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Overall, the colorectal cancer story is encouraging

163 points by ZeroGravitas 8mo ago

proee 8mo ago
Wow, I had no idea there is a 15X increase for endurance athletes. Make me want to dial down the running a bit, which make you wonder where the sweet spot is for distance training.
- parl_match 8mo ago
  It may be the damage of repetitive motion, it may be chemicals released into the bloodstream from endurance athletics. It may be something else. Without knowing the root cause, it's impossible to figure out the "sweet spot"
  - tekno45 8mo ago
    i saw something recently that pointed to the fact that ultra runners end up with less blood in their guts while running for SO long its leading to cancers and such.
    - porknubbins 8mo ago
      This makes the most sense to me. I wonder how long distance cycling compares given that they can go for even longer than runners.
  - elric 8mo ago
    Could be a lot of things. Lots of long distance runners consume a lot of sugary gels to keep going. Not sure what the typical composition is, but likely lots of glucose and no fibre. The marathon runners I know also seem to eat tons of junk food, they can get away with it from a weight perspective because a long run will burn it off, but it could have other consequences. Point being: there's a lot about long distance runners that's quite different from other people.
    - reenorap 8mo ago
      But the rates of obese people who presumably consume a lot of sugars and carbs are 1/10th the rate of ultra marathon runners. It's scary to think that such conditioned athletes could be subject to this horrible disease.
  - deleted 8mo ago
    [deleted]
- reducesuffering 8mo ago
  It's not simply endurance athletes though. It was 2x ultra-marathons >26 miles, or at least 5 marathons completed.
  - inglor_cz 8mo ago
    Which is way more than what original hunters and gatherers ever clock. They do move a lot, but not so much, and they alternate their activities a lot too (running, walking, resting, taking entire days off and just guarding their village). We're not really optimized for this sort of extreme endurance and long-term development of serious pathologies is unsuprising.
    - greygoo222 8mo ago
      You shouldn't so offhandedly assume a hunter-gatherer lifestyle couldn't lead to issues like increased risk of CRC, or that activities which lead to increased risk of CRC couldn't be what hunter-gatherers did. Evolution is neither fast nor perfectly precise. Plenty of animal populations have common health problems that simply weren't harmful enough to reproduction to be selected out, much less something rare and late-onset like CRC.
      - inglor_cz 8mo ago
        I don't assume anything. From what we know about health of the last surviving hunter-gatherers, they suffer significantly less from "diseases of civilization" when taken in proportion to their settled neighbours. Some of those diseases (such as high blood pressure or diabetes 2nd type) seem to be totally absent in them. Cancers do happen, but not as often. This pattern is quite old. Already ancient Egyptians suffered from civilizational diseases much more than hunter-gatherers, especially the richer ones (heart attacks, gout, cancer).
        greygoo222 8mo ago
        I won't bother checking or disputing the accuracy of your factual claims, because it does not matter. Colorectal cancer is not the same thing as high blood pressure, or type 2 diabetes, or any other cancer that isn't colorectal cancer. Diseases are not a monolith and you cannot assume low risk of some diseases means low risk of others. That is wild guesswork passed off as logic, like measuring the shadow your testicles cast on the wall and announcing it is 24.1 degrees Celsius. Ultra-marathon runners also have low risk of type 2 diabetes! Do you have specific evidence that modern hunter-gatherers have low rates of colorectal cancer that cannot be explained by survivorship bias, screening, genetic differences, and all other confounders, and that they are representative of historical hunter-gatherers? No? Then you cannot confidently conclude that hunter-gatherers didn't experience elevated rates of CRC.
- ZeeSee 8mo ago
  It's rare but can happen where long distance running causes ischemic colitis which is where on a long run enough blood is diverted from the large intestine that it damages the intestine long term. It isn't surprising to me that there's higher likelihood of colon cancer given this. It seems like repeated bouts of lower blood for the intestine on long runs has a cumulative impact and damages the colon even if it doesn't cause ischemic colitis.
  - sigmoid10 8mo ago
    This theory has been put forward, but it's important to point out that there is no real evidence yet. An alternative theory is diet, which is also the leading theory for increasing incidences in non-athletes. Highly processed, calorie dense foods have been on the watchlist for a while, and ultra endurance athletes have a special need for these to satisfy their caloric requirements. It could also be a combination of these factors or something else that was missed entirely so far.
- PenguinCoder 8mo ago
  Interesting, I wasn't aware of that connection either. I was diagnosed with stage IV colon cancer, but was identified as 'genetic' and not caused by diet or lifestyle. I used to be a heavy runner too, done a few marathons, and plenty more 10k, 8ks etc. Wonder if that could be a correlation... Treatments have it contained/in maintenance so at least I have that going for me.
  - greedo 8mo ago
    I too was diagnosed with stage 2 rectal cancer, but it was back in 2005. How did they determine your cause was genetic?
    - PenguinCoder 8mo ago
      Did the genetic genome tests from the biopsy, from a third party company. Helped guide the treatments.
      - greedo 8mo ago
        Ah, that definitely wasn't offered to me as an option. Glad to see the progress however. It would be nice if there was an alternative test so that I could tell my kids it's not genetic.
  - javiramos 8mo ago
    Best of luck with your treatment.
- francisofascii 8mo ago
  I have an ultra-runner friend who just got diagnosed with stage 4 colon cancer. Absolutely devastating. He had a colonoscopy just a few years ago. His only symptom was not feeling well after a long race.
- AstroBen 8mo ago
  I wonder if it's due to diet. Endurance athletes love their simple carbs, highly processed gels. I've seen plenty of cyclists taking gummy bears on rides for fuel, or a concoction that is effectively sugar water to drink The study referenced is really light on details and they don't say if they controlled for that
  - xaldir 8mo ago
    I was thinking the same thing. Simple sugars and highly processed foods tends to affect the gut microbiome. I guess "more ressearch is needed".
anigbrowl 8mo ago
I stopped after the 4th click, I found it irritating to have to click to get 1 or 2 sentences at a time. This would have been just fine as a short article, making it interactive annoyed me more than the revealed content informed.
- GaryBluto 8mo ago
  Made even more annoying by the "next page" button constantly moving with the page height.
- plopz 8mo ago
  Very annoying UX, I found it felt like it was breaking continuity and making the ideas on each page disjointed.
dexwiz 8mo ago
