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To include a summary: the authors report that poor diet and exercise may be a factor for many cases, but often are not a factor in many others. A willingness to push medical professionals for screening, even if they have skepticism, would also improve survivability.

Highlights include:

“One suspected factor is obesity, which has soared among children and young people. Lifestyle changes that increase the risk of being overweight, such as increased consumption of highly processed, low-fiber foods and a lack of exercise, could be boosting the risk of colorectal cancer.

“Researchers note, however, that many young colorectal cancer patients have no history of obesity. That suggests that more subtle, systemic factors could be at work, such as changes in gut bacteria — the microbiome — according to medical experts. […]

“Jones, the gastroenterologist, said about 15 percent of colon cancer patients younger than 50 have a genetic vulnerability, such as Lynch syndrome. Another 25 percent of cases involve people with a strong family history. The other 60 percent have no risk factors.

“Although some doctors have pointed to bad diet, alcohol use and lack of exercise as factors, Jones notes that the actor Chadwick Boseman, the star of “Black Panther” and other movies who died of colon cancer at 43, “was hardly a smoking, drinking guy. He was a young, vigorous person.” […]

“Colorectal cancer remains a relatively uncommon disease among young people. But that creates a diagnostic hurdle: When a young woman, for example, tells a doctor that she’s experiencing severe pain in her lower abdomen, or blood in her stool, or unexplained weight loss, the doctor probably isn’t going to think “colon cancer.” […]

“A common symptom among patients with colorectal cancer is rectal bleeding, and such patients are usually diagnosed with hemorrhoids, Siegel said. Doctors “are thinking horses, not zebras.””