Colon cancer now leading cause of cancer deaths under 50 in US

[nativeit]

As a Multiple Sclerosis patient since I was a teenager, let me just say: all you “healthy diet” zealots aren’t helping. Your advice on which blended kale and gogi berry smoothie I should try is cringe and annoying. Normally, the person is right in front of me, and well-intentioned, so I typically smile and politely thank them with a non-committal gesture towards trying it someday.

But since this is all one-party and relatively anonymous, I’d like to take the opportunity to tell everyone that unless you have a PhD or MD in a relevant field, your thoughts about fiber are irrelevant and unwelcome to anyone actually suffering from the disease(s) in question.

[achandra03]

I think this is probably due to people suffering from the just-world fallacy. Most folks like to believe that if you do the right things and consume the right stuff you'll have a long and healthy life when the fact of the matter is that luck/randomness plays a much larger role in your health than most people would like to admit.

[staticassertion]

You're on a discussion forum where the topic is colon cancer. Surely you understand that people are going to discuss it?

It's a bit hard to tell from your post what you're saying. Certainly I can imagine being annoyed by constantly being given health advice from layman. But this is... a forum.

[jancsika]

> As a Multiple Sclerosis patient since I was a teenager, let me just say: all you “healthy diet” zealots aren’t helping.

I don't understand the relevance to the article. Does Multiple Sclerosis come with a higher risk of colon cancer?

[logannyeMD]

I'll echo this by saying that, as someone who has their MD, there is much we simply do not know. We're always updating our priors and have much to base our decisions off of, but we simply do not understand many things. Medicine is out here winging it with the best of intentions, but there are no "experts" in the grand scheme of things.

[dham]

They need to lower the screening to 40. I just had mine at 40, turned out fine luckily. Did it without sedation which my doctor said was rare in US, but common outside of US. I found surprising, wasn't that big of a deal. Pain was probably at a 7/10 during the turns (like 3 times) but ok the rest of the time. A little uncomfortable. Some new sensations, some familiar (feeling like you are crapping your pants).

I walked in and walked out no issue and went on about my day. Prep was fine but would be hard if I didn't work at home.

[rootusrootus]

With old school sedation I think it might be worth avoiding it. But with propofol you are out like a light, and then wake back up just as fast when they turn it off -- and it feels like you just had a nice nap. Aside from feeling a bit groggy for a few minutes, you just get up and walk out the door and go about your day. Personally, I do not think I'd volunteer for 7/10 pain just to avoid that.

[y-c-o-m-b]

Which state did you have it done in if I may ask? I'm in Oregon and haven't been able to find a doc that does it without sedation. I can't be put under sedation for medical reasons, but I definitely need this procedure done sooner than later due to new GI problems.

[phainopepla2]

Do you have specific risk factors that caused your doctor to recommend getting it at 40, or did you have to convince them? My understanding is that if the doctor doesn't order it, many insurance companies won't cover it.

[gniv]

The prep is by far the worst of it. I wish they could do it differently.

[kvgr]

There is going to be some big AHA moment tied so couple food practices. Like washing chicken in chlorine or something. I wonder how are the stats in other developed countries. The title says US.

[imglorp]

My money is on massive overexposure to high fructose corn syrup in the Western diet.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9170474/

[taeric]

The trend has been down, even for this cancer. Such that I agree there were probably some big AHA moments. But I assert they almost certainly happened 50 years ago.

My expectation is that it is less that there has been a growing trend of this cancer getting worse, and far more that we have gotten better at many other cancers. That is, overall, this is good news on progress. Not a scare headline.

[toraway]

That seems like wishful thinking, IMO. Seems more likely we will find it’s due a complex constellation of genetics, diet, lifestyle factors like exercise, environmental exposure, etc associated eith a modern sedentary lifestyle with no clear smoking gun or single preventative intervention.

It sort of reminds me of when Lesswrong was fixated on a hypothesis that lithium levels in the water supply was the cause of the obesity epidemic. There was a lot of enthusiasm for the idea at the time, and somewhat understandably as it would have been a single variable that could be tweaked for massive societal benefits.

But there wasn’t really any credible evidence to support it. Trying to reduce the complexity of human biology and lifestyle to single cause/effect relationship is an easy and tempting trap to fall into to explain unknowns in medicine.

[leetrout]

I had no clue this was a thing. Thanks for sharing your thought...

