Colon Cancer Is Rising in Younger Adults — 5 Ways to Protect Yourself Now

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0:42Gemini and Chrome is here for it. Ready to make anything online make sense? There's no place like Chrome. Check responses set up required. Compatibility and availability varies 18+. colorectal cancers are on the rise in younger and younger and healthier healthier people that's one of the reasons i want to talk about it colorectal cancer or colon cancer is rising in younger adults and we're not talking about like 60 year olds okay we're talking about people in their 30s some in their 40s and currently screening isn't happening for most people until 45 recently we lost James Van Der Beek and he was only 48 years old and this was after his battle with colorectal cancer.

1:25If you grew up in the 90s, this definitely hits differently and my heart goes out to his family, his children especially. This is just so hard but I appreciate him raising awareness around this. Now, I want to be clear, this episode is not about fear. I want to empower you on the top five things that you can do to help you prevent colon cancer because colon cancer is one of the most preventable cancers we know of and yet most people are walking around with zero plan or zero idea outside of just eat fiber about what they can do about it. So in today's episode we are going to talk about why younger adults are being diagnosed more often, what actually reduces the risk of colon cancer and, you know, weeding out some of the hype, how fiber really works, how you can hit your fiber goals.

2:19We're going to talk about screening. So Cologuard versus colonoscopy and help you wade through the confusion around this because certainly in the wake of James Van Der Beek's passing, there has been a lot of confusion and a lot of chatter online. Now, first, welcome back to the Dr. Brighton Show. I'm your host, Dr. Jolene Brighton. I'm board certified in naturopathic endocrinology, and I'm a nutrition scientist. And if you could take two minutes to hit that subscribe button, leave me a review, I would be so grateful. It is your support that helps this information get out to the people who need it most.

2:55Now, I don't want to hold you up, so let's get into it. Firstly, why is colon cancer rising in young adults? This is something that is freaking all of us out. You know, James Van Der Beek, he passed away right before I had a birthday, and I'm like major pause in my life. So here's what the data show. So the rates of colorectal cancer in adults under age 50 has been increasing for the past couple of decades. Now, let's be honest, we don't have a single smoking gun. We don't know exactly why this is happening. Like we can't just name one thing. It's not one chemical and it's not one food despite what all of the influencers are telling you.

3:36The reality is, is that it is more than likely multifactorial and so much of it comes down to your nutrition, your lifestyle, how you live your life every single day. So we are seeing increased ultra processed food intake. As ultra processed foods go up, we know nutrient density and fiber goes down. So low fiber diets, super ultra processed food, like overwhelmed in our diets coupled with sedentary behavior. I'm not accusing anyone, by the way, but this is the picture that we're starting to see that is leading to so many health problems in our society, including the increase in colon cancer. So sedentary lifestyle, low fiber, ultra processed food, more sugar, and we get central adiposity.

4:24So we get visceral adiposity, fat packing around our organs. Fat packing around our organs leads to metabolic dysfunction. Metabolic dysfunction, by the way, is not just like, oh, you have some insulin resistance and like blood sugar problems. It's highly inflammatory as well. And because the little ecosystem that is our microbiome is not in a vacuum container, all of these shifts can cause microbiome shifts. Like what you eat is going to influence what they're able to eat and how much they can thrive. Now, I think on top of that, there are environmental exposures going on as well. There are environmental toxins that we are getting exposed to and that we are just barely scraping the surface to understand.

5:06And all of that together chalks up to a cumulative inflammatory burden. And I want to pause here because this is not something where like 35-year-olds suddenly have like an old colon. something about the modern metabolic environment is changing our risk to be earlier. And that means that we don't wait until 65 to get care, okay? If you're listening to this now, if we have any kind of changes going on, we want to make sure that we get care. Now, before we get into the five ways to prevent colon cancer, I want you to know I do a fiber-rich meal plan and recipes at drbrighton.com slash plan. That's D-R-B-R-I-G-H-T-E-N.com slash plan.

5:53So if you need some direction, a place to get started, you can grab that. And I do just want to note, you know, James Vanderbeek had come out and said that he had bowel changes and he chalked it up to diet and he changed his diet and it didn't improve. And that's when he finally went and got care. So we're going to talk about some red flags today, but I just want you to know that living in your own body is really, really important data. So with that said, let's get into like the first thing, which is screening. I'm going to go into screening deeper later in this episode, but a colonoscopy doesn't just detect cancer.

