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> Get a colonoscopy at 45. We are seeing a big increase in younger people. N.B. this is not just an increase in detection (as could happen with more/better scr

> Get a colonoscopy at 45. We are seeing a big increase in younger people. N.B. this is not just an increase in detection (as could happen with more/better screening where the true rate isn't changing), but mortality: > In people under 55, however, death rates have been increasing about 1% per year since the mid-2000s. https://www.cancer.org/cancer/types/colon-rectal-cancer/about/key-statistics.html https://www.cancer.org/cancer/types/colon-rectal-cancer/abou...

margalabargala 1y ago
It's certainly the case that colorectal cancer is becoming more common, and among younger people. Plenty of possible reasons; diet, plastics, PFAS, all of the above, take your pick. However, the fact that mortality has been decreasing above the age of frequent screenings, and increasing below that age, tells us that whatever the problem, the symptom (cancer) could be addressed with better screening, leading to earlier detection and treatment. Mortality is increasing in young people because they don't get screened, so when it does happened no one catches anything until it's too late. If the age for recommended regular colonoscopies was 40 or 45, we would see the same mortality reduction above that cutoff.
- oarfish 1y ago
  > Plenty of possible reasons; diet, plastics, PFAS, all of the above, take your pick. I think obesity is the main confounder in all such statistics. Thats the thing that has most markedly gone up over the past decades
  - deleted 1y ago
    [deleted]
  - jajko 1y ago
    You don't know that. Environment is much more polluted, and thus is our food. We move less. And so on.
    - barney54 1y ago
      Whose environment is much more polluted. In the developed world, pollution is decreasing. For the U.S., for example: https://gispub.epa.gov/air/trendsreport/2024/ https://gispub.epa.gov/air/trendsreport/2024/
      - lithocarpus 1y ago
        That's showing that air pollution I would guess mostly from cars has gone down since 1990. There are lots of other new chemicals not shown on that chart that are in our food and clothes and everything, particularly almost everything modern babies in the US come in contact with.
        looofooo0 1y ago
        There is also a lot less toxic chemicals around nowadays such as flame retardants, DDT, lead (petrol), asbestos, PCB etc.
        Cthulhu_ 1y ago
        While PFAS and microplastics and the like are a huge problem, you can't just dismiss the major efforts done over the decades to reduce pollution and improve health; wood / coal fire bans, mandatory catalytic converters, ban on asbestos and CFCs, lead-free fuel and paint, EVs, renewable electricity generation, emission zones, trash collection & safe disposal, smoking bans and discouraging measures, etc. It's not an either/or, and not celebrating successes means there will be less inclination to also solve the newly discovered issues.
        lithocarpus 1y ago
        Fair points honestly. We tried a lot of awful stuff in the 1900s that has been stopped and that should be celebrated. There's also a lot that was never stopped, and more and more coming all the time.
  - Cthulhu_ 1y ago
    Obesity is a symptom; food poverty, financial poverty, lifestyle choices, city design, culture, etc etc etc.
    - chucksmash 1y ago
      This mindset drives me nuts. It's like the rhetorical opposite of victim-blaming. It takes something that is within an individual's locus of control and pretends they have zero agency in the matter. Last week I finished a two month diet where a big chunk of my weekly calories and nutrients came from cheap staples I prepared myself (specifically brown rice, black beans, steelcut oats, spinach, and eggs). Aside from the food, the cost was 1. watching some ads in the free version of the calorie counter app I used to make sure I was getting the nutrients I needed and 2. ~$30 for a food scale so I could be precise about what I was eating. Circumstances make it easier to be unhealthy but what I did is attainable by the vast majority of obese people.
      - const_cast 1y ago
        It's complicated because it's both, with varying levels of influence. Obviously, it cannot be 100% on the individual. Because then, how did we get an obesity epidemic? Did people somehow, magically, become more lazy since 1970? That doesn't sound plausible to me. It's systemic in nature. Consider tobacco use, a problem we've largely solved in the US. We went from something like 50% of people smoking in 1960 to about 10% now. In young people, the results are even more drastic. It's sort of magic - a reverse obesity epidemic. How did we do this? A combination of things. Of course people worked very hard to quit, but they also got PSAs and their doctor's helped them. And then we made it much, much harder to smoke. The thing is, people are creatures of influence and habit. Much of what we do is because it's low resistance. We've allowed obesity to become a systemic problem because of our food available, our culture, and our lifestyles. It's not that some place like, say, Paris is healthy. But it's a lot easier to be accidentally not-obese in Paris, France than in Paris, Texas.
        deleted 1y ago
        [deleted]
  - baranul 1y ago
    While it's true that obesity has risen, a percentage of the human population has always been overweight. While on the other hand, the increasing amounts of environmental pollution and contamination is newer. It can be argued as being the greater challenge to human health and straining the genetic ability to adapt to such problems.