Something I've never seen in these analyses is drinking. Millennials are heavy drinkers. Both craft brews and cocktails were defining generational traits. Not everyone is a drinker but it appears they are heavy drinkers compared to other generations. The theory behind the ultra marathoners is that extreme distance running disrupts the epithelial layer and microbiome in the gut. Wouldn't drinking have similar effects?
- zbentley 8mo ago
  I thought lots of data indicated that millennials were drinking less than previous generations?
- deleted 8mo ago
  [deleted]
- caminante 8mo ago
  > Millennials are heavy drinkers. That's news to millenials and the graveyard of craft breweries. I thought alcohol consumption is trending off for younger generations.
  - SamoyedFurFluff 8mo ago
    Millennials are not the younger generation anymore. That refers to Gen Z and alpha.
    - hyperbovine 8mo ago
      It’s more like, millennials got older and started drinking less (as happens), and Gen Z drinks different things like hard seltzer, and also drinks a bit less overall. Plus there were just way too many craft brewers making hoppy ipa to begin with.
      - sevensor 8mo ago
        Unfortunately, hoppy IPA seems to constitute the majority of the survivors. I have no interest personally in suffering through another hazy sour grapefruit triple ipa, but that seems to be about 90% of craft brewery output these days.
nubinetwork 8mo ago
Strange, because I've heard the exact opposite... https://www.cbc.ca/news/health/colorectal-cancer-keeps-rising-among-younger-adults-no-one-s-sure-why-1.6772096 https://www.cbc.ca/news/health/colorectal-cancer-keeps-risin...
- stevenjgarner 8mo ago
  That is EXACTLY what the post is saying: > But that progress belongs almost entirely to people 50 and over. For people under 50, both incidence and mortality have been climbing. CRC is now the #1 cancer killer in men under 50. You need to go to the 2nd screen "Split by age group"
  - nubinetwork 8mo ago
    Maybe their website sucks and all I saw was 2 graphs
- pcorsaro 8mo ago
  You didn't actually click and read anything. Hank's page is saying exactly what the article you linked is saying. CRC is on the rise in young people. I'm not sure why the moderators changed the title of this post. It should be "Something is Going on with Colorectal Cancer."
atleastoptimal 8mo ago
Very effective way of conveying information. I think a major factor is the increase in microplastics in our diets. https://www.sciencedirect.com/science/article/abs/pii/S1877782125001006 https://www.sciencedirect.com/science/article/abs/pii/S18777...
- SpaceManNabs 8mo ago
  i disagree. content is great. hitting back button messes stuff up for me. a long form article is preferred for me but maybe this is better for people used to swiping.
Der_Einzige 8mo ago
My layman's thoughts are it has something to do with young people spending way too much time on the toilet sitting doomscrolling on their phones. (also yes to microplastics and endocrine disruptiors) Also, hope that bidets may help with it in some way? Bidets supposedly reduce hemorrhoids.
gwbas1c 8mo ago
Years ago, I went to a show where Hank Green sang a song about his IBS. I still chuckle at the lyric about rerouting his bowel to a spigot. That being said, I wish this was a normal page that scrolled. The click click click just breaks the web.
y-curious 8mo ago
I’m in my early 30s and am starting to think about getting a screening. Problem is, it’s not trivial to do. You have to really upsell your doctor to get one so early, even though it’s a relatively benign procedure. There is a noninvasive testing method called Shield but it is way too flawed to be reliable (with poor positive rates for malignant tumors)
- nphardon 8mo ago
  If you tell your doctor that a parent had polyps removed (say, recently), that will give you your best chance of getting one. Most likely, if you're in an even remotely progressive area, your doc wants you to have one, but their hands are tied by the insurance company. Afaik you dont have to provide any proof of your claim re parental polyps.
  - lotsofpulp 8mo ago
    > but their hands are tied by the insurance company. Doctors' ability to prescribe or refer is never restricted by an insurance company. If they think a patient should get whatever healthcare, they are free to say it.
    - anoojb 8mo ago
      In CA, my doctor can refer me to get a Cologuard. But it's private pay, and they want payment up front since isurance companies don't restrict doctor's ability, only reimbursement. So they may not be willing (even though they are able) perform procedure/test if they aren't confident they'll get paid.
    - maxerickson 8mo ago
      You are just ignoring their intended meaning. Boring.
      - lotsofpulp 8mo ago
        Is the intended meaning that health insurance should pay for anything and everything? Even systems where the government pays directly like the UK have parameters under which the government will pay for a procedure or medicine.
autoexec 8mo ago
It's rare to see a website that fails to display anything without JS being enabled that also has such nice looking code. I'm both disappointed and impressed! Reading between the script tags was enough to get the idea at least
kazinator 8mo ago
If you screen more people for the disease, and do it better, such that you reduce the incidences and fatalities in the 50+ cohort, that improvement logically implies that you must be catching incidences in the under 50 cohort. So it's going to skew the numbers. Incidences that would have been tallied in the 50+ cohort, are now counted in the under 50. E.g. a 45-year-old with a latent colorectal cancer who would previously not have been diagnosed early, but only late when they developed symtpoms, by which time they hit 50, would have counted as an incidence or a likely fatality, among the 50+ data. But if that same individual had been caught at 45, they would have counted as an incidence against int he under-50 cohort. Earlier, better and more available screening alone will shift the data this way.
- greygoo222 8mo ago
  This mostly can't explain the fact that mortality is also rising in under 50s. It is true mortality is rising less than incident, and that a small proportion instances of mortality could be deaths related to reasonable risks taken on from treatment side effects (to make up numbers, it makes sense to take a 5% chance of dying from treatment this year over a 80% chance of dying from cancer in 5 years), but this is probably not the whole effect. Something is causing more CRC in people under 50.
  - kazinator 8mo ago
    No, it can't explain that; but the rise is very small. On the per 100,000 mortality graphs divided into the age cohorts, the under fifty mortality is almost a flat line. There is something there, but it doesn't seem like a huge alarm.
  - pfannkuchen 8mo ago
    Does treatment ever speed up death? Given that chemo is super hard on the body I imagine it could? That might just account for your use of “mostly”, though.
    - greedo 8mo ago
      It would depend on the treatment. In my case I had neoadjuvant radiation followed by chemo, then surgery, capped off with more chemo to kill any cancer cells that might have tried to make a dash for it. I would assume that while the radiation treatment elevated my risk for future cancers, the greater risk was my 10 hour surgical procedure.
bahmboo 8mo ago
Excellent content. The delivery mechanism of the site cited is very polarizing! At the very least it’s generated a lot of opinions. If I think of the target audience used to TikTok engagements it makes a lot of sense. It’s swipey influenced and interactive. It breaks the back button oh well we have browser tabs right? The web is best for me when experimental UX like this is tried out.