6:32It removes polyps before they become cancer, and that can be prevention. Now, I know some people are like really anti-colonoscopies. I still don't understand why. You can let me know in the comments while you are. You know, the one argument that I see made over and over again is that, well, other countries don't do colonoscopies as frequently as the U.S. And I'm like, well, sometimes when you look at those other countries, it's because of resources and how many people are trained. And also, socialized medicine has to keep the cost down as much as possible. And so, you know, it is something that I'm like, I get where that comes from.

7:08And certainly, you know, there's people that would rather do less invasive testing. However, that less invasive testing is not 100 % accurate. So I will spend some more time talking about that later in the episode, but the number two thing that you could be doing is fiber. And no, it's not just take a supplement, okay? So fiber is one of the most consistently protective dietary factors against colorectal cancer, and here's why. I want to break this down simply for you to understand. So when you eat fiber, especially fermentable fiber, your gut bacteria are going to feed on it. When they eat that fiber, they then produce short-chain fatty acids like butyrate.

7:51If you've heard in the ADHD episodes, we talk about butyrate before. It's such a great short-chain fatty acid that helps ADHD brains, but why does it help ADHD brains? Because butyrate reduces inflammation, and so it's also helping the health of your gut as well. And so eating more fiber feeds these bacteria. They produce butyrate. Butyrate helps lower inflammation. Lowering inflammation improves colon cell health. Butyrate also helps with regulating cell growth and keeping those cells optimized. So fiber helps your colon cells behave better. And beyond that, it's also going to increase your stool bulk.

8:33So the bulk of your stool and that can help with reducing transit time, helping you have more regular bowel movements, which means less time for potential carcinogens, cancer-causing agents, to sit there near the cells. And fiber on top of that is going to help with improving insulin sensitivity. So I already said at the top of this, like the metabolic issues that we have can be leading to inflammation and maybe leading to this increased risk for colon cancer. So anything that's helping with improved insulin sensitivity, that's a plus. And in the U.S., the average intake of fiber is like 15 grams or less a day.

9:13And the recommended amount is a minimum of 25 grams for women, 38 grams if you're a man. So we need to be looking at how we can increase our fiber intake because the reality is that most people are not even close. But while I want you to eat more fiber, if you are only eating like 10 grams a day and you jump to 35 grams a day, you will bloat, you will hate me, you will be mad. And that doesn't mean fiber is bad. It means your microbiome needs to adjust, your gut needs to adjust. But the best sources of fiber, and you can let me know in the comments, are you eating these? How many do you get? I want you to score yourself.

9:52So beans, lentils, chia seeds, flax seeds. We want to eat those ground. Berries, like especially raspberries, a great source of fiber. Are you keeping track? How many are you at right now? Cruciferous vegetables. So we're talking about broccoli, kale, getting some Brussels sprouts in, cauliflower, oats. I know there's a lot of oats haters out there because they're like, they're rich in glyphosate, opt for organic, but oats are still a really good source of fiber. And remember, we're rotating these things out. We're getting variety in our diet. Whole grains, another good source. If you tolerate whole grains, like we're talking brown rice, whole wheat.

10:44So let me know how many of these you're hitting. And notice I didn't say fiber gummies. No, I'm not saying that like fiber supplements are bad, far from it. But we want to be starting with real food as we make the fiber shift, not just supplements. We don't want to rely on just supplements. Do you need supplements sometimes? Absolutely. But I want you to be looking at your diet and how you can increase fiber from whole foods. Now, number three, what you can be doing to prevent colon cancer is looking at your body composition, your insulin. So visceral fat increases inflammatory cytokines, chemical messengers.

11:20That increases insulin resistance, high insulin, insulin-like growth factor one signaling can promote cellular proliferation, lots of growing. That matters in the colon. So when we talk about maintain a healthy weight, that's not diet culture. As much as people say that, like, it's about inflammatory signaling and control. So maintaining a healthy weight is a great way to prevent cancer, as is number four, which is regular physical activity. Regular physical activity helps reduce the risk of many cancers, colorectal cancer being one of those. And the mechanism is that it improves insulin sensitivity, like we talked about multiple times now, which also is going to improve your inflammation.

12:07We'll see improvement in how your gut actually functions. We know with long-term diabetes, we have damage to nerves and your gut can be one of those areas where motility starts to suffer because we've had nerve damage happen. Now, when we have regular exercise, we are also seeing shifts in immune surveillance. So, checking out those cancer cells may be happening more often. Now, when it comes to exercise and cancer prevention, we're not talking about running a marathon or doing an Ironman. We're talking about consistency. Every single day, trying to get some movement in. Wherever your body is at, you need it there and get some movement.

