[HN Gopher] Overall, the colorectal cancer story is encouraging
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Overall, the colorectal cancer story is encouraging
Author : ZeroGravitas
Score : 76 points
Date : 2026-02-19 20:32 UTC (2 hours ago)
(HTM) web link (www.hankgreen.com)
(TXT) w3m dump (www.hankgreen.com)
| proee wrote:
| 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 wrote:
| 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 wrote:
| 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.
| elric wrote:
| 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.
| reducesuffering wrote:
| It's not simply endurance athletes though. It was 2x ultra-
| marathons >26 miles, or at least 5 marathons completed.
| inglor_cz wrote:
| 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 wrote:
| 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 wrote:
| 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 wrote:
| 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.
| pfannkuchen wrote:
| Absolutely, we may have a depressed rate of CRC where
| ultramarathoners just get back up to the historical
| baseline. Who knows, but we don't know it isn't that.
| inglor_cz wrote:
| "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..."
|
| Diseases are not a monolith, but they _do_ tend to arise
| and fall in some specific clusters, and that is not
| "logic", good or bad (too many computer-minded people
| drag logic into the chaos that is biology), but rather a
| long-time empirical observation, albeit with some
| exceptions.
| owenversteeg wrote:
| >2x ultra-marathons >26 miles, or at least 5 marathons
| completed
|
| Yes, and it seems like it's really a 7.5x risk increase.
| Still pretty spectacular, though!
|
| I really wonder what could cause that. Randomly throwing out
| possible causes: 1) blood redirected away from gut, 2)
| overuse of NSAIDS, 3) ultraprocessed foods (gels etc), 4)
| strange microbiome issues (gels + stress in gut from extreme
| exertion = altered gut flora?)
|
| The study that found the result is DOI:
| 10.1200/JCO.2025.43.16_suppl.3619
| ZeeSee wrote:
| 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 wrote:
| 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 wrote:
| 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.
| anigbrowl wrote:
| 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.
| plopz wrote:
| Very annoying UX, I found it felt like it was breaking
| continuity and making the ideas on each page disjointed.
| GaryBluto wrote:
| Made even more annoying by the "next page" button constantly
| moving with the page height.
| dexwiz wrote:
| 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 wrote:
| I thought lots of data indicated that millennials were drinking
| less than previous generations?
| caminante wrote:
| _> 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 wrote:
| Millennials are not the younger generation anymore. That
| refers to Gen Z and alpha.
| hyperbovine wrote:
| 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 wrote:
| 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.
| caminante wrote:
| 40% of the US population is older than 45, and millenial
| includes < 50th percentile.
|
| We're also talking about alcohol consumption. Only half of
| Gen Z can drink and none of Alpha.
| rybosworld wrote:
| Not to be rude but, google is free:
|
| https://www.google.com/search?q=are+millenials+heavy+drinker.
| ..
| caminante wrote:
| Well, your first Google result is a blog post that makes my
| point.
|
| _> For example, baby boomers are the generation with the
| most dramatic increase in harmful alcohol abuse. In
| contrast, Gen Z prefers the sober lifestyle as they are
| known to consume alcohol much less than any of their older
| counterparts, including millennials._
| panzagl wrote:
| I hate to break it to you, but Millennials aren't a younger
| generation anymore...
|
| though I'm not sure they drank any more than the 2-3
| generations that proceeded them.
| caminante wrote:
| _> but Millennials aren 't a younger generation anymore..._
|
| Not younger than GenX/Baby Boomer? How?
| anoojb wrote:
| This finding is crazy! I wonder how many modern health issues
| have to do with healthy blood/nutrient flow to tissues, that
| are basically solved with either mild/moderately amounts of
| movement and a balanced diet.
| nubinetwork wrote:
| Strange, because I've heard the exact opposite...
|
| https://www.cbc.ca/news/health/colorectal-cancer-keeps-risin...
| stevenjgarner wrote:
| 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"
| pcorsaro wrote:
| 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 wrote:
| 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/S18777...
| SpaceManNabs wrote:
| 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 wrote:
| 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 wrote:
| 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 wrote:
| 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 wrote:
| 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 wrote:
| > 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 wrote:
| 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.
| helterskelter wrote:
| Lie about family history, but even colonoscopies are not
| perfect; I just had somebody in my family die of CRC because...
