Why are young people more prone to colon cancer in India?

New Delhi: India is seeing a significant rise in the number of colon or colorectal cancer in young adults, said doctors on Monday.

They blamed late diagnoses, lack of screening and Western diet that is more processed and calorie-rich food as the major reasons for the rise.

Speaking to IANS, Dr Rajeev Jayadevan, co-chairman of the National Indian Medical Association Covid Task Force, said that the majority of people in India get diagnosed with colorectal cancer in later stages. Lack of better screening facilities and awareness about the disease among the people are the key reasons, he said.

“Many people do not have access to testing facilities or specialist doctors who do such procedures. Unlike Western nations, we do not have organised screening programmes in India. In addition, people tend to ignore red flag symptoms such as bleeding while moving bowels or get misdiagnosed as haemorrhoids or ‘piles’ by their doctor. Sometimes they go to local indigenous practitioners initially. As a result, they often present late,” said Dr Rajeev, a Kochi-based gastroenterologist.

A 2023 study by the Delhi State Cancer Institute (DSCI) showed that from people above the age of 50, the incidence of colon cancer is now increasingly shifting to young adults between ages 31 to 40 years.

“Young onset colonic cancer is now seen to be on the rise in our country. In fact, some recent statistics have shown that almost one-third of colonic cancer which is affecting the country in India is seen in the younger age group,” Dr. Amit Maydeo, Chairman of Institute of Gastro Sciences, Sir HN Reliance Foundation Hospital, told IANS.

“And the main reason is that the youngsters are adopting more and more of a Western lifestyle and their food is also now a calorie-rich diet and more processed food,” he added. He also blamed habits like smoking and alcohol; obesity and inflammatory bowel disease as the reasons for the rise in colon cancer.

Dr Rajeev said that in developed nations colonoscopy has been the standard screening procedure. But in India, this is not widely accepted or practised.

“We are not doing enough to prevent colorectal cancer in India. Waiting for symptoms to appear is the wrong approach, as many cases have no symptoms until late stages,” he lamented.

Family history and eating non-vegetarian have long been known as major risk factors.

But Dr Rajeev told IANS that “contrary to popular belief, there are studies that show it is equally common among vegetarians. Although it is more likely to occur among someone with a family history of similar cancer, over 90 per cent of cases have no known family history. Hence if we only look at these subsets of people, we will be missing the vast majority of colorectal cancers. A change in approach and mindset is required.”

He also suggested offering “opportunistic screening colonoscopy to those who are interested in reducing their own individual risk of cancer,” starting from the age of 40.