12:49It doesn't have to look like everybody, what everybody on the internet says. Now, before we talk about the last one, I want to remind you to stick around to the end. We're going to talk about colonoscopy versus Cologuard. Number five, first I want to say I I need to say something that might make you uncomfortable, might make you mad, might make you eye roll at me, but you need to limit your processed meats. So that includes the nitrate-free deli turkey meat. Deli meats are classified as a group one carcinogen by the World Health Organization's cancer research team. And that's the same level of evidence category as tobacco.

13:25So I don't want to say, like, I wanted to say, like, this is not because the risk is equal. It's because the evidence linking process meat to colorectal cancer is strong. And here's the number that's going to maybe really upset you. And that is eating just 50 grams per day, which is about like three slices of deli meat, increases colorectal cancer risk by about 18%. So if you're eating a sandwich every day, that's chronic exposure. her. And I want you to listen to me very carefully because if you're like, I have to turn her off right now. Look, this is not about never eating bacon again. No, I love me some bacon.

14:06It's also not about never eating deli meat because sometimes that is the best thing that you can reach for is because you're hungry and you're on the go and like, I get it. This is about not making processed meat, your default protein, every meal, every day. Because many people will think it's turkey, it's lean, it's healthy, but processing, so smoking and curing and nitrates and nitrites create compounds that damage colon cells over time. And when you combine that with a low fiber or low movement, high stress, metabolic dysfunction kind of lifestyle, that's a modern risk profile. So hear me, I'm not about to be like, never eat these convenience meats.

14:50Like I eat them. I definitely have patients who eat them, people that are just like, this is what I have access to right now. But what we don't want to do is make it the only thing we're eating day in and day out. So with that said, let's talk about screening. So Cologuard versus colonoscopy. So firstly, let's get practical. For the average risk adults, screening is going to start at age 45. It's going to be earlier if you have a first degree relative with colon cancer. If you have a history of inflammatory bowel disease, so that's going to include ulcerative colitis or Crohn's, you may need to get screened even earlier.

15:31So you definitely want to talk to your provider about your current state. This is where like having a great gastroenterologist is amazing because I can give you the lifestyle ways that you can try to dodge colon cancer, but we've got to be working with a gastroenterologist as well. One thing I hear from women all the time is that they're struggling with symptoms like hot flashes, sleep disruptions, and brain fog, but aren't sure where to turn to for help. Menopause is inevitable, but suffering through it isn't. That's why I want to tell you about Alloy. Alloy is a digital health platform that connects you with a menopause-specialized doctor who can create a personalized treatment plan tailored to your needs, all from the comfort of your home.

16:17Join the 95 % of women who tried Alloy and saw relief in the first two weeks. Head to myalloy.com and use the code DRBRYTEN. That's myalloy.com, M-Y-A-L-L-O-Y.com and the code DRBRYTEN, D-R-B-R-I-G-H-T-E-N. Share your symptoms and you'll get a fully customized treatment plan and unlimited messaging with your doctor. Plus, you'll get$20 off your first order today. That's M-Y-A-L-L-O-Y dot com code Dr. Brighton. Now, if you have a high hereditary risk, you would also need to be screened before age 45. So I want to now compare options with that in mind. Now, if you get a colonoscopy at age 45 and everything is normal, then your doctor is likely not going to recommend that you get another one for another 10 years.

17:18So you're going to go 45 to 55. And what a colonoscopy does, it's different than Cologuard that we're going to talk about. It's different than doing a stool test, is it's going to visualize the entire colon. And if there are polyps that are like, those are suspicious, we're going to just see those taken out there and they're going to send them off to pathology. So they're going to remove the polyps on the spot. And for some people, that actually removes precancerous or even maybe the beginning of cancerous lesions and then they get the treatment that they need. The downside is that it does require prep.

17:57Nobody likes it. Nobody likes having to prep their colon. And it does require sedation. And any time that we are sedated, there is always a risk of complications. And that's part of the risk of why people will say like, oh my god, but you could die from this. The risk of complications are very small with a colonoscopy. So to put it in perspective, what most people are concerned about is bowel perforation. That happens in about 0.1 % of colonoscopies. To put that in perspective, IUD perforations of your uterus is about 0.1 to 0.2%. And so this is where I kind of kind of scratch my head because people will be like, I don't want to get a colonoscopy because there's the risk of perforation.

18:41But nobody bats an eye about the IUD. And you might be listening to this being like, no, I wouldn't get an IUD either. I mean, fair. I had an IUD. I'll never do that again either. But the risk of perforation is very low. There is like the possibility you could have a reaction to the sedation that maybe there's some bleeding that occurs afterwards. But a good gastroenterologist, so I'll just tell you right now, if you're considering a colonoscopy, meet with a gastroenterologist. If he doesn't go through like, here's the risks and here's the risks for you and like, here's the benefits and doesn't go through all of that and is just like, just get it done, you'll be fine.