l5870uoo9y 8mo ago
One of Europe's leading nutrition experts also highlighted energy drinks in connection with the growing incidence of colon cancer among young people.
- throwway120385 8mo ago
  What evidence is there of that?
- ZeroGravitas 8mo ago
  Sugary drinks is one of the cited contributers in this piece.
elric 8mo ago
If anyone here is up for disrupting the medical field: please come up with a colonoscopy-equivalent with a less awful prep experience.
- hansvm 8mo ago
  I think they could do pretty well just not adding bubble gum or whatever nasty flavors the prep has. Sure it'll still be unpleasant and salty, but burping up that nonsense all day really doesn't make it better.
  - sumeno 8mo ago
    Depending on the doctor some are now recommending getting a tub of miralax, mixing it all into gatorade, and using that for prep instead of the prescription stuff. Still sucks, but at least it isn't a disgusting flavor, although I haven't had a desire for blue gatorade in the last 3 years
    - bored_student 8mo ago
      I do this, I have gone through 10 Costco tubs so far in my 1+ year of suffering from chronic constipation
- seattle_spring 8mo ago
  By far the worst part. By far. Though having to push out a huge fart at the request of the nurse while they stare at you when you wake up is a close 2nd.
  - hansvm 8mo ago
    I've never heard of that. Is it standard?
- brocha 8mo ago
  When I got my second, I had a bidet and it made a huge difference. That and a bit of vaseline to prevent too much irritation. It's an uncomfortable process so taking every win you can saves your sanity
dkural 8mo ago
How much of the rise do the listed later on (endurance athletes, obesity, sugary drinks, sedentary lifestyle) explain the relative youth rise? After all, some of this was an issue in 2006 as it is in 2026. Does it explain most of the relative rise, or is there a major missing piece / a mystery still to be explained? I doubt the % of endurance athletes changed meaningfully population-wide, to be a major contributing factor, for example.
- trillic 8mo ago
  You'd be surprised. COVID-19 fundamentally altered a lot of people's habits. https://www.businessofapps.com/data/strava-statistics/ https://www.businessofapps.com/data/strava-statistics/
  - andy_ppp 8mo ago
    I had to have a good read of the article and put the content in ChatGPT for further more detailed analysis. I still can’t infer a single thing about how I should be surprised or how people’s habits changed, so feel free to enlighten me!
    - liveoneggs 8mo ago
      Food delivery is now an "essential" for more people than it ever was before. Doordash/Uber Eats is how a weirdly large amount of people eat in general. The rate of increase in childhood obesity went up during covid.
      - dkural 8mo ago
        You realize that is far too recent to show up in cancer death rates for under-40 year olds right? It takes 10-15 years for a change-in-behavior to show up in incidence and even longer for deaths. As a classic example, see the shift (i.e. the delay) in curve of reduced smoking and reduced lung cancer.
        8mo ago
NedF 8mo ago
[dead]
inglor_cz 8mo ago
Even in Czechia, where the combination of traditional "heavy" food and, probably, some sort of genetic burden (people with Czech ancestry tend to suffer from colorectal cancers even if they live in regions with very different diets) used to make us the record holders, mortality has gone significantly down. Humanity seems to be getting this particular snake in its grip.
GlibMonkeyDeath 8mo ago
The graph showing risk factors in age groups 18-49 is interesting - obesity, "sugary drinks (>2/day)", and sedentary lifestyle (>2 hr TV/day) are each about 1.5-2x increase in risk factor. Obesity has roughly doubled over this time period, and people are more sedentary. What I could find about "sugary drinks" seems to indicate it hasn't changed much or even dropped slightly over this time. So obesity/sedentary lifestyle probably explains a lot of the increase (maybe not everything, but probably close; a 50% increase in population incidence, where a ~2x risk factor affected ~50% of the population would explain it.)
- orionsbelt 8mo ago
  Obviously this is just anecdotal and you could still be correct, but the two celebrities the article cited (Chadwick Boseman and James Van Der Beek) don’t seem to fit that mold.
  - Earw0rm 8mo ago
    True, although how many celebrities do?
deleted 8mo ago
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WarOnPrivacy 8mo ago
My Dr just ordered a test for colon cancer. If it's positive, I'm dead. I don't have enough savings to score a hospital bed, nevertheless surgery. In this, I'm in the same boat as millions of other Americans. Positive medical news rarely applies to us.
- ALittleLight 8mo ago
  Nonsense. There are many ways to get free or reduced price medical care in the US, especially if you are poor. Your doctor will have resources to help you if needed. You can also rack up huge medical debt and then not pay it. The hospital will sell your debt to bill collectors who will call you for a while, and eventually sue you. At that point you can offer to settle for pennies on the dollar, or you might lose the lawsuit and have to declare bankruptcy which would mean you have negative credit for a few years. Obviously it will be a difficult time, and hopefully you have something else, but they won't just let you die because you can't afford it.
  - porknubbins 8mo ago
    Also if you have a low paying job its probably not a big loss to quit it and go on Medicaid if you have a six or seven figure illness. Though it seems like they are trying to change this path for 2027.
  - bored_student 8mo ago
    Well, unfortunately the current administration has blocked a bill that would have prohibited medical debt from reflecting on your credit score.
    - ALittleLight 8mo ago
      If someone is dying of colorectal cancer, trying to get them to worry about their credit score is not only not helpful, it's actively harmful. Messing up your credit for a few years is in the category of "inconvenience" and it's not the kind of thing that you need to worry about when surviving cancer.
gnarlouse 8mo ago
Hey Hank, if youre on HN, you're one of my favorite humans that I don't personally know.
- krapp 8mo ago
  If Hank Green even knew what Hacker News was, I think my respect for him would diminish considerably.
recallingmemory 8mo ago
It doesn't look like meat consumption was mentioned anywhere. Frequent consumption of red and processed meat is strongly linked to a higher risk of colorectal cancer, with studies showing a 30% to 40% increased risk for high consumption levels [1]. Processed meat, in particular, raises CRC risk by about 18% for every 50-gram daily portion [2]. Your ultra-endurance athletes might be convinced they need more protein in their diets and are most likely consuming large quantities of meat. 1: https://pmc.ncbi.nlm.nih.gov/articles/PMC10194058/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10194058/ 2: https://www.umassmed.edu/news/news-archives/2015/10/umms-colorectal-expert-urges-caution-on-new-who-processed-meat-warning/#:~:text=The%20International%20Agency%20for%20Research%20on%20Cancer,risk%20of%20colorectal%20cancer%20by%2018%20percent. https://www.umassmed.edu/news/news-archives/2015/10/umms-col...
- briHass 8mo ago
