Although the number of people diagnosed with colorectal cancer in the United States is dropping among people age 65 or older, rates of colon cancer are on the rise among younger adults. This disturbing trend is something Shawn Farrah, 47, of Marietta, Ohio, is living firsthand, and he is on a mission to spread an important message: Don’t ignore warning signs of colon cancer, and get screened. “I am living proof that colorectal cancer is not a disease that just impacts older people. You are never too young to develop colon cancer. Timely screening is critically important, especially if you have a family history. I encourage anyone who is experiencing potential symptoms of colon cancer to talk to your doctor sooner rather than later. It could literally save your life,” says Farrah. Farrah was 45 and training for the Cleveland Marathon in May 2018 when he developed debilitating pain and was taken to the hospital for an emergency appendectomy. During his surgical recovery, he noticed blood in his bowel movement. He assumed it was a side effect of his pain medication and went on with life. But the issue got worse, so with encouragement from his wife and on the advice of his family physician, Farrah underwent a screening colonoscopy in November 2018. His diagnosis: stage 3B/3C colon cancer. Farrah was referred to The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James), where he began taking an oral chemotherapy drug combined with targeted radiation treatments to shrink the colorectal tumor so it could be surgically removed. “That’s when I learned the cancer had spread to my liver, which was a frustrating setback,” Farrah recalls. He began a different intravenous chemotherapy to address the liver cancer, which was not operable at the time. After eight months of treatment, the liver tumor was surgically removed in March 2019. He’s had no evidence of disease since that time. While there were setbacks and challenges, Farrah says staying physically active and involved in his church helped him remain strong in mind and body. He also became involved in the Colorectal Cancer Alliance as a patient ambassador to help spread the important message of early detection for colorectal cancer, a disease that impacts nearly 148,000 Americans annually. Now Farrah is back to running regularly and has completed three half marathons since his original diagnosis. What You Need to Know About Colorectal Cancer Risk and Screening Colorectal cancer is the second-leading cause of cancer-related death among men and women in the United States, after lung and prostate cancer in men, and lung and breast cancer in women. Colorectal cancer cases among those under 50 have been increasing since the 1990s, according to a March 2020 report by the American Cancer Society. Half of all new colorectal cancer diagnoses are in people under age 66, and Black men have a 20% higher risk than white men. The American Cancer Society recommends that people begin screening for colorectal cancer at age 45. When detected early, precancerous polyps in the colorectal tract can be removed and prevent cancer development. “We have seen tremendous progress in early detection through screening colonoscopy in older adults, but we are seeing rates of colorectal cancer rising at alarming rates in people under age 60,” says Darrell Gray II, MD, gastroenterologist and deputy director of the Center for Health Equity at the OSUCCC – James. “It is important for us all to focus on lifestyle changes we can make to reduce our risk and to seek medical advice — sooner rather than later — if we have concerning symptoms that could indicate a problem.” Gray recommends all people consider these lifestyle changes to mitigate their colorectal cancer risk: Limit alcohol intake. Alcohol is associated with higher risk of colorectal cancer, especially for men. Avoid or limit red and processed meat intake. Studies suggest a balanced diet full of plant-based foods and whole grains could help reduce risk of colorectal cancer and support overall health. Commit to daily exercise. Maintaining a consistent workout routine can be challenging but is very important. Even adding moderate activity to a sedentary life can reduce colorectal cancer risk by up to 24%, he notes. Have open conversations about family history of cancer. “We typically recommend starting screening at age 45 for African Americans, but if an immediate family member was diagnosed with colorectal cancer, you may need to start screening colonoscopy at age 40 or earlier,” Gray says. Kick stress to the curb. Not only does chronic stress impact your mental and physical health, it can lead people to engage in stress-relieving behaviors like smoking, drinking, overeating or being sedentary. All of these things can increase risk of colorectal cancer. To schedule a screening colonoscopy, call 800-293-5066 or visit cancer.osu.edu/coloncancer to learn more.