Know the Symptoms You Should Never Ignore
3D image of the colon.
Colorectal cancer is not typically considered a young person’s disease. However, over the past two decades, its incidence and mortality have significantly increased among individuals aged 20 to 49.
This increase is expected to continue over the next two decades. Among all new colorectal cancer cases in young patients, most are found between the ages of 45 and 49.
That is why the American Cancer Society’s 2018 guidelines recommend routine colorectal screening starting at age 45.
An Unexplained Trend
As colorectal cancer rates have declined in older adults, researchers are trying to understand why they are rising in younger adults.
There is no definitive evidence explaining the increase, especially among very young individuals. However, rising obesity rates and dietary trends may be contributing factors.
We also know that certain diets and environmental factors can increase the risk of colorectal cancer in older adults. This may play a role for younger individuals as well, as our diets continually change and evolve from generation to generation.
What is clear is the need for colorectal cancer prevention, and we recommend following these steps to protect yourself:
Start Colorectal Cancer Screening at Age 45
Experts largely attribute the reduction in overall colorectal cancer incidence after age 50 to colorectal screening via colonoscopy. By screening average-risk patients aged 45 to 50, they hope to achieve similar results.
Why not start at age 40?
The largest increase in colorectal cancer rates is among individuals aged 45 to 50. We must always weigh our desire to screen patients against the risk of complications and costs.
While numbers are rising, the overall incidence in this age group remains low. However, it is imperative to continue updating guidelines as we learn more about screening risks and benefits.
Other screening options, such as highly sensitive DNA tests for colorectal cancer based on stool samples, are becoming more effective. These tests are available and will increasingly be utilized in the future.
Don’t Ignore Rectal Bleeding with Changes in Bowel Habits
Young adults have repeatedly heard that colorectal cancer is a middle-aged and older person’s disease.
We see many young patients who may have initially ignored symptoms or were told they were “too young” to have colorectal cancer.
Many of the advanced cases of colorectal cancer we see are in young people who had a misdiagnosis or delayed evaluation for this reason.
Any change in bowel habits accompanied by rectal bleeding should prompt a visit to your doctor. Keep in mind that not all colorectal cancers have the same symptoms:
- Some people develop anemia (low red blood cell count).
- Others find blood mixed with their stool.
- Some report abdominal pain or other obstruction symptoms (sometimes, but not always, indicating that cancer is more advanced).
Know Your Risk and Family History
Often, patients do not have symptoms in the early stages of colorectal cancer when it is easier to treat.
That is why it is vital to identify those at greater risk of developing the disease. Primary care doctors can help assess your risk, as can risk assessment tools.
Eat Healthier, Exercise, and Quit Smoking
Fresh fruits and vegetables, along with other high-fiber foods, and regular exercise help keep your gut healthy.
Experts still have much to learn about how lifestyle affects the risk of colorectal cancer. However, they advise young adults to reduce their intake of red meats and highly processed foods.
And if you smoke—now is the time to quit.
Don’t Be Afraid to Talk to Your Doctor
Take your health seriously—even if you’re in your 20s.
We also recommend developing a good relationship with a primary care physician. This way, you will feel comfortable reporting any unusual or concerning symptoms.
Don’t just assume you have hemorrhoids if you see blood on toilet paper or in the toilet. There is no such thing as “normal” bleeding. Inform your doctor so they can evaluate you promptly.
As scientists learn more about the specific biology of colorectal cancer, they will develop new ways to treat the disease in every patient, regardless of age.
We are learning so much every day. Could colorectal cancer that develops in young people have different biology or behavior than in older adults