  Though ostensibly supportive of your claim, the first article says it best a few pages in (surprisingly honest): "To date, there are no clearly established biological mechanisms that could explain the role of red and processed meat in the process of CRC carcinogenesis." In other words, we see some small signal in epidemiological studies, and we want to speculate about mechanistic causes, even though this has been tried before to no success.
  - recallingmemory 8mo ago
    I would point to the conclusion of the study: "Red and processed meat consumption and its interaction with the gut microbiota are found to be major associated factors. The CRC-associated gut microbiota is made of pro-inflammatory or pro-carcinogenic bacteria and opportunistic pathogenic bacteria that enrich the tumor microenvironment by promoting disease progression." I would also add that the World Health Organization after evaluating 800 studies classified processed meat as a Group 1 carcinogen back in 2015, indicating a strong causal link to colorectal cancer, placing it in the same risk category as tobacco. [1] While I linked to a single study in my original comment, I believe the results are more than a small signal.. enough for the WHO to come out and say processed meat does in fact have a causal link to CRC. 1: https://nutritionsource.hsph.harvard.edu/2015/11/03/report-says-eating-processed-meat-is-carcinogenic-understanding-the-findings/ https://nutritionsource.hsph.harvard.edu/2015/11/03/report-s...
epistasis 8mo ago
Excellent science communication, as would be expected from this author. A recent finding from last year looked at the mutational signatures in colon cancer in those under 50: https://www.nature.com/articles/s41586-025-09025-8 https://www.nature.com/articles/s41586-025-09025-8 The different processes that damage DNA have sequence preferences for the direct change in the DNA (e.g. G-->C versus G-->T), as well as the sequence around the damage. Smoking causes very very different signatures of DNA damage than, say, damage from UV from being in the sun. So every cell in our body carries with it a (noisy) history of the mutagenic processes it has been exposed to. This paper found some differences in these mutational signatures of later colon cancers, and attributed them to colibactin, a mutagen produced by bacteria. It remains to be seen what percentage of the increase in under-50 colon cancers this would explain, but it's an additional risk factor that didn't make it onto the chart, likely because it's not coming from standard epidemiological analysis, and instead from the world of molecular analysis.
AstroBen 8mo ago
I wonder why fiber is never brough up with this. Only ~5% of people get enough fiber and it lowers your risk a lot
- abbefaria27 8mo ago
  It’s covered in the risk factors section at the end.
  - AstroBen 8mo ago
    Ah, you're right. I actually looked it up after I made that comment and it looks to be a 10% reduction in relative risk per 10g extra fiber consumed Considering Americans as an example only get 10-15g per day, and it's perfectly possible to get 60g.. that could have a huge impact
- coppsilgold 8mo ago
  You can buy Psyllium husks by the pound as well.
  - elric 8mo ago
    There are apparently cases of psyllium leading to weird allergic reactions. IIRC this is frequently reported in caretakers who prepare psyllium for eldery patients, presumably because they end up inhaling some of the stuff?
- porknubbins 8mo ago
  Fiber is so inconvenient to get in adequate quantity. We cook all our meals using tons of vegetables and none of it has much fiber if I remember. Occasionally I’ll try to start eating oatmeal but get burned out after a week or two.
  - bored_student 8mo ago
    I eat a lot of fibrous frankenfoods and I’m not sure if the net effect is positive, but I think it helps my bowel movements…
bill_from_tampa 8mo ago
The encouragement is that the rate of "death from colorectal carcinoma" seems to be reduced in studies of screening. This is a 'disease specific' mortality statistic. Most of us don't care why we die, or what is ultimately written upon our death certificates, we would simply rather still be alive! So reduction in "total mortality" would be a more convincing endpoint. If a study of some screening test for a dread disease does NOT show a reduction in the 'total mortality' of the group screened at some clinically reasonable point of time in the future, one could argue that the screening was pointless. Yes, perhaps less people died from the condition being screened for, but if the same number of persons died in the screened -vs- unscreened group, what has been accomplished? It has been hard, well impossible, to show that screening for colorectal cancer reduces the total or overall death rate. For example, a recent study published in the NEJM in 2022 did find a reduction in persons who died from colorectal carcinoma after screening with colonoscopy. But they did NOT find that the total or overall death rate had decreased! "The risk of death from any cause was 11.03% in the invited group and 11.04% in the usual-care group (risk ratio, 0.99; 95% CI, 0.96 to 1.04)." N Engl J Med 2022;387:1547-1556 DOI: 10.1056/NEJMoa2208375V When reading 'screening' studies, one usually needs to look very carefully at the article and published data to find this statistic. Sometimes it is not even reported at all, it is simply ignored. It's almost like the authors don't want the fact that the screening program does not reduce one's risk of dying to any measurable degree is ... embarrassing? This problem is not unique to colorectal cancer screening.
- epistasis 8mo ago
  When studies are designed a key parameter is the statistical power that the size of the stud provides: how big of a difference in the key stat can it find? I would expect that the design of a study will be able to find differences in the key readout: did screening reduce death in the types of cancer it could find. Colon cancer deaths are only a small fraction of total mortality, and statistically, finding a small change in a ratio close to zero is far easier to see than a that same change in a ratio that's further away from zero. So I would not expect a study to be powered to be able to find changes in total mortality from all causes. That would take a far larger number of people and generally be considered a waste of resources that would be better spent investigating other things. So I wouldn't take the lack of statistical significance in total mortality as evidence of anything, unless total mortality was a primary outcome that was being tested. Pretty much all the good interventions for reducing mortality will not have much impact on total mortality because there are so many things causing total mortality. But add up all the small ones and it starts to make differences in total mortality.
dwd 8mo ago
Australia has a national screening program, originally for over-50s but now also open to 45-49yo to request a home test kit. You'll get a kit every two years, and should they find blood in the sample they will then refer you to get a colonoscopy exam. They should probably extend the eligibility to these younger high-risk groups. https://www.health.gov.au/our-work/national-bowel-cancer-screening-program https://www.health.gov.au/our-work/national-bowel-cancer-scr...
chromehearts 8mo ago
I love the way the information is displayed!
deleted 8mo ago
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trainspotter 8mo ago
Just want to thank the author and poster for sharing this. These are the thoughtful, intellectual, helpful articles that make this site worth continuing to come back to. Ditto on the discussion.

