Once regarded as a disease affecting people over the age of 50, colorectal cancer is now rising at an alarming rate among adults aged between 20 and 40.
Health experts attribute the growing trend to unhealthy lifestyles, changing dietary habits and a lack of awareness, warning that early detection significantly improves treatment outcomes while reducing costs.
Doctors say regular consumption of processed foods, fast food, excessive red meat and fatty foods, combined with physical inactivity and obesity, is increasing the risk of colorectal cancer. They also expressed concern over the excessive use of chemicals and pesticides in food production, as well as the adulteration of food at different stages of the supply chain.
According to the American Cancer Society (ACS), the incidence of colorectal cancer among people under the age of 50 is increasing by around 3% annually.
Experts say the risk is even higher for those with a family history of the disease. They also cautioned against ignoring symptoms such as blood in the stool, persistent constipation or diarrhoea, changes in bowel habits and unexplained weight loss.
Treatment depends on the stage of the disease. In Bangladesh, the cost of treatment generally ranges from Tk500,000 to Tk3 million, although expenses can rise further if advanced targeted therapy or immunotherapy is required. However, treatment is considerably less expensive and more successful when the disease is diagnosed early.
Doctors recommend that people at average risk begin regular colorectal cancer screening from the age of 45. They also advise annual stool blood tests and immediate medical consultation if any unusual symptoms develop.
Professor Syed Akram Hossain, a cancer specialist at Bangladesh Medical Hospital, told Dhaka Tribune that colorectal cancer among people under 50 is increasing at an alarming rate worldwide.
"Although the exact cause has not yet been fully established, several important risk factors have already been identified," he said.
According to him, unhealthy eating habits—particularly diets high in processed foods, red meat and low-fibre foods—along with obesity, physical inactivity, smoking, alcohol consumption and changes in the gut microbiome significantly increase the risk of colorectal cancer.
He added that inherited conditions such as Lynch syndrome and Familial Adenomatous Polyposis (FAP), as well as long-standing ulcerative colitis and Crohn's disease, also increase the likelihood of developing the disease.
Professor Akram Hossain said one of the biggest challenges among younger patients is that many dismiss the symptoms as common gastric problems or piles.
"As a result, the disease is often diagnosed at a much later stage, making treatment more complicated," he said.
He said a significant proportion of colorectal cancer cases could be prevented through healthy lifestyle choices and regular health check-ups.
People should reduce their intake of processed foods and excessive red meat, exercise regularly, maintain a healthy weight and eat plenty of vegetables, fruits and fibre-rich foods every day, he said, adding that smoking and alcohol consumption should also be avoided.
He also urged people not to ignore warning signs such as persistent constipation, changes in bowel habits, blood in the stool or unexplained weight loss, and to seek prompt advice from a colorectal specialist if such symptoms occur.
For people with a family history of colorectal cancer, Professor Akram Hossain stressed the importance of risk assessment and, where appropriate, genetic counselling.
"These individuals may need to begin screening earlier than the general population," he said.
He said treatment costs vary depending on the stage of the disease and whether surgery, chemotherapy, radiotherapy, targeted therapy or immunotherapy is required.
"In Bangladesh, the overall cost of treatment generally ranges from Tk500,000 to Tk3 million or more. The cost rises further if advanced targeted therapy or immunotherapy is needed," he said.
According to him, prevention and early diagnosis remain the most effective and cost-efficient ways to tackle colorectal cancer.
Current international guidelines recommend that people at average risk begin regular colorectal cancer screening from the age of 45.
Those with a family history of colorectal cancer or inherited conditions such as Lynch syndrome, Familial Adenomatous Polyposis (FAP) or long-standing inflammatory bowel disease should begin screening even earlier, in consultation with their physician.
