HNPCC), Peutz-Jeghers syndrome and others. The mean age of onset varies with the disease. In the case of HNPCC, for example, patients are on average only 45 years old when the colon cancer first makes itself felt, rarely younger than 25 years. The mean age of onset of Peutz-Jeghers syndrome is 35 years.
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Unfortunately, there are also cases of colon cancer in adolescence, albeit rare. These can occur in connection with the genetic disease FAP (familial adenomatous polyposis). FAP occurs with a frequency of 1: 10,000 inhabitants in Germany and accounts for about 1% of all colon cancer cases. In this disease, a genetic genetic change in the genetic make-up leads to the formation of> 100 polyps in the large intestine during childhood. In almost 100% of cases, these then lead to the development of colon cancer, which usually develops from the age of 15. Therefore, the large intestine is often prophylactically removed in affected children and adolescents, usually between the ages of 10 and 15.
You can find out more about the various polypoid bowel diseases at: Symptoms of intestinal polyps
There are some known risk factors that favor colon cancer at a younger age. First of all, there are the genetic diseases that lead to the early onset of colon cancer. This includes hereditary non-polypous colon carcinoma (HNPCC) and the group of familial polyposis syndromes. An increased incidence of colon cancer in the family as well as close relatives who develop colon cancer at an early age also increase the risk of developing the disease before the age of 50. In addition, polyps in the intestine increase the risk of cancer, which is why those affected and close relatives of those affected have an increased risk of developing the disease at a young age if the polyps are not removed in time.
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You can find out more about the various polypoid bowel diseases at:
Chronic inflammatory bowel diseases also promote the occurrence of colon cancer at a younger age; especially ulcerative colitis, more rarely Crohn's disease.
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Lifestyle factors are currently being discussed as further circumstances that may favor early disease. What is certain is that a diet rich in meat and fat and low in fiber, a lack of exercise, obesity and long-term nicotine and alcohol consumption increase the risk of developing colon cancer. However, it is currently unclear whether they also cause the disease to occur earlier.
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Colon cancer at an advanced age can pose a number of problems. First of all, old age can make it difficult to recognize colon cancer. Since colon cancer, like most types of cancer, has no specific symptoms and only progresses insidiously, accompanying symptoms such as weight loss, exhaustion and reduced performance can be misinterpreted by both the doctor and the person affected as "normal" old age and thus delay the diagnosis.
Irregular bowel movements and constipation, other symptoms of colon cancer, are also common among the elderly. It is also important that hemorrhoids (the frequency of which also increases with age), like colon cancer, can lead to blood in the stool and therefore can mask a colon cancer. Aside from being diagnosed with colon cancer, old age can also make it difficult to treat for a number of reasons. On the one hand, the frequency of secondary diseases increases with age, such as CHD, high blood pressure, heart failure and diabetes mellitus, which in some cases drastically increase the risk of surgery and can therefore exclude surgery as a treatment option. In general, the rate of complications after an operation is higher in old age.
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Furthermore, physical reserves shrink in old age, which is why high doses of chemotherapy are no longer so well tolerated and more often lead to complications, which also limits the therapeutic options in this regard.
You might also be interested in: Colon cancer symptoms
The age at which colon cancer screening should begin varies and depends on the individual risk profile. In principle, for people who are not at risk, i.e. the vast majority of the population, early detection by means of an annual blood test in the stool from the age of 50 or a colonoscopy every 10 years from the age of 55 is recommended. For people at risk, the general rule is that colon cancer screening should take place earlier. First-degree relatives of a patient with colon cancer should ideally begin screening 10 years before the onset of the onset in the affected relative, but no later than 40 to 45 years of age. For those affected by genetic diseases, preventive care is tailored to the respective disease and usually begins around the age of 25. With FAP, however, due to the high risk, preventive care must be started from the age of 12.
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