I think it's a combination of our pesticide usage and general food processing but like a sibling said these are educated guesses.

[zvqcMMV6Zcr]

My bet is on low-fiber diet and people spending half hour playing with phone instead of getting up from toilet.

[hombre_fatal]

> An estimated 95% of American adults and children fail to meet daily fiber recommendations, with intake often falling below 10 grams per 1,000 calories consumed

It's tempting to focus on some magic bad ingredient/practice to explain our bad health (like seed oils), but we don't exercise, we eat directly against dietary guidelines, and we eat foods that we know are bad for us.

Now add on to that the social media grifters and industry advocates who tell you that eating poorly is good for you.

I don't blame individuals just trying to live their life though. This is how we've let our whole food environment set up shop.

[rauljordan2020]

So many folks that have it say things like "I was super healthy! Did exercise, young, don't drink, etc." Then you dig deeper and realize the last vegetable meal they ate was a soggy brussel sprout their mom made them when they were 17 years old, and also eat cold cut turkey sandwiches every lunch because they're "healthy", and maybe have a tiny shred of lettuce in the sandwich. For breakfast, they eat pancakes or sugary foods, and dinner is just a piece of steak

[tptacek]

You can quickly find historical availability & consumption data and I don't think it supports any trivially obvious hypotheses like these. You'll find headlines saying things like that we're at a low point in vegetable consumption going back to 1988, but I'm reading an NIH paper charting '70-'2010 and the patterns look stable, except for increases in total calories, in dairy, and in added dairy fats and oils.

Whatever's going on, it's probably going to end up being complicated and multifactorial.

(I do love me a crucifer, though).

[cm2012]

The correlation to any of that stuff and cancer is basically meaningless in the scale of one persons life

[thinking_cactus]

I wonder the flipside as well. I'm extremely confident a healthy vegeterian or vegan diet will be generally a bit healthier than a meat-heavy alternative. But I believe you can overdo it too, like if you eat enormous amounts of hard raw foods and leaves with low calories that might not be all that great for your gut either? (our gut is probably adapted to eating cooked stuff).

My armchair recommendation: avoid processed foods (but you can have processed if you're really confident what goes in isn't harmful or just very occasional I guess), eat a good amount of salads and veggies alongside some cooked main course, like beans, rice, tofu, etc.. Eat some fruits throughout the day, and a reasonable amount of water. Chew your foods well. Exercise, bla bla bla, you know the drill ;)

[throwawaytea]

"Guys, it's not the chemicals present in every packaged food you ever set your eyes on, or the pesticides every vegetable is grown in, it's just that you don't eat vegetables."

[boringg]

Are you serious? Do you really think thats the reason that this is happening -- that people don't just eat their veggies? Fiber is important but, um, that's a pretty hot take.

I suspect there are other factors at play.

[casualscience]

Victim blaming cancer patients as cope so you can convince yourself "it won't happen to me" is a disgusting trend

[gavinray]

https://realfood.gov/

[xbryanx]

Recent discussion on this topic:

Overall, the colorectal cancer story is encouraging https://news.ycombinator.com/item?id=47078840

[everdrive]

Quite scary since we don't know what causes it. I know there are some intelligent guesses, but my understanding is that we don't have any hard proof.

[ifwinterco]

Yep, there is something going on here (some environment toxin that most/all of us are exposed to), but we don't know what it is

[Pxtl]

Hah, I've counted 10+ different intelligent(?) guesses in the replies.

[Pxtl]

Amazing how everybody in this thread has posted their pet theories as to cause:

- insufficient fibre

- too much high fructose corn syrup

- too much milk

- too much citric acid

- toxins and parasites (gut cleanse!)

- washing chicken in chlorine (voiced as hypothetical)

- ultra-marathoners - maybe their supplements and too much carbs or dehydration?

- too much processed junk

- vitamin and mineral deficiencies

- radiation

- insufficient veggies

[ceedan]

The decline in mortality for so many other types of cancer has caused colon cancer to become the leading cause of cancer deaths under 50 in US. Eat more fiber.

[tim333]

In other stories - a toxin called colibactin produce by some strains of E Coli may be involved

>E. coli toxin could be linked to rising rates of bowel cancer in younger adults https://news.cancerresearchuk.org/2025/04/23/colibactin-e-co...

