It’s one of the mysteries that has puzzled cancer epidemiologists: Why are younger and younger people becoming sick with colorectal cancer?
The latest national cancer statistics from the American Cancer Society show adults under the age of 55 have seen their colorectal cancer rate increase 2 percent per year since the mid-1990s. Overall, those born in 1990 have double the risk of developing colon cancer and four times the risk of getting rectal cancer compared to those born around 1950. That’s why, in response to the alarming trend, the ACS in 2018 lowered the recommended age for routine colorectal cancer screening to 45 from 50.
“It’s not like the problem is bad and has stabilized,” said Thomas Weber, the director of surgical oncology at New York’s Northwell Health, who organizes an annual summit for researchers trying to solve the mystery. “The problem has continued to worsen.”
A new study, published on May 17 in Lancet Gastroenterology & Hepatology, suggests the trend may be global. Looking at long-term data on colon and rectal cancer incidence, the authors found increases in people younger than 50 in Australia, Canada, Denmark, New Zealand, Norway, and the UK.
Researchers have a couple of potential explanations for what’s going on: the rising rates of obesity and factors that shape the microbiome in early childhood. Since 1980, the obesity prevalence has doubled in more than 70 countries around the world. Thirty-nine percent of US adults, are now obese, along with 19 percent of children and adolescents.
A recent JAMA study looked at 85,000 women and found a link between a higher body weight, particularly obesity, and a greater risk of colorectal cancer.
But not so fast: One of the study’s authors, Washington University School of Medicine cancer epidemiologist Yin Cao, warned this study isn’t the final answer: “I think we are getting closer but this is not the final answer for [the mystery].” Here’s why.
The link between obesity and colorectal cancer
Colorectal cancer is the third most common cancer diagnosed in the United States, with a lifetime risk of 4 to 5 percent in men and women. While it used to be a disease that mainly surfaced after middle age, the shift to younger and younger ages has alarmed researchers. And not only are people in their 20s and 30s increasingly being diagnosed with the disease; they’re also dying from it.
The main reason obesity is thought of as a potential driver of early-onset colorectal cancer is because it’s associated with inflammation in the body.
You can think about inflammation in two ways. There’s helpful inflammation, as with your body’s immune response to an attack by a foreign invader — your skin reddens and heats up to fight off bacteria in a cut.
There’s also harmful, or chronic, inflammation: when your body’s inflammatory response goes into overdrive, hampering its ability to fight off viruses and disease. One measure of it is a blood marker called C-reactive protein (CRP). Researchers have found associations between higher levels of CRP and various chronic illnesses, including cancer, arthritis, cardiovascular disease, and diabetes. People who are inactive or obese or who eat an unhealthy diet seem to have higher levels of CRP in their systems too.
The JAMA study looked at 85,000 women aged 25 to 42 who were followed from 1989 to 2011 as part of the ongoing Nurses’ Health Study II. The researchers mapped early-onset colorectal cancers against body mass index (BMI) — both current and at age 18 — to figure out whether having a higher BMI at any point in a person’s life was associated with greatest colorectal cancer risk before age 50. And they found strong associations.
The 114 women who developed colorectal cancer in the study tended to have a higher BMIs. Their risk also increased the higher their body weights climbed. So people with obesity (a BMI of 30) had nearly double the risk of early-onset colorectal cancer compared with women in the normal BMI range (18.5 to 22.9). In other words, it looked like as obesity rates climb, so too does colorectal cancer risk.
Why this mystery is hard to solve
But the impact of obesity on cancer risk is pretty hard to untangle from other behaviors or attributes people with obesity may have, like their diet. Scientists have found strong associations between Western-style, pro-inflammatory diets — heavy in processed meat, red meat, organ meat, sugary beverages, and refined grains — and a higher risk of colorectal cancer. And it’s possible the heavier people in the study followed a diet that was more inflammation-promoting.
