Statistics show rise in colorectal cancer among younger Alaska adults, especially younger Natives

Colorectal cancer, which hits Alaska Natives harder than any other demographic group in the world, is often thought of as a disease of older people.

But newly released statistics in Alaska show increasing rates of early onset colorectal cancer affecting younger adults – and especially younger Alaska Natives adults – suggests that such thinking might be becoming outdated.

A new bulletin from the Alaska Division of Public Health’s epidemiology section shows how colorectal cancer rates for Alaska adults younger than 50 have risen while rates for Alaskans older than 50 declined. The increase is most dramatic for Alaska Natives adults younger than 50; for that population segment, rates of colorectal cancer increased 5.2% annually from 1996 to 2019, the analysis found. That compares to an annual increase of 3.8% among white Alaskans of the same age group, the analysis found.

More frequent and diligent screening was credited for the 2% annual drop in colorectal cases among Alaskans 50 and older from 1996 to 2019. That includes a 1.6% annual decrease in rates among Alaska Native people 50 and older over the same period, the bulletin said.

The data was taken from the Alaska Cancer Registry.

Despite the changing pattern in cases, colorectal cancer is still diagnosed mostly in older adults, said Diana Redwood, an epidemiologist with the Alaska Native Tribal Health Consortium and an expert in the subject who helped compile the newly released bulletin. During the 1996-2019 study period, 85% of Alaska colorectal cancer cases were among people 50 and older, she noted.

Still, the increasing trend in what is known as “early onset colorectal cancer” is occurring nationally, including in Alaska, she said. “And the reasons aren’t entirely understood, although known risk factors like smoking and lack of exercise likely play a role,” she said by email.

The shift toward more cases among younger adults can cause some problems, Redwood said.

“Younger people who aren’t yet at screening age and their providers might not automatically think of colorectal cancer if the younger person is experiencing symptoms. Therefore, younger people tend to be diagnosed at a more severe stage of disease than older people when it is harder to treat,” she said by email. “That being said, younger people have higher survival rates, partly because younger people generally have fewer additional health issues that older adults experience.”

Some of the symptoms of colorectal cancer are blood in the stool, diarrhea, prolonged constipation or abdominal pain and unexplained weight loss, according to the bulletin.

Health officials have already made some adjustments. In 2021, the U.S. Preventive Services Task Force changed its colorectal screening age recommendation to age 45 for all Americans, Redwood said.

The Alaska Native Medical Center and Alaska Native Tribal Health Consortium call for screenings to start even earlier. In 2013, the ANMC adopted new guidelines recommending that screenings start at age 40.