In general, it is uncommon to be diagnosed with colon cancer under the age of 30 if there is no family history. However, there are two well-recognized hereditary syndromes in which cancer can develop in young people. The first is Familial Adenomatous Polyposis (FAP). This is a disease in which affected people develop hundreds to thousands of precancerous polyps in the colon. Unless the colon is removed, every one of these patients will develop colon cancer, usually by their late 30s. The disease is inherited directly from an affected parent (autosomal dominant inheritance), and the average age for polyp development in this syndrome is the mid-teens. If a family is known to have FAP, the affected parent and at-risk children may be screened for a gene mutation with a genetic test. Children who do not or cannot have genetic tests should start having sigmoidoscopies or colonoscopies at about ten or 12 years old and repeated every six to 12 months. Once numerous polyps are found, surgery to remove the colon is planned.

The other syndrome is Hereditary Non-Polyposis Colorectal Cancer (HNPCC), or Lynch syndrome. In this disorder, cancers also occur early and develop from polyps. The disease can also present at a later age. The standard recommendation for at-risk children of affected families is colonoscopy beginning at age 25 and repeated every two years. Genetic testing may also be helpful. There are specific recommendations for children in families with high rates of colon cancer. However, the specific syndrome must be known. It is very important for children from families with FAP or HNPCC to be seen by experts who have experience with these syndromes and where genetic counseling and testing services are available.

Colon Cancer Statistics

Each year, more than 145,000 people are diagnosed with colon cancer in the United States and almost 50,000 people die from the disease. It is the third-leading cause of cancer-related deaths in the U.S. in both men and women. A recent report showed that screening has helped to reduce incidence and death rates from the disease. The study, by the American Cancer Society, the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries, on the status of cancer in the U.S. showed that from 1975 to 2000, the incidence rate dropped 22 percent and the death rate dropped 26 percent. These declines reflect the impact of increased colon cancer screening, changes in lifestyle and diet, and improved treatments. The report stated that "screening appears to have had a considerable impact on reducing CRC incidence and mortality."

While this is good news, it could be even better. Many people who should be screened are not actually being screened. The report also noted that if current trends persist, death rates from colon cancer could decline 36 percent by 2020 and there could be as much as a 50 percent decline if there are further improvements in risk factor control, screening and treatment.

Colon Cancer Symptoms

Colon cancer is often present in people without symptoms, making prevention and screening for colon cancer very important. A polyp may be found and removed even before it becomes cancerous or presents with symptoms; once symptoms appear, a colonoscopy is performed to aid in diagnosis, rather than screen for disease. The following signs or symptoms, however, might indicate colon cancer: blood in stools, narrower than normal stools, unexplained abdominal pain, unexplained change in bowel habits, unexplained anemia, and unexplained weight loss. These symptoms may be caused by other benign diseases such as hemorrhoids, inflammation in the colon or irritable bowel syndrome. The presence of these symptoms for more than a few days is an indication to talk with a gastrointestinal specialist about these symptoms and the patient's family history.

SOURCE American Society for Gastrointestinal Endoscopy