Ask the Doctor: Colorectal Cancer
Colorectal cancer is increasingly no longer a disease that affects only older adults. Dr. Zuri Murrell explains why younger people are experiencing higher rates and how to stay healthy.

Despite numerous advancements, colorectal cancer rates continue to rise among younger and younger populations. According to Dr. Zuri Murrell, “colorectal cancer should be almost completely preventable and if caught early, it is almost completely curable.” Yet many young people, especially those in Black and brown communities, are getting diagnosed with the cancer at earlier ages. 

Take beloved actor Chadwick Boseman. Best known for his role as Black Panther in the Marvel film of the same name, Boseman passed away unexpectedly last year at the age of 43 after secretly battling the disease (while also working) for years. 

Some of the most approachable ways to prevent colorectal cancer include diet and exercise. But the most important may be early screenings. Colonoscopies are typically recommended for men and women after age 50, but with numbers increasing for younger populations, many in the medical fields are pushing for broader testing guidelines. 

“I love the fact that patients have much of the power to prevent this disease,” says Murrell. “I encourage people to be their own health care advocate, meaning being prepared for their doctor’s visit knowing what issues they need addressed and working together with their health care professional so they can live the healthiest, happiest life possible.” For this issue’s edition of Ask the Doctor, we spoke to Murrell about this cancer. 

For this column, we’d like to focus on the rise in incidence rates in young individuals of colorectal cancers. Why is this happening?

Since the 1990s, the rate of colorectal cancer has doubled in adults younger than 50 years of age. This is in light of the fact that overall, colorectal cancer rates have dropped from some adult populations. One of the most likely culprits is our obesity epidemic. Seventy percent of millennials will be obese by the time they reach middle age. Obesity places the body in an inflammatory state which contributes to the occurrence of colorectal cancer.

Moreover, high fat, high red meat, high processed food consumption is also a risk factor for colorectal cancer independent of obesity. Humans break down red meat into a compound that is pro-carcinogenic. Combining these factors with physical inactivity becomes a perfect agar for cancer cells to grow. Unfortunately, colorectal cancer is not on the minds of many young adults nor their doctors. The good news is all of these factors can be curbed. Genetic syndromes in young patients are only thought to be the cause of 10-20 percent of cancers.  

What are some things young people should know about colorectal cancer?

Young people, as with all patients, need to be proactive. We all need 25-30 grams of fiber a day.  Some delicious options are blackberries, raspberries and kiwi. Fiber helps to eliminate toxins from the body. 

Exercise, exercise, exercise!

Something that is incredibly important is knowing one’s family history, not just about colon cancer but regarding colon polyps found during their parents’ colonoscopies. Knowing this information may allow earlier screening for themselves.

There are also disparities in Black and brown communities. For example, African Americans have a higher chance of being diagnosed at a later stage and a higher mortality rate. Why does that occur? The COVID pandemic showed the world something that colorectal surgeons were already aware of: the significant health care disparities in this country. African Americans have one of the highest rates of colorectal cancer in the world. Part of the reason that this happens in America is that [African Americans] are offered colonoscopies less than their white counterparts and most of the colorectal cancers that African Americans get are on the right side of the colon, which can only be reached during a colonoscopy. Also, African Americans have lower vitamin D levels and that can be easily corrected with supplementation. 

I do medical missions to Uganda, and Uganda and Nigeria have some of the lowest rates of colorectal cancer in the world. Their diets are low in red meat, exceptionally low in processed food consumption, and high in fiber. So, doing these things I’ve outlined can have a significant impact on the rate of colorectal cancer.


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