19:15Okay, no, go see someone else because you deserve informed consent and you deserve to have your mind put at ease and you can bring a list of questions and ask them. But as of right now, a colonoscopy is considered the gold standard because it is prevention and detection in one. Now, in recent years, the stool DNA testing Cologuard has come out. That's done like one every three years. What is great about this is it's at home. So if I have someone who's like, I'm 40, I don't have linked the checklist of risk factors, but I'm just concerned. We can just do this test and see at home, like, do you have any reason to go get a colonoscopy sooner.

19:55This is going to look for not just blood, but also abnormal DNA markers. And I think that's important because a lot of people are like, oh, it's just like a fecal cult, which is a way of testing hidden blood in your stool, but it goes beyond that. It's going to look at DNA markers as well. If it's positive, you must get a colonoscopy. So if you are someone who's like, I never want a colonoscopy, understand that positive means you're getting a colonoscopy. And that's not because we hate you. We want to torture you, okay? It's because we care about you and we want you to survive and live a really long life.

20:31Like James Van Der Beek should have been able to and it breaks my heart and I don't want any of that for you. Now the Colgard is a good option for the average risk adult who's otherwise going to not get a colonoscopy and avoid it. But it's not an equivalent to a colonoscopy in its prevention power. So the best test though, So, I mean, let's be honest. Like as doctors were like, get a colonoscopy. The best test is the one you're actually going to complete and you're going to follow up with appropriately. And so sometimes that might be the Cologuard that you're doing first. But there's some things you need to know about the Cologuard.

21:05So firstly, when it comes to colon cancer detection, it's anywhere from like 92 to 94 % accurate. That's really good. Those really high numbers. So that's why some people like to take that option over starting with a colonoscopy. But when it comes to precancerous polyps, it's less than 50 % accurate, whereas a colonoscopy is over 95 % accurate, okay? So keep that in mind, is that the colonoscopy is going to catch the precancerous stuff. The ColoGuard isn't going to be as effective with that. The ColoGuard can also have false positives and false negatives, so keep that in mind. Now, this part matters a lot for the U.S., unfortunately.

21:48If you get a Cologuard and it's positive and then you need to go for a colonoscopy that's no longer a screening exam that may be covered by your insurance, at that point it becomes diagnostic and then you might have more out-of-pocket co-pays or expenses that you have to think about. And unfortunately, you have to think about that in the United States, is that there's a real possibility that things get found in that Cologuard, and then that changes how your insurance is going to actually cover things. Now, if you are someone who is high risk or you have the red flag symptoms we're going to talk about here, but one of them is bleeding blood in your stool, then Cologuard's not right for you.

22:29It's time for a colonoscopy, and that's the real talk there. Now, the red flag symptoms that you absolutely want to go see your provider for. If there's blood in the stool, if your stool is red, if blood is dripping into the toilet, if it's tar-like, that might be bleeding higher up, but we want to go see a doctor. If you're having changes in your bowel movements, if you're constipated and it's not getting better, if you're having diarrhea and it's persistent, If you're having gas, bloating, constantly having abdominal pain, it's probably time to meet with the gastroenterologist. Make sure something more isn't going on than I just need to shift my diet.

23:11And then if you have iron deficiency anemia and they don't know why, like you don't have heavy periods, but you're deficient and you eat meat, but you're iron deficient, okay, good time to see the gastroenterologist. Because that means we may have a bleed somewhere. We're having absorption issues. we need to make sure that your gut is healthy. Now, if you're having unexplained fatigue, unexplained weight loss, and you're like tired, you're losing weight, or, you know, back on the bowel movements, you got like pencil, thin stools, things are just not seeming right in your body. Those are red flags.

23:50Anytime you're like, this is not normal, don't get gaslit into believing it's normal. You live in your body. You're the only one that knows what's normal for you. And if it's not normal for you, it's worth investigating. So I hope this episode was helpful for you. Again, I am very sad at the passing of James Van Der Beek. I'm very sad at anybody passing so young. And it really inspired this episode. His advocacy inspired this episode, that he was so open and advocated about this that I was like, you know, we should do an episode on this talking about ways that you can prevent colon cancer in your life every day.

24:29I appreciate you being here. I appreciate your reviews. I appreciate your support. And I will see you next time. Your call has been forwarded to voicemail. Hi, this is Zoe Deutsch. And Nick Robinson. Our brand new movie, Voicemails for Isabel, is all about those little moments that feel like the universe is looking out. Feeling homesick, then your sister calls. Hearing that perfect song exactly when you need it.

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