If you’re under 50 years old and experiencing symptoms like diarrhea, stomach pain, bloody stools, or anemia, you may want to get screened for colorectal cancer.
That’s because having just one of these symptoms is associated with an almost doubled risk of colorectal cancer (often shortened to colon cancer) in adults under 50, according to a new study published in the Journal of the National Cancer Institute.
With two of these symptoms, the colon cancer risk more than triples. And with at least three of these symptoms, the risk is more than 6 times higher.
“Colorectal cancer is not simply a disease affecting older people; we want younger adults to be aware of and act on these potentially very telling signs and symptoms — particularly because people under 50 are considered to be at low risk, and they don’t receive routine colorectal cancer screening,” senior study author Yin Cao, ScD, an associate professor of at the Washington University School of Medicine in St. Louis, said in a statement.
Who Should Be Screened for Colorectal Cancer?
This year, roughly 13 percent of the estimated 153,000 new cases of colorectal cancer will be diagnosed in people under 50 years old, according to a study published in March by the American Cancer Society. That’s 9 percent more cases among younger adults than there were in 2020, this analysis found.
Recognizing the rising cases among younger adults, the U.S. Preventive Services Task Force in 2021 revised its screening recommendations to urge people to start testing for colon cancer at age 45, instead of waiting until 50.
Because of these screening recommendations and improved treatment options, the death rate among older adults from colorectal cancer has been dropping for several decades, according to the American Cancer Society.
But early-onset colorectal cancer (before the age of 45) is more likely to be diagnosed at an advanced stage with lower survival odds — which is why paying attention to these red-flag symptoms is important.
Still, many don’t get screened because they don’t want to undergo an invasive colonoscopy, which requires advance preparation to empty the bowels and then general anesthesia during the procedure. Roughly one-third of adults 50 to 75 years old, a group that has long been advised to get screening, don’t do so, according to the Centers for Disease Control and Prevention.
Symptoms Frequently Reported Before a Colorectal Cancer Diagnosis
For the new study, researchers examined insurance data for 113 million adults aged 18 to 64 years old. They compared symptoms experienced by 5,075 colorectal cancer patients up to two years before their diagnosis with symptoms over that same time period for similar individuals who didn’t get colon cancer.
About 1 in 5 people with colorectal cancer experienced at least one of the following symptoms between three months and two years before their cancer diagnosis, the study found:
About half of the people with colon cancer experienced these symptoms in the three months before their diagnosis.
One limitation of the study is that it used insurance records designed for medical billing, which can lack more detailed medical information about patients. It’s also possible that some people experienced symptoms that could be an early warning of colon cancer but weren’t noted in the insurance records.
Still, it’s important for people to be aware that colorectal cancer doesn’t just happen to old people, says Peter Liang, MD, an assistant professor at the New York University School of Medicine in New York City, who wasn’t involved in the study.
“Everyone, regardless of age, should recognize that symptoms such as ongoing abdominal pain and rectal bleeding, as well as lab tests showing anemia, could be a sign of colorectal cancer,” Dr. Liang says. “If you have any of these symptoms, you should talk to a physician.”
Don’t Jump to Conclusions, Though
Seeing a doctor won’t necessarily lead to an invasive screening test, says study coauthor Samir Gupta, MD, a professor of medicine at the University of California in San Diego.
“In many cases, a patient and doctor may decide that a diagnosis other than colon cancer is the likely cause, and move forward with a diagnosis and treatment plan that does not include colonoscopy,” Dr. Gupta says. If this treatment works within a month or two, then additional cancer screening most likely wouldn’t be needed, Gupta says.
“If the original treatment plan is not working, and symptoms persist, then colonoscopy should be strongly considered to rule out colorectal cancer,” Gupta adds.
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