163 points by ZeroGravitas 8mo ago

proee 8mo ago

Wow, I had no idea there is a 15X increase for endurance athletes. Make me want to dial down the running a bit, which make you wonder where the sweet spot is for distance training.

parl_match 8mo ago
It may be the damage of repetitive motion, it may be chemicals released into the bloodstream from endurance athletics. It may be something else. Without knowing the root cause, it's impossible to figure out the "sweet spot"
- tekno45 8mo ago
  i saw something recently that pointed to the fact that ultra runners end up with less blood in their guts while running for SO long its leading to cancers and such.
  - porknubbins 8mo ago
    This makes the most sense to me. I wonder how long distance cycling compares given that they can go for even longer than runners.
- elric 8mo ago
  Could be a lot of things. Lots of long distance runners consume a lot of sugary gels to keep going. Not sure what the typical composition is, but likely lots of glucose and no fibre. The marathon runners I know also seem to eat tons of junk food, they can get away with it from a weight perspective because a long run will burn it off, but it could have other consequences. Point being: there's a lot about long distance runners that's quite different from other people.
  - reenorap 8mo ago
    But the rates of obese people who presumably consume a lot of sugars and carbs are 1/10th the rate of ultra marathon runners. It's scary to think that such conditioned athletes could be subject to this horrible disease.
- deleted 8mo ago
  [deleted]
reducesuffering 8mo ago
It's not simply endurance athletes though. It was 2x ultra-marathons >26 miles, or at least 5 marathons completed.
- inglor_cz 8mo ago
  Which is way more than what original hunters and gatherers ever clock. They do move a lot, but not so much, and they alternate their activities a lot too (running, walking, resting, taking entire days off and just guarding their village). We're not really optimized for this sort of extreme endurance and long-term development of serious pathologies is unsuprising.
  - greygoo222 8mo ago
    You shouldn't so offhandedly assume a hunter-gatherer lifestyle couldn't lead to issues like increased risk of CRC, or that activities which lead to increased risk of CRC couldn't be what hunter-gatherers did. Evolution is neither fast nor perfectly precise. Plenty of animal populations have common health problems that simply weren't harmful enough to reproduction to be selected out, much less something rare and late-onset like CRC.
    - inglor_cz 8mo ago
      I don't assume anything. From what we know about health of the last surviving hunter-gatherers, they suffer significantly less from "diseases of civilization" when taken in proportion to their settled neighbours. Some of those diseases (such as high blood pressure or diabetes 2nd type) seem to be totally absent in them. Cancers do happen, but not as often. This pattern is quite old. Already ancient Egyptians suffered from civilizational diseases much more than hunter-gatherers, especially the richer ones (heart attacks, gout, cancer).
      - greygoo222 8mo ago
        I won't bother checking or disputing the accuracy of your factual claims, because it does not matter. Colorectal cancer is not the same thing as high blood pressure, or type 2 diabetes, or any other cancer that isn't colorectal cancer. Diseases are not a monolith and you cannot assume low risk of some diseases means low risk of others. That is wild guesswork passed off as logic, like measuring the shadow your testicles cast on the wall and announcing it is 24.1 degrees Celsius. Ultra-marathon runners also have low risk of type 2 diabetes! Do you have specific evidence that modern hunter-gatherers have low rates of colorectal cancer that cannot be explained by survivorship bias, screening, genetic differences, and all other confounders, and that they are representative of historical hunter-gatherers? No? Then you cannot confidently conclude that hunter-gatherers didn't experience elevated rates of CRC.
ZeeSee 8mo ago
It's rare but can happen where long distance running causes ischemic colitis which is where on a long run enough blood is diverted from the large intestine that it damages the intestine long term. It isn't surprising to me that there's higher likelihood of colon cancer given this. It seems like repeated bouts of lower blood for the intestine on long runs has a cumulative impact and damages the colon even if it doesn't cause ischemic colitis.
- sigmoid10 8mo ago
  This theory has been put forward, but it's important to point out that there is no real evidence yet. An alternative theory is diet, which is also the leading theory for increasing incidences in non-athletes. Highly processed, calorie dense foods have been on the watchlist for a while, and ultra endurance athletes have a special need for these to satisfy their caloric requirements. It could also be a combination of these factors or something else that was missed entirely so far.
PenguinCoder 8mo ago
Interesting, I wasn't aware of that connection either. I was diagnosed with stage IV colon cancer, but was identified as 'genetic' and not caused by diet or lifestyle. I used to be a heavy runner too, done a few marathons, and plenty more 10k, 8ks etc. Wonder if that could be a correlation... Treatments have it contained/in maintenance so at least I have that going for me.
- greedo 8mo ago
  I too was diagnosed with stage 2 rectal cancer, but it was back in 2005. How did they determine your cause was genetic?
  - PenguinCoder 8mo ago
    Did the genetic genome tests from the biopsy, from a third party company. Helped guide the treatments.
    - greedo 8mo ago
      Ah, that definitely wasn't offered to me as an option. Glad to see the progress however. It would be nice if there was an alternative test so that I could tell my kids it's not genetic.
- javiramos 8mo ago
  Best of luck with your treatment.
francisofascii 8mo ago
I have an ultra-runner friend who just got diagnosed with stage 4 colon cancer. Absolutely devastating. He had a colonoscopy just a few years ago. His only symptom was not feeling well after a long race.
AstroBen 8mo ago
I wonder if it's due to diet. Endurance athletes love their simple carbs, highly processed gels. I've seen plenty of cyclists taking gummy bears on rides for fuel, or a concoction that is effectively sugar water to drink The study referenced is really light on details and they don't say if they controlled for that
- xaldir 8mo ago
  I was thinking the same thing. Simple sugars and highly processed foods tends to affect the gut microbiome. I guess "more ressearch is needed".

anigbrowl 8mo ago

I stopped after the 4th click, I found it irritating to have to click to get 1 or 2 sentences at a time. This would have been just fine as a short article, making it interactive annoyed me more than the revealed content informed.