|
| - They had symptoms and wanted a screening, but their PCP
| repeatedly denied them a referral for like a year because they
| were "too young".
|
| - They lied about family history after symptoms got worse and
| got their referral.
|
| - They got the colonoscopy which came back clean, and then
| symptoms continued to get worse.
|
| - Finally their doctor gave them a referral for an MRI.
|
| Results were stage 4 CRC. The doctor performing the colonoscopy
| missed the tumor, which was tucked into the sigmoid (the bend
| in your colon), where he didn't properly inflate because he
| wasn't taking it very seriously. It had a thumb-tip sized
| protrusion inside the colon but had gotten huge on the opposite
| side of the colon wall. They fought it for 8 years after the
| diagnosis and over 100 rounds of chemo (!!!), were about to get
| a new procedure at Yale, in which the doctor told them to think
| of it in terms of "this really may be a complete cure", but it
| was canceled because of the Big Beautiful Bill.
|
| If you have symptoms (even if you don't), don't let some
| fuckass Nurse Practitioner tell you no. They don't know shit
| and they let their egos get in the way when they have to deal
| with moderately informed patients advocating for themselves.
| This was preventable and tge medicap system failed them because
| both the PCP and the doctor performing the colonoscopy were not
| paying attention to what they were being presented with and saw
| only their own expectations.
|
| Also...apparently doctors wanted to lower the screening age to
| like 35, but insurance companies fought it, so it's at 45.
| lotsofpulp wrote:
| >Also...apparently doctors wanted to lower the screening age
| to like 35, but insurance companies fought it, so it's at 45.
|
| On this website, it is frequently opined that because health
| insurers have a legal minimum medical loss ratio, that health
| insurers prefer inflated costs so that their medical losses
| are higher, which means their premiums can be higher, which
| means their revenue is higher, which means their profit is
| higher.
|
| I would have thought health insurers would support a lower
| screening age, especially since it would inflate costs for
| all insurers so everyone's cut of the now bigger pie gets
| bigger.
| jorblumesea wrote:
| while it sucks, paying for it out of pocket is probably cheaper
| if you can't get it covered. In the long run, $1500 as a bridge
| until your 40s feels cheaper than stage 4 cancer.
| bluGill wrote:
| > even though it's a relatively benign procedure.
|
| Not completely. Every once in a while they accidentally
| puncture the intestine with the probes and that becomes a
| significant medial problem. It doesn't happen often, but that
| is still a risk that doctors need to consider. If you are over
| 50 getting one every 10 years is a good idea, and there is some
| consideration if younger might be worth it. However so few
| people get colon cancer under 40 that it isn't worth the risks
| for most - but if there are other signs of a problem (either
| family history or symptoms) that changes things and it may be
| worth it.
| autoexec wrote:
| 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 wrote:
| 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 wrote:
| 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 wrote:
| 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 wrote:
| 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.
| bahmboo wrote:
| 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 wrote:
| One of Europe's leading nutrition experts also highlighted energy
| drinks in connection with the growing incidence of colon cancer
| among young people.
| throwway120385 wrote:
| What evidence is there of that?
| ZeroGravitas wrote:
| Sugary drinks is one of the cited contributers in this piece.
| elric wrote:
| If anyone here is up for disrupting the medical field: please
| come up with a colonoscopy-equivalent with a less awful prep
| experience.
| hansvm wrote:
| 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.
| seattle_spring wrote:
| 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.
| brocha wrote:
| 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
| nikole9696 wrote:
| This may be regional but I just had pills. It was fine. My
| first one had that terrible salty liquid and I cannot stand the
| salt. I had a very hard time with it, despite adding some
| flavoring. I just can't drink salt water. So my second one I
| got pills and it was miles and miles easier. Now the hardest
| part is fasting for a day.
| yodsanklai wrote:
| I really didn't mind the prep experience. I can't say it was
| pleasant, but not a big deal. For me the worst part is the risk
| of perforation: it's rare but adds risk to the procedure.
| dkural wrote:
| 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 wrote:
| You'd be surprised. COVID-19 fundamentally altered a lot of
| people's habits.
|
| https://www.businessofapps.com/data/strava-statistics/
| andy_ppp wrote:
| 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 wrote:
| 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.
| inglor_cz wrote:
| 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 wrote:
| 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 wrote:
| 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.
| WarOnPrivacy wrote:
| My Dr just ordered a test for colon cancer. However, 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.
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