[lend000]

My step-brother had this around 40. He's okay now, but it was a terrible process involving surgery, carrying around a bag, and chemo which aged him significantly during treatment (from no gray hair to all gray in a couple years).

You would have never guessed he was an unhealthy guy by looking at him, but I do assume it has something to do with foods we consider normal in the US. I've taken a page out of Bryan Johnson's book and started eating well over 100% of recommended daily fiber intake (easy and enjoyable if you make some chia seed porridge every morning), and I will say my digestion has never been better. Keeping the system clear seems like a sane first line of defense to preventing this kind of thing.

[TrackerFF]

If you have the symptoms, go get yourself checked out. I delayed my colonoscopy for YEARS, hell - I even delayed my doctors visit for years, and I had pretty much every symptom there is. My anxiety was through the roof when taking the blood test, and getting the colonoscopy - as I simply assumed they'd find something.

But, no. They didn't find a single thing. Blood and stool tests came back fine. Not even a polyp was found during the colonoscopy.

The only thing that kind of sucked, was the prep - there's no way around that. But the colonoscopy itself, no problem. I get some mild sedatives, but was completely awake during the procedure - even watched it on the screen.

[elinear]

Hank Green's visualization[0] a few weeks ago cite several statistically significant risk increases to CRC incidence (omitting ultra endurance athletes):

- Sugary drinks (≥2/day as teen) - 2x

- Sedentary lifestyle (>2hr TV/day) - 1.7x

- Childhood antibiotics (recurrent) - 1.5x

Have any studies tracked the growth of these behaviors in recent decades, potentially lining up with the increase in early onset CRC?

[0] https://www.hankgreen.com/risk-factors

[m3nu]

Interesting but link is dead? Would love to see this.

Found it: https://www.hankgreen.com/crc

[gavinray]

Scary. I had whole-genome sequencing done and the results came back with dozens of "Increased risk for colo-rectal cancer" results.

I'm likely going to die of either a heart attack (already had one, at age 28), or cancer, and it seems genetic.

EDIT: Specific genes and alleles below, if anyone is curious

https://i.imgur.com/szplWSj.png

[ankraft]

https://archive.ph/UUKZ1

[taeric]

This almost certainly speaks more to how much we have advanced on other cancers? The chart for total incidence shows it peaked in the 80s at about 70 per 100k and is down to about 40 per the same amount, now.

Such that, yes, we can still get better. But people here are reacting as if there is some damning evidence that just doesn't track with the data. Even with an uptick in younger people getting this, we still don't have a smoking gun on anything that is directly causal to this.

Also, holy crap, if you have rectal bleeding, don't ignore it! That that is listed as an early warning sign that people ignore is terrifying.

[UltraSane]

One of the healthiest things you can do is buy a vitamix or similarly powerful blender and make kale, spinach, broccoli, and mixed berry smoothies with olive oil. They don't have to taste GOOD, just good enough to be chugged as fast as possible.

[freediddy]

Ultra-marathoners have a 7x chance of getting colon cancer under 50. This is where it needs to be studied, maybe it's a common food or common supplement they are taking?

[ifwinterco]

That's such a big disparity I'm very suspicious of that data, but there seems to be plenty of evidence that grossly excessive cardiovascular exercise is bad for you in various ways.

If people enjoy it and really get a lot out of it then I wouldn't judge them for doing it, but let's not pretend it's healthy, because all the evidence is that it isn't.

In terms of cardio being able to run a half decent 5k a couple of times a week is probably a good idea, any more volume than that is really not necessary and at some point becomes harmful

[kjkjadksj]

I remember when that paper hit HN the thinking was actually to do with reduced bloodflow to the colon while running for long periods of time.

[moi2388]

Dehydration? Overconsumption of carbohydrates?

[Drunk_Engineer]

I can find only a single paper making this claim about marathoners. And that study has attracted a lot of criticism.

[slibhb]

Can you provide a link? I looked and all I found was one study that looked for pre-cancerous adenomas.

[tomasphan]

Here take your pick:

Antibiotics, Potassium bromate, aspartame, Red 40, rBGH/rBST, Chlorpyrifos, Atrazine and many more

[zby]

Hmm - but has its incidence increased or just other causes have fallen down faster?

[IAmGraydon]

So…what was the leading cause of cancer deaths for age < 50 before now?