Early Signs of Colorectal Cancer: What Adults Under 50 Should Know

Over the past few decades, colorectal cancer rates among all U.S. adults have declined. While this is good news, those declines have mostly occurred in adults older than age 50. Colorectal cancer rates in adults younger than 50 have risen, with those patients representing one in five new cases. These adults are often too young to qualify for screenings, which current recommendations say should start at age 45. Younger adults also often think signs of colorectal cancer, such as rectal bleeding, are caused by other problems.

“There are a lot of different theories about why we’re seeing colon cancer in younger people, but the fact remains that there are people now being diagnosed at younger ages than there have been in the past, which is very scary,” says Dr. Michael Sciarra, a board-certified gastroenterologist at Beaufort Memorial