GaryBluto 8mo ago
Made even more annoying by the "next page" button constantly moving with the page height.
plopz 8mo ago
Very annoying UX, I found it felt like it was breaking continuity and making the ideas on each page disjointed.

dexwiz 8mo ago

Something I've never seen in these analyses is drinking. Millennials are heavy drinkers. Both craft brews and cocktails were defining generational traits. Not everyone is a drinker but it appears they are heavy drinkers compared to other generations. The theory behind the ultra marathoners is that extreme distance running disrupts the epithelial layer and microbiome in the gut. Wouldn't drinking have similar effects?

zbentley 8mo ago
I thought lots of data indicated that millennials were drinking less than previous generations?
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caminante 8mo ago
> Millennials are heavy drinkers. That's news to millenials and the graveyard of craft breweries. I thought alcohol consumption is trending off for younger generations.
- SamoyedFurFluff 8mo ago
  Millennials are not the younger generation anymore. That refers to Gen Z and alpha.
  - hyperbovine 8mo ago
    It’s more like, millennials got older and started drinking less (as happens), and Gen Z drinks different things like hard seltzer, and also drinks a bit less overall. Plus there were just way too many craft brewers making hoppy ipa to begin with.
    - sevensor 8mo ago
      Unfortunately, hoppy IPA seems to constitute the majority of the survivors. I have no interest personally in suffering through another hazy sour grapefruit triple ipa, but that seems to be about 90% of craft brewery output these days.

nubinetwork 8mo ago

Strange, because I've heard the exact opposite... https://www.cbc.ca/news/health/colorectal-cancer-keeps-rising-among-younger-adults-no-one-s-sure-why-1.6772096 https://www.cbc.ca/news/health/colorectal-cancer-keeps-risin...

stevenjgarner 8mo ago
That is EXACTLY what the post is saying: > But that progress belongs almost entirely to people 50 and over. For people under 50, both incidence and mortality have been climbing. CRC is now the #1 cancer killer in men under 50. You need to go to the 2nd screen "Split by age group"
- nubinetwork 8mo ago
  Maybe their website sucks and all I saw was 2 graphs
pcorsaro 8mo ago
You didn't actually click and read anything. Hank's page is saying exactly what the article you linked is saying. CRC is on the rise in young people. I'm not sure why the moderators changed the title of this post. It should be "Something is Going on with Colorectal Cancer."

atleastoptimal 8mo ago

Very effective way of conveying information. I think a major factor is the increase in microplastics in our diets. https://www.sciencedirect.com/science/article/abs/pii/S1877782125001006 https://www.sciencedirect.com/science/article/abs/pii/S18777...

SpaceManNabs 8mo ago
i disagree. content is great. hitting back button messes stuff up for me. a long form article is preferred for me but maybe this is better for people used to swiping.

Der_Einzige 8mo ago

My layman's thoughts are it has something to do with young people spending way too much time on the toilet sitting doomscrolling on their phones. (also yes to microplastics and endocrine disruptiors) Also, hope that bidets may help with it in some way? Bidets supposedly reduce hemorrhoids.

gwbas1c 8mo ago

Years ago, I went to a show where Hank Green sang a song about his IBS. I still chuckle at the lyric about rerouting his bowel to a spigot. That being said, I wish this was a normal page that scrolled. The click click click just breaks the web.

y-curious 8mo ago

I’m in my early 30s and am starting to think about getting a screening. Problem is, it’s not trivial to do. You have to really upsell your doctor to get one so early, even though it’s a relatively benign procedure. There is a noninvasive testing method called Shield but it is way too flawed to be reliable (with poor positive rates for malignant tumors)

nphardon 8mo ago
If you tell your doctor that a parent had polyps removed (say, recently), that will give you your best chance of getting one. Most likely, if you're in an even remotely progressive area, your doc wants you to have one, but their hands are tied by the insurance company. Afaik you dont have to provide any proof of your claim re parental polyps.
- lotsofpulp 8mo ago
  > but their hands are tied by the insurance company. Doctors' ability to prescribe or refer is never restricted by an insurance company. If they think a patient should get whatever healthcare, they are free to say it.
  - anoojb 8mo ago
    In CA, my doctor can refer me to get a Cologuard. But it's private pay, and they want payment up front since isurance companies don't restrict doctor's ability, only reimbursement. So they may not be willing (even though they are able) perform procedure/test if they aren't confident they'll get paid.
  - maxerickson 8mo ago
    You are just ignoring their intended meaning. Boring.
    - lotsofpulp 8mo ago
      Is the intended meaning that health insurance should pay for anything and everything? Even systems where the government pays directly like the UK have parameters under which the government will pay for a procedure or medicine.

autoexec 8mo ago

It's rare to see a website that fails to display anything without JS being enabled that also has such nice looking code. I'm both disappointed and impressed! Reading between the script tags was enough to get the idea at least

kazinator 8mo ago

If you screen more people for the disease, and do it better, such that you reduce the incidences and fatalities in the 50+ cohort, that improvement logically implies that you must be catching incidences in the under 50 cohort. So it's going to skew the numbers. Incidences that would have been tallied in the 50+ cohort, are now counted in the under 50. E.g. a 45-year-old with a latent colorectal cancer who would previously not have been diagnosed early, but only late when they developed symtpoms, by which time they hit 50, would have counted as an incidence or a likely fatality, among the 50+ data. But if that same individual had been caught at 45, they would have counted as an incidence against int he under-50 cohort. Earlier, better and more available screening alone will shift the data this way.

greygoo222 8mo ago
This mostly can't explain the fact that mortality is also rising in under 50s. It is true mortality is rising less than incident, and that a small proportion instances of mortality could be deaths related to reasonable risks taken on from treatment side effects (to make up numbers, it makes sense to take a 5% chance of dying from treatment this year over a 80% chance of dying from cancer in 5 years), but this is probably not the whole effect. Something is causing more CRC in people under 50.
- kazinator 8mo ago
  No, it can't explain that; but the rise is very small. On the per 100,000 mortality graphs divided into the age cohorts, the under fifty mortality is almost a flat line. There is something there, but it doesn't seem like a huge alarm.
- pfannkuchen 8mo ago
  Does treatment ever speed up death? Given that chemo is super hard on the body I imagine it could? That might just account for your use of “mostly”, though.
  - greedo 8mo ago
    It would depend on the treatment. In my case I had neoadjuvant radiation followed by chemo, then surgery, capped off with more chemo to kill any cancer cells that might have tried to make a dash for it. I would assume that while the radiation treatment elevated my risk for future cancers, the greater risk was my 10 hour surgical procedure.

bahmboo 8mo ago

Excellent content. The delivery mechanism of the site cited is very polarizing! At the very least it’s generated a lot of opinions. If I think of the target audience used to TikTok engagements it makes a lot of sense. It’s swipey influenced and interactive. It breaks the back button oh well we have browser tabs right? The web is best for me when experimental UX like this is tried out.

