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Rates of colorectal cancer diagnoses and deaths are climbing among patients younger than 55, researchers have shown.
Actor James Van Der Beek shocked the entertainment world this week when he announced he had received a diagnosis of colorectal cancer.
“I have colorectal cancer. I’ve been privately dealing with this diagnosis and have been taking steps to resolve it, with the support of my incredible family,” Van Der Beek told PEOPLE, who broke the news on Nov. 3.
Van Der Beek, known for his television work in the late 1990s and early 2000s as the star of “Dawson’s Creek,” also told PEOPLE that “there’s reason for optimism, and I’m feeling good.”
Van Der Beek is 47 years old and colorectal cancer, a disease that starts in the colon or rectum, is on the rise among younger American adults, according to current researchers.
There will be approximately 106,590 new cases of colon cancer and 46,220 new cases of rectal cancer in the United States in 2024, the American Cancer Society estimated.
Although rates of people receiving diagnoses of colon or rectal cancer have declined overall since the mid-1980s — with incidence rates dropping approximately 1% a year from 2011 to 2019 — this trend is among older patients, the American Cancer Society reported. It noted that, in contrast, the rates of patients younger than 55 years old have been climbing by 1% to 2% a year since the mid-1990s.
In an interview with CURE®, Dr. Michael Cecchini explained that Van Der Beek would be considered to have early-onset colorectal cancer, which is reserved for patients who are younger than 50 years old.
Cecchini is the co-director of the colorectal program in the Center of Gastrointestinal Cancers at Yale Cancer Center and Smilow Cancer Hospital.
“There's been a rise in the incidence of colorectal cancer in that age group for the last several decades, actually, and has risen about 2% per year, some from the ’90s,” said Cecchini.
The medical community, Cecchini said, is still working to understand the rise in cases of colorectal cancer among younger adults.
“The bottom line is, we don't know [exactly how], but we do know that there's something [about] lifestyle and some environmental factor about this, so it's not genetic,” he said. “There are genetic causes of colorectal cancer, but that's not what's driving the rising incidence in young adults. … But what exactly the lifestyle factor is — is it obesity? I'm sure that is playing some role. Diet is probably playing some role. But exactly what about the diet, the processed foods, the meats we eat? I think those are probably impacting the incidents, but exactly how and which of those is playing a major role, we have not unpacked that as a field yet, so I can say it'd be premature for me to land this all on any one of those things.
“And then again, [there are] exposures. We don't have significant exposure like we do with lung cancer and smoking in the development of cancer, but certainly, there are environmental exposures, and there's a whole host of literature for other cancers about certain exposures and dyes, for example, driving other cancers. But we don't know exactly what that exposure is for colorectal cancer.”
The lifetime risk of developing colorectal cancer is approximately one in 23 for men and one in 25 for women, the American Cancer Society noted. It also stated that when men and women are combined, colorectal cancer is the second most common cause of cancer death, expected to cause 53,010 deaths in 2024. Although the colorectal cancer death rate has been falling among older adults for decades, people younger than 55 years old have been climbing by approximately 1% per year since the mid-2000s, according to the American Cancer Society.
The American Cancer Society reported earlier this year that although colorectal cancer had been the fourth-leading cause of cancer death in men and women younger than 50 years old in the late 1990s, it is now the first in men and second in women.
Van Der Beek, PEOPLE reported, will appear in the Dec. 9 television special “The Real Full Monty” to raise awareness for prostate, testicular and colorectal cancer testing and research.
As far as what treatment he may undergo under the current standard of care, Cecchini said it depends on the stage of Van Der Beek’s disease.
“We think of most cancers this way, the first question would be like, is this stage 4 or not?” Cecchini said. “So, stage 4 means has this spread more distantly, typically in colorectal cancer's case, has this spread to the liver, or has it spread to the lung or the abdominal cavity elsewhere? And if the answer is no, then it is a stage 1, 2, [or] 3, somewhere in that range.”
Stage 1, he explained, is minimally invasive into the colon wall, while stage 2 means the cancer has gone further into the colon wall and stage 3 disease has spread to lymph nodes. For those three stages, the first step would be surgical resection, where a surgeon surgically removes the disease. Then, providers decide whether chemotherapy should be performed next to potentially address any remaining cancer cells.
“The standard of care, in summary, for localized disease is surgery, plus or minus chemotherapy after the surgery, and for certain for metastatic disease, for the disease where it's stage 4 and it's spread more distantly, the standard of care is a lot more complicated, but it's generally going to involve some chemotherapy, and in some select cases, may involve some surgeries to remove some of the metastatic sites of the disease.”
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