Roundup: Colorectal Cancer in Younger Adults; Daily Aspirin Risk; and Misuse of Antibiotics

More Colorectal Cancer Cases Diagnosed in Younger Adults, With Advanced Disease More Likely

Diagnoses of colorectal cancer in adults under the age of 50 are more likely to be of advanced disease, reveals a new study that also confirms that the colon and rectal cancer rates continue to rise in younger adults.

Colorectal cancer — of the colon or rectum — ranks as third in the U.S. among the most common cancers for women and men. It is the second leading cause of cancer deaths in the U.S. for men and women combined.

The trend toward younger adults is striking and still somewhat of a mystery to researchers. Lifestyle factors, including a persistent obesity epidemic in the United States, is considered a contributor to the rise in colorectal cancer among younger people. Last year, the American Cancer Society modified its screening guidelines. People at average risk should start getting screened for colorectal cancer at age 45, instead of 50, the guidelines recommend.

In the new study, researchers with the departments of internal medicine and oncology at the University of Texas at Austin, focused on trends over the past two decades. Looking at data from the National Cancer Database registry, they found that 12.2 percent of colorectal cancer diagnoses in the U.S. in 2015 were in people under the age of 50 years, compared with 10 percent in 2004. A total of 1.1 million cases were included in the study.

More strikingly, researchers found signs of advanced disease in more than half (51.6 percent) of colorectal cancer diagnoses in younger adults — compared with 40 percent in those over 50 years of age. The team reported their findings in a Cancer journal paper.

Other study findings:

  • The proportion of young adults being diagnosed was higher in African-American and Hispanic populations, compare to non-Hispanic whites, from 2004 to 2015.
  • The proportion of colorectal cancers diagnosed in younger individuals rose in urban areas, but not in rural areas.
  • Rates of colorectal cancer diagnosis in young adults increased over time regardless of income level.

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Millions of U.S. Adults Needlessly Taking Daily Aspirin for Heart Health, Study Says

About 29 million people 40 and older were taking an aspirin a day in 2017, even though they were not diagnosed with heart disease, according to a new study by Harvard University and Beth Israel Deaconess Medical Center.

That’s a troubling statistic because people who don’t have risk factors linked to heart disease run the risk of internal bleeding from taking a daily aspirin, previous studies have shown.

Researchers concluded that millions of Americans who take aspirin every day to prevent heart attacks need to consult with their doctors to determine if they truly need it. The study found about 6.6 million people used aspirin even when a doctor never recommended taking them. About 10 million people older than 70 who didn’t have heart disease took daily aspirin for prevention, the researchers reported in Annals of Internal Medicine.

Several studies last year found that only a marginal benefit, if any, could be found from routine aspirin use – especially among older adults.

Earlier this year, the American College of Cardiology (ACC ) and the American Heart Association (AHA ) updated its guidelines. Every adult should avoid using aspirin as way to prevent heart disease because of the risk of bleeding, unless prescribed by a doctor, the new guidelines say. The new recommendation does not apply to people who already have had a stroke or heart attack, or who have undergone bypass surgery or a procedure to insert a stent in their coronary arteries, according to the ACC and the AHA.

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Use of Antibiotics Without a Prescription is a Growing Health Problem, Study Reveals

Americans using antibiotics that are not prescribed by a doctor has become a public health problem, according to findings from a large review of previous studies published in Annals of Internal Medicine.

The non-prescribed antibiotics were obtained through a range of ways, including saving leftover prescriptions for later use, getting them from friends and family, or obtaining them “under the counter” by other means.

This growing practice is linked to preventable health issues stemming from not taking the proper medication or the proper quantity. The use of non-prescribed antibiotics may also increase the risk of fueling antibiotic resistance, a growing public health issue in the U.S. and other nations.

Researchers from Baylor College of Medicine and the Center for Innovations in Quality, Effectiveness, and Safety reviewed 31 published studies to examine the the scope of nonprescription antibiotic use in the U.S., and to find the factors that influence this trend.

The prevalence of nonprescription antibiotic use varied from 1 percent among people visiting a clinic to 66 percent among Hispanic migrant workers. Storage of antibiotics for future use varied from 14 percent to 48 percent. A quarter of the participants in another study reported that they intended to use antibiotics without a prescription.

Factors that led to the use of these non-prescription meds included lack of insurance or access to healthcare, the expense of seeing a physician or the cost of a prescription, embarrassment about contracting a sexually transmitted infection, not being able to get time off of work to visit a healthcare facility or doctor’s office.

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