l5870uoo9y 8mo ago

One of Europe's leading nutrition experts also highlighted energy drinks in connection with the growing incidence of colon cancer among young people.

throwway120385 8mo ago
What evidence is there of that?
ZeroGravitas 8mo ago
Sugary drinks is one of the cited contributers in this piece.

elric 8mo ago

If anyone here is up for disrupting the medical field: please come up with a colonoscopy-equivalent with a less awful prep experience.

hansvm 8mo ago
I think they could do pretty well just not adding bubble gum or whatever nasty flavors the prep has. Sure it'll still be unpleasant and salty, but burping up that nonsense all day really doesn't make it better.
- sumeno 8mo ago
  Depending on the doctor some are now recommending getting a tub of miralax, mixing it all into gatorade, and using that for prep instead of the prescription stuff. Still sucks, but at least it isn't a disgusting flavor, although I haven't had a desire for blue gatorade in the last 3 years
  - bored_student 8mo ago
    I do this, I have gone through 10 Costco tubs so far in my 1+ year of suffering from chronic constipation
seattle_spring 8mo ago
By far the worst part. By far. Though having to push out a huge fart at the request of the nurse while they stare at you when you wake up is a close 2nd.
- hansvm 8mo ago
  I've never heard of that. Is it standard?
brocha 8mo ago
When I got my second, I had a bidet and it made a huge difference. That and a bit of vaseline to prevent too much irritation. It's an uncomfortable process so taking every win you can saves your sanity

dkural 8mo ago

How much of the rise do the listed later on (endurance athletes, obesity, sugary drinks, sedentary lifestyle) explain the relative youth rise? After all, some of this was an issue in 2006 as it is in 2026. Does it explain most of the relative rise, or is there a major missing piece / a mystery still to be explained? I doubt the % of endurance athletes changed meaningfully population-wide, to be a major contributing factor, for example.

trillic 8mo ago
You'd be surprised. COVID-19 fundamentally altered a lot of people's habits. https://www.businessofapps.com/data/strava-statistics/ https://www.businessofapps.com/data/strava-statistics/
- andy_ppp 8mo ago
  I had to have a good read of the article and put the content in ChatGPT for further more detailed analysis. I still can’t infer a single thing about how I should be surprised or how people’s habits changed, so feel free to enlighten me!
  - liveoneggs 8mo ago
    Food delivery is now an "essential" for more people than it ever was before. Doordash/Uber Eats is how a weirdly large amount of people eat in general. The rate of increase in childhood obesity went up during covid.
    - dkural 8mo ago
      You realize that is far too recent to show up in cancer death rates for under-40 year olds right? It takes 10-15 years for a change-in-behavior to show up in incidence and even longer for deaths. As a classic example, see the shift (i.e. the delay) in curve of reduced smoking and reduced lung cancer.
      - 8mo ago

NedF 8mo ago

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inglor_cz 8mo ago

Even in Czechia, where the combination of traditional "heavy" food and, probably, some sort of genetic burden (people with Czech ancestry tend to suffer from colorectal cancers even if they live in regions with very different diets) used to make us the record holders, mortality has gone significantly down. Humanity seems to be getting this particular snake in its grip.

GlibMonkeyDeath 8mo ago

The graph showing risk factors in age groups 18-49 is interesting - obesity, "sugary drinks (>2/day)", and sedentary lifestyle (>2 hr TV/day) are each about 1.5-2x increase in risk factor. Obesity has roughly doubled over this time period, and people are more sedentary. What I could find about "sugary drinks" seems to indicate it hasn't changed much or even dropped slightly over this time. So obesity/sedentary lifestyle probably explains a lot of the increase (maybe not everything, but probably close; a 50% increase in population incidence, where a ~2x risk factor affected ~50% of the population would explain it.)

orionsbelt 8mo ago
Obviously this is just anecdotal and you could still be correct, but the two celebrities the article cited (Chadwick Boseman and James Van Der Beek) don’t seem to fit that mold.
- Earw0rm 8mo ago
  True, although how many celebrities do?

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WarOnPrivacy 8mo ago

My Dr just ordered a test for colon cancer. If it's positive, I'm dead. I don't have enough savings to score a hospital bed, nevertheless surgery. In this, I'm in the same boat as millions of other Americans. Positive medical news rarely applies to us.

ALittleLight 8mo ago
Nonsense. There are many ways to get free or reduced price medical care in the US, especially if you are poor. Your doctor will have resources to help you if needed. You can also rack up huge medical debt and then not pay it. The hospital will sell your debt to bill collectors who will call you for a while, and eventually sue you. At that point you can offer to settle for pennies on the dollar, or you might lose the lawsuit and have to declare bankruptcy which would mean you have negative credit for a few years. Obviously it will be a difficult time, and hopefully you have something else, but they won't just let you die because you can't afford it.
- porknubbins 8mo ago
  Also if you have a low paying job its probably not a big loss to quit it and go on Medicaid if you have a six or seven figure illness. Though it seems like they are trying to change this path for 2027.
- bored_student 8mo ago
  Well, unfortunately the current administration has blocked a bill that would have prohibited medical debt from reflecting on your credit score.
  - ALittleLight 8mo ago
    If someone is dying of colorectal cancer, trying to get them to worry about their credit score is not only not helpful, it's actively harmful. Messing up your credit for a few years is in the category of "inconvenience" and it's not the kind of thing that you need to worry about when surviving cancer.

gnarlouse 8mo ago

Hey Hank, if youre on HN, you're one of my favorite humans that I don't personally know.

krapp 8mo ago
If Hank Green even knew what Hacker News was, I think my respect for him would diminish considerably.

recallingmemory 8mo ago

It doesn't look like meat consumption was mentioned anywhere. Frequent consumption of red and processed meat is strongly linked to a higher risk of colorectal cancer, with studies showing a 30% to 40% increased risk for high consumption levels [1]. Processed meat, in particular, raises CRC risk by about 18% for every 50-gram daily portion [2]. Your ultra-endurance athletes might be convinced they need more protein in their diets and are most likely consuming large quantities of meat. 1: https://pmc.ncbi.nlm.nih.gov/articles/PMC10194058/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10194058/ 2: https://www.umassmed.edu/news/news-archives/2015/10/umms-colorectal-expert-urges-caution-on-new-who-processed-meat-warning/#:~:text=The%20International%20Agency%20for%20Research%20on%20Cancer,risk%20of%20colorectal%20cancer%20by%2018%20percent. https://www.umassmed.edu/news/news-archives/2015/10/umms-col...

briHass 8mo ago
Though ostensibly supportive of your claim, the first article says it best a few pages in (surprisingly honest): "To date, there are no clearly established biological mechanisms that could explain the role of red and processed meat in the process of CRC carcinogenesis." In other words, we see some small signal in epidemiological studies, and we want to speculate about mechanistic causes, even though this has been tried before to no success.
- recallingmemory 8mo ago
  I would point to the conclusion of the study: "Red and processed meat consumption and its interaction with the gut microbiota are found to be major associated factors. The CRC-associated gut microbiota is made of pro-inflammatory or pro-carcinogenic bacteria and opportunistic pathogenic bacteria that enrich the tumor microenvironment by promoting disease progression." I would also add that the World Health Organization after evaluating 800 studies classified processed meat as a Group 1 carcinogen back in 2015, indicating a strong causal link to colorectal cancer, placing it in the same risk category as tobacco. [1] While I linked to a single study in my original comment, I believe the results are more than a small signal.. enough for the WHO to come out and say processed meat does in fact have a causal link to CRC. 1: https://nutritionsource.hsph.harvard.edu/2015/11/03/report-says-eating-processed-meat-is-carcinogenic-understanding-the-findings/ https://nutritionsource.hsph.harvard.edu/2015/11/03/report-s...

epistasis 8mo ago

Excellent science communication, as would be expected from this author. A recent finding from last year looked at the mutational signatures in colon cancer in those under 50: https://www.nature.com/articles/s41586-025-09025-8 https://www.nature.com/articles/s41586-025-09025-8 The different processes that damage DNA have sequence preferences for the direct change in the DNA (e.g. G-->C versus G-->T), as well as the sequence around the damage. Smoking causes very very different signatures of DNA damage than, say, damage from UV from being in the sun. So every cell in our body carries with it a (noisy) history of the mutagenic processes it has been exposed to. This paper found some differences in these mutational signatures of later colon cancers, and attributed them to colibactin, a mutagen produced by bacteria. It remains to be seen what percentage of the increase in under-50 colon cancers this would explain, but it's an additional risk factor that didn't make it onto the chart, likely because it's not coming from standard epidemiological analysis, and instead from the world of molecular analysis.

AstroBen 8mo ago

I wonder why fiber is never brough up with this. Only ~5% of people get enough fiber and it lowers your risk a lot

abbefaria27 8mo ago
It’s covered in the risk factors section at the end.
- AstroBen 8mo ago
  Ah, you're right. I actually looked it up after I made that comment and it looks to be a 10% reduction in relative risk per 10g extra fiber consumed Considering Americans as an example only get 10-15g per day, and it's perfectly possible to get 60g.. that could have a huge impact
coppsilgold 8mo ago
You can buy Psyllium husks by the pound as well.
- elric 8mo ago
  There are apparently cases of psyllium leading to weird allergic reactions. IIRC this is frequently reported in caretakers who prepare psyllium for eldery patients, presumably because they end up inhaling some of the stuff?
porknubbins 8mo ago
Fiber is so inconvenient to get in adequate quantity. We cook all our meals using tons of vegetables and none of it has much fiber if I remember. Occasionally I’ll try to start eating oatmeal but get burned out after a week or two.
- bored_student 8mo ago
  I eat a lot of fibrous frankenfoods and I’m not sure if the net effect is positive, but I think it helps my bowel movements…

bill_from_tampa 8mo ago

The encouragement is that the rate of "death from colorectal carcinoma" seems to be reduced in studies of screening. This is a 'disease specific' mortality statistic. Most of us don't care why we die, or what is ultimately written upon our death certificates, we would simply rather still be alive! So reduction in "total mortality" would be a more convincing endpoint. If a study of some screening test for a dread disease does NOT show a reduction in the 'total mortality' of the group screened at some clinically reasonable point of time in the future, one could argue that the screening was pointless. Yes, perhaps less people died from the condition being screened for, but if the same number of persons died in the screened -vs- unscreened group, what has been accomplished? It has been hard, well impossible, to show that screening for colorectal cancer reduces the total or overall death rate. For example, a recent study published in the NEJM in 2022 did find a reduction in persons who died from colorectal carcinoma after screening with colonoscopy. But they did NOT find that the total or overall death rate had decreased! "The risk of death from any cause was 11.03% in the invited group and 11.04% in the usual-care group (risk ratio, 0.99; 95% CI, 0.96 to 1.04)." N Engl J Med 2022;387:1547-1556 DOI: 10.1056/NEJMoa2208375V When reading 'screening' studies, one usually needs to look very carefully at the article and published data to find this statistic. Sometimes it is not even reported at all, it is simply ignored. It's almost like the authors don't want the fact that the screening program does not reduce one's risk of dying to any measurable degree is ... embarrassing? This problem is not unique to colorectal cancer screening.

epistasis 8mo ago
When studies are designed a key parameter is the statistical power that the size of the stud provides: how big of a difference in the key stat can it find? I would expect that the design of a study will be able to find differences in the key readout: did screening reduce death in the types of cancer it could find. Colon cancer deaths are only a small fraction of total mortality, and statistically, finding a small change in a ratio close to zero is far easier to see than a that same change in a ratio that's further away from zero. So I would not expect a study to be powered to be able to find changes in total mortality from all causes. That would take a far larger number of people and generally be considered a waste of resources that would be better spent investigating other things. So I wouldn't take the lack of statistical significance in total mortality as evidence of anything, unless total mortality was a primary outcome that was being tested. Pretty much all the good interventions for reducing mortality will not have much impact on total mortality because there are so many things causing total mortality. But add up all the small ones and it starts to make differences in total mortality.

dwd 8mo ago

Australia has a national screening program, originally for over-50s but now also open to 45-49yo to request a home test kit. You'll get a kit every two years, and should they find blood in the sample they will then refer you to get a colonoscopy exam. They should probably extend the eligibility to these younger high-risk groups. https://www.health.gov.au/our-work/national-bowel-cancer-screening-program https://www.health.gov.au/our-work/national-bowel-cancer-scr...

chromehearts 8mo ago

I love the way the information is displayed!

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trainspotter 8mo ago

Just want to thank the author and poster for sharing this. These are the thoughtful, intellectual, helpful articles that make this site worth continuing to come back to. Ditto on the discussion.