What’s more, the study only looked at a subset of cases. “There were 114 cases under the age of 50 [in the study], and there are some 16,000 cases a year of colorectal cancer of people under the age of 50 in the US,” Weber said.
So while obesity may play a role in driving this alarming trend, it’s probably not the entire explanation. Weber added: “Many, many providers are struck by how fit and active many of their young colorectal cancer patients are. And this includes the fact the vast majority of these cases have nothing to do with hereditary syndromes.”
Other researchers are looking at whether colorectal cancer in young people may be the result of exposures to certain things in early childhood.
“There is persuasive evidence that features of early life contribute to risks for a number of adverse health effects that occur in later childhood, teen ages, and even in young adults,” writes Franklin Berger, research and outreach director at the University of South Carolina, in a recent Conversation article. This can include things like antibiotic treatments, whether a baby was born vaginally or through a C-section, stress, and again, diet and nutrition.
The idea is these factors may alter the microbiome — the ecology of diverse bacteria lining the intestines and colon. The trillions of microbes “undergo many changes during the period between birth and ages 3 to 4, and are highly susceptible to perturbation by the kinds of exposures listed above,” Berger writes. Again, the science here is still in its early stages — but it’s an area to watch.
For now, patients — including young adults — should be aware of this emerging trend, and the signs and symptoms of colorectal cancer.
Lil Nas X and Wrangler’s “Old Town Road” clothing line inspires country music fan backlash
“Old Town Road” star Lil Nas X’s latest move is into fashion, courtesy of a collaboration with Wrangler, the legacy denim and apparel brand that’s become a signature element of the Western aesthetic.
The chart-topping rapper has partnered with the company to launch a capsule clothing collection inspired by his hit song and featuring graphic T-shirts, jeans, and other denim apparel. The collaboration is essentially an extension of one of the most memorable lyrics in “Old Town Road,” which shouts out Wrangler by name: “Cowboy hat from Gucci / Wrangler on my booty.”
Wrangler describes the capsule collection, which launched May 20, as “fresh remixes of classic Wrangler styles for the kind of modern cowboy that can’t be put in a box.”
That’s a cheeky reference to “Old Town Road” itself, which sparked an intense debate over whether the song counts as country music when it debuted on Billboard’s Hot Country Songs chart in March, and was subsequently removed. Despite its references to established Western themes and imagery — the song’s lyrics revolve around a lone cowboy riding his horse into the sunset, after all — Billboard said the song “does not embrace enough elements of today’s country music to chart in its current version.”
Some country music fans and industry observers agreed, arguing that “Old Town Road” qualifies more as hip-hop than country. Others criticized Billboard for feeding rigid ideas about who or what qualifies as country enough, and suggested that Lil Nas X’s race played a part in the song’s reclassification; the fact that Lil Nas X is a black teenager from Atlanta and country is a predominantly white genre did not go unnoticed.
The song quickly became the catalyst for an industry-wide discussion about the definition of country music and racially tinged gatekeeping within the genre. It also became the top song in the country, and has now been No. 1 on the Billboard Hot 100 for six weeks straight.
Just like the song itself riled some country music fans amid an outpouring of support for Lil Nas X from his own expansive fanbase, the rapper’s collaboration with Wrangler has met with a polarized response.
The Lil Nas X capsule collection is clearly intended to celebrate and capitalize on the success of “Old Town Road.” Although many Lil Nas X fans have expressed interest in buying the collection, Wrangler is also facing criticism from some consumers, many of whom are threatening to boycott.
Much of the backlash is playing out on social media, where Wrangler has received thousands of comments from customers expressing anger and “disappointment.” (It is unclear if customers have also been contacting the company via other, less public methods; Vox has reached out to Wrangler for comment.) And much of the current conversation revolves around how Wrangler seems to be promoting inclusivity by branching out from its reputation as a brand worn by cowboys and farmers.
Two recent Instagram posts from Wrangler showcasing items from its Lil Nas X collection have received more than 1,000 comments each. While plenty of people have commented on how awesome it looks or asking questions about where to buy, several have declared that the “Old Town Road” items are “ruining the cowboy name that y’all have.”
“Wranglers are to be worn by cowboys and farmers not rappers this is very disappointing,” reads one representative Instagram comment.
Some commenters have more explicitly mentioned race — or called out others’ racism.
“This is the dumbest thing i have seen all day,” one user wrote. “Wtf @wrangler? Why is it about diversity and equality ? There jeans. Quit playin politics.”
WRANGLER JUST PARTNERED WITH LIL NAS X AND THE RACIST ARE MAD GO BUY UP ALL THE WRANGLER LIL NAS X COLLAB JEANS YOU CAN PEOPLE SUPPORT DIVERSITY pic.twitter.com/gwH2G7dULj
— tyler (@tylerujhazy) May 21, 2019
Lil Nas X, for his part, seemed mildly surprised by the response.
i mean honestly white people act like they are the only ones who are cowboys. come to my town in louisiana, we pull up to mcdonalds on horses and have rodeos every weekend.
— Blair Waldorf (@teonnyspears) May 21, 2019
These comments are in the same vein as those used by some country music fans to describe “Old Town Road” when the song made its chart debut, arguing that rappers have no place in the genre (often while neglecting to acknowledge modern country’s own hip-hop influences). Lingering over this debate is race, which many Instagram users have called out in the comments on Wrangler’s posts. Country music is perceived as an insular, predominantly white genre, while Lil Nas X is a black rapper who draws influences from black artists and musical styles.
But Wrangler’s continued support of Lil Nas X is clear; the brand has been actively responding to its detractors on social media, simply repeating on that is devoted to creating high-quality products for all of its customers.
Perhaps unsurprisingly, the drama over the Lil Nas X collection has only served to draw more attention to it. Some pieces have already sold out, like a pair of shorts that say “Wrangler” on the booty, in keeping with the lyrics of “Old Town Road.” Considering that items in the collection cost between $39 for a graphic T-shirt and $129 for a pair of jeans, the outcry, at least from Wrangler’s perspective, seems to have paid off.
20 Times People Snapped Something Truly Exceptional and Shared the Pics With the World
We are living in the world that is full of surprises where every single day is a new chance to see something so unusual that it makes you doubt your own vision. A treble clef in a bag of fries, a cat whose fur went gray only on his ears, or a person with 6 fingers — these are just a few extraordinary sights that made people reach for their phones and take a pic.
Here at Bright Side we can’t wait to share our list with you of pics showing the standout things people snapped on their ordinary days.
20. Someone found a treble clef in their fries.
19. The pattern on this dog’s chest resembles a cat’s silhouette.
18. Someone saw a landscape on the bottom of their coffee mug.
17. This stone looks like a pile of mini chocolate bars.
16. This cloud looks like a shark.
15. “This stick I found looks like a burning torch, flame included!”
14. “My sweater sort of matches my pillowcase.”
13. “This truck is carrying nothing but a toy dump truck.”
12. “My empanadas have the filling stamped into them.”
11. “I randomly found the tiniest snail I’ve ever seen! (standard bobby pin for scale)”
10. “My cat has double fangs on both sides.”
9. “This tree near my school track has absorbed a fence and shows the pattern on its bark.”
8. “This is an X-ray of my hedgehog.”
7. “My 12-year-old sister made this perfect cake on her first ever try making one.”
6. “I won every single prize on this lottery ticket.”
5. “I made a giant cardboard statue of my face.”
4. “My cousin’s wedding dress from last night has its own pockets.”
3. This is one million dollars in $10 bills.
2. “A customer came in and let me take a picture of her hands that had 6 fingers on each.”
1. “My aunt’s cat’s ears grayed to here a couple years ago and haven’t changed since.”
Have you ever spotted something truly rare? Did you manage to take a picture of the unusual sight?
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