margalabargala 1y ago

It's certainly the case that colorectal cancer is becoming more common, and among younger people. Plenty of possible reasons; diet, plastics, PFAS, all of the above, take your pick. However, the fact that mortality has been decreasing above the age of frequent screenings, and increasing below that age, tells us that whatever the problem, the symptom (cancer) could be addressed with better screening, leading to earlier detection and treatment. Mortality is increasing in young people because they don't get screened, so when it does happened no one catches anything until it's too late. If the age for recommended regular colonoscopies was 40 or 45, we would see the same mortality reduction above that cutoff.

oarfish 1y ago
> Plenty of possible reasons; diet, plastics, PFAS, all of the above, take your pick. I think obesity is the main confounder in all such statistics. Thats the thing that has most markedly gone up over the past decades
- deleted 1y ago
  [deleted]
- jajko 1y ago
  You don't know that. Environment is much more polluted, and thus is our food. We move less. And so on.
  - barney54 1y ago
    Whose environment is much more polluted. In the developed world, pollution is decreasing. For the U.S., for example: https://gispub.epa.gov/air/trendsreport/2024/ https://gispub.epa.gov/air/trendsreport/2024/
    - lithocarpus 1y ago
      That's showing that air pollution I would guess mostly from cars has gone down since 1990. There are lots of other new chemicals not shown on that chart that are in our food and clothes and everything, particularly almost everything modern babies in the US come in contact with.
      - looofooo0 1y ago
        There is also a lot less toxic chemicals around nowadays such as flame retardants, DDT, lead (petrol), asbestos, PCB etc.
      - Cthulhu_ 1y ago
        While PFAS and microplastics and the like are a huge problem, you can't just dismiss the major efforts done over the decades to reduce pollution and improve health; wood / coal fire bans, mandatory catalytic converters, ban on asbestos and CFCs, lead-free fuel and paint, EVs, renewable electricity generation, emission zones, trash collection & safe disposal, smoking bans and discouraging measures, etc. It's not an either/or, and not celebrating successes means there will be less inclination to also solve the newly discovered issues.
        lithocarpus 1y ago
        Fair points honestly. We tried a lot of awful stuff in the 1900s that has been stopped and that should be celebrated. There's also a lot that was never stopped, and more and more coming all the time.
- Cthulhu_ 1y ago
  Obesity is a symptom; food poverty, financial poverty, lifestyle choices, city design, culture, etc etc etc.
  - chucksmash 1y ago
    This mindset drives me nuts. It's like the rhetorical opposite of victim-blaming. It takes something that is within an individual's locus of control and pretends they have zero agency in the matter. Last week I finished a two month diet where a big chunk of my weekly calories and nutrients came from cheap staples I prepared myself (specifically brown rice, black beans, steelcut oats, spinach, and eggs). Aside from the food, the cost was 1. watching some ads in the free version of the calorie counter app I used to make sure I was getting the nutrients I needed and 2. ~$30 for a food scale so I could be precise about what I was eating. Circumstances make it easier to be unhealthy but what I did is attainable by the vast majority of obese people.
    - const_cast 1y ago
      It's complicated because it's both, with varying levels of influence. Obviously, it cannot be 100% on the individual. Because then, how did we get an obesity epidemic? Did people somehow, magically, become more lazy since 1970? That doesn't sound plausible to me. It's systemic in nature. Consider tobacco use, a problem we've largely solved in the US. We went from something like 50% of people smoking in 1960 to about 10% now. In young people, the results are even more drastic. It's sort of magic - a reverse obesity epidemic. How did we do this? A combination of things. Of course people worked very hard to quit, but they also got PSAs and their doctor's helped them. And then we made it much, much harder to smoke. The thing is, people are creatures of influence and habit. Much of what we do is because it's low resistance. We've allowed obesity to become a systemic problem because of our food available, our culture, and our lifestyles. It's not that some place like, say, Paris is healthy. But it's a lot easier to be accidentally not-obese in Paris, France than in Paris, Texas.
      - deleted 1y ago
        [deleted]
- baranul 1y ago
  While it's true that obesity has risen, a percentage of the human population has always been overweight. While on the other hand, the increasing amounts of environmental pollution and contamination is newer. It can be argued as being the greater challenge to human health and straining the genetic ability to adapt to such problems.