It was "virtually unheard of in the 20th century" but now bowel cancer in people under the age of 50 accounts for "around 10% of all new cases worldwide", said New Scientist. And England is one of the countries most affected.
Rates of early-onset bowel cancer in England have increased by 3.6% per year over the past decade, an "alarming rise" that's higher than any other country analysed, except New Zealand, Chile and Puerto Rico, according American Cancer Society research published in The Lancet – and a stark contrast to the decreasing rates of bowel cancer in England among the over-50s.
"It's important to note that rates in younger adults are still very low, compared to people over 50," said Michelle Mitchell, chief executive of Cancer Research UK, in response to the research. But "we need to understand what's causing this trend in younger people".
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What is bowel cancer?
Bowel cancer, also called colorectal cancer, is caused by the growth of abnormal cells in the inner lining of the large bowel (which includes the colon and the rectum). Symptoms can include bleeding from your back passage, blood in your poo, a change in your "bowel habit" (such as needing to poo more often) or losing weight when you haven't been trying to.
Around 44,100 people in the UK are diagnosed with bowel cancer every year, making it the country's fourth-most common cancer. It's also the UK's second-most common cause of death from cancer, with more than 16,800 people dying from the disease each year. Mortality rates are highest among the elderly, with almost six in ten of all bowel-cancer deaths affecting people over the age of 75, according to Cancer Research UK.
If diagnosed early enough, however, bowel cancer is both treatable and survivable: around 90% of people in England who are diagnosed with stage 1 of the disease are still alive five years later.
Awareness of bowel cancer among younger people has grown over the past few years –boosted by the efforts of campaigners such as "Bowelbabe" Deborah James. She was diagnosed at 35, and used her podcast to highlight the disease symptoms, and tackle its stigmas, until her death in 2022, aged 40.
Why are rates in younger people rising?
Experts are "still in the early stages of understanding" why there has been a rise in early-onset bowel cancer, said The Guardian, but higher consumption of junk food, lower physical activity and "the obesity epidemic" are "likely to be among the factors".
The countries most affected have seen "major changes in lifestyle", said the New Scientist, with people "sitting more and moving less", and consuming "more highly-processed, low-fibre foods", red meats and alcohol.
At the same time, there has also been a "soaring" increase in the use of antibiotics. These can have a "profound impact on the gut microbiome, and there is good evidence that disturbances to the microbiome are a risk factor" for bowel cancer. Scientists don't think it's a coincidence that there has also been a dramatic rise in other inflammatory bowel diseases, including ulcerative colitis and Crohn’s disease, among young people.
So far, though, the research into these potential triggers has "produced conflicting results". Some scientists are floating the idea that early-onset bowel cancer "may not be the same" as late-onset bowel cancer but "a distinct disease that would require a different treatment strategy". While research continues, it's important that young people are "made more aware of the risk" and look at their lifestyle choices, Sarah Bailey, a cancer-diagnostics researcher at the University of Exeter, told the New Scientist.
How can you reduce your risk?
Experts agree that diet is an "important factor", said The Guardian. Too much red and processed meat are thought to be responsible for an estimated 13% of bowel cancer cases in the UK. Eating more fibre (fruit, vegetables, pulses and wholegrains) and cutting back on alcohol and sugary drinks should also help. Aim, too, to maintain a healthy weight and take regular exercise: there is "strong evidence" to show that "people who are more physically active have a lower rate of bowel cancer".
You could also look at upping your calcium intake: Oxford University researchers have found that women who drink a large glass of cow's milk every day can cut their bowel-cancer risk by nearly a fifth, said The i Paper. There is also some research on the positive benefits of coffee: one study of bowel-cancer survivors in the Netherlands found that those who drank coffee were at a much lower risk of re-developing the disease. It's thought this may be linked to the high polyphenol content of both caffeinated and decaffeinated coffee.
