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Men Are Dying of Colorectal Cancer at High Rates in 232 Hot Spots. What Gives?

By 2030, colorectal cancer will be the leading cause of cancer-related deaths in people 20 to 49.

Colorectal cancer is usually thought of as an old person’s disease. But it’s claiming the lives of more and more young men in their 40’s, 30’s, and even 20’s — notably the late actor Chadwick Boseman. And in 232 hot spots around the U.S., it’s killing way more young people than it should be.

Colorectal cancer — which can cause abdominal pain, blood in the stool, and a change in bowel habits — is most common in older people. People aged 50 and over account for nine out of 10 new cases. But prevalence is dropping in the elderly while rising in the young. Cases have more than doubled in Americans aged 49 and under since the 90s, according to the National Cancer Institute. And the scary thing is that no one knows why, Stat reports.

“Hopefully this will get more attention so that people know that colon cancer is no longer an old person’s disease,”  Charles Rogers, a professor of public health at the University of Utah School of Medicine and lead author of the hot spots study, told Stat. “It’s starting to get traction. But unfortunately, it only really gets traction when somebody dies.”

Colorectal cancer risk is especially high for men under 50 in 232 county hot spots around the country, almost all in the South, according to a study that was published last year. Black men are particularly at risk. Compared to white men, they’re 24 percent more likely to get colorectal cancer and 42 percent more likely to die from it.

“We don’t know where this is coming from,” Rogers said. “Just like we don’t really know why Black people have the highest chance of getting and dying from it.”

In the hot spots, death from colorectal cancer is linked strongly to smoking. It’s also associated with obesity and not having access to healthy foods. Other factors are likely at play, such as eating high-fructose corn syrup.

Masculinity is also a factor. Men may be uncomfortable talking about symptoms or getting screened because of the rectal end of colorectal cancer. They may also have poor communication with their provider and could be unaware of family history of the disease, which increases their own risk.

“Toughness — which basically means you’re not going to be an advocate for yourself in terms of your emotional state, your physical state — has a deleterious effect on your health,” Justin Moore, a cancer epidemiologist at Augusta University in Georgia and a collaborator on the hot spot study, told Stat. “Masculinity in itself definitely plays a role, I think, in delayed care.”

Colorectal cancer is the second deadliest cancer in the U.S. By 2030, it will be the leading cause of cancer-related deaths in people aged 20 to 49, according to a study from April. What stage you catch it is a major determinant of survival. If you catch the disease at stage 1 or 2, the survival rate is 90 percent. At stage 3, survival lowers to 70 percent. By the time you reach stage 4, you only have a 14 percent chance of survival.

Luckily, it can take seven to 10 years for the tumor to grow, so there is plenty of time to catch it. That’s why it’s so important to get screened starting at age 45. Colonoscopy is one of the most common screening options, but there are also choices such as stool tests for a less invasive alternative.

“Being your biggest advocate is key,” Rogers said. “Regardless of the fight you may have, you still need to push forward and do what’s best for you and your health and your family.”