Colorectal cancer, often called colon cancer or rectal cancer, is among the most common and deadly cancers worldwide. Long considered a disease primarily affecting the elderly, it is now showing a worrying increase in adults under 50 in several developed countries. Specialists are warning of the need to improve screening, prevention, and treatment to limit the number of new cases and deaths.
According to estimates from the World Health Organization (WHO), nearly 1,9 million new cases of colorectal cancer are diagnosed worldwide each year. It is the third most common cancer and the second leading cause of cancer death, with approximately 900,000 deaths annually. In France, Public Health France estimates that around 48,000 new cases are diagnosed each year, resulting in nearly 17,000 deaths. Men are slightly more affected than women, but the disease affects both sexes.
Screening that saves thousands of lives
Colorectal cancer usually develops from polyps in the colon or rectum. Their transformation into a cancerous tumor can take several years, leaving a significant window for prevention. This is why health authorities recommend regular screening starting at age 50 for people at average risk. In France, a free immunochemical test is offered every two years to people aged 50 to 74. If the result is positive, a colonoscopy is performed to look for and remove any polyps before they become cancerous.
Despite its proven effectiveness, screening remains underutilized. In France, the participation rate hovers around 35%, far from the 65% target set by health authorities. Yet, when detected at an early stage, colorectal cancer has a five-year survival rate exceeding 90%. Conversely, when diagnosed at a metastatic stage, this rate drops sharply, highlighting the importance of early diagnosis.
Diet and lifestyle play a determining role
Researchers have identified several modifiable risk factors. A diet high in red meat and processed meats, low fiber intake, being overweight or obese, excessive alcohol consumption, smoking, and a sedentary lifestyle significantly increase the risk of developing colorectal cancer. Conversely, a diet rich in fruits, vegetables, whole grains, and legumes, combined with regular physical activity, helps reduce this risk.
Some people are also at increased risk due to hereditary factors or chronic inflammatory bowel diseases, such as Crohn's disease or ulcerative colitis. In these situations, closer medical monitoring and more frequent colonoscopies are recommended to detect any lesions before they develop into cancer.
Therapeutic progress, but heightened vigilance is needed.
Colorectal cancer treatments have evolved considerably in recent years. Surgery remains the standard treatment when the tumor is localized, often followed by chemotherapy or radiation therapy depending on the stage of the disease. Targeted therapies and immunotherapy also offer new perspectives for certain patients with specific genetic profiles, improving survival rates and quality of life.
Faced with the increasing number of cases observed in younger adults, several research teams are investigating the causes of this trend, which could be linked to dietary changes, the gut microbiota, obesity, or environmental factors. Experts emphasize a simple message: consult a doctor promptly if you experience blood in your stool, persistent abdominal pain, a lasting change in bowel habits, or unexplained weight loss. In the fight against colorectal cancer, early detection and prevention remain the most effective tools for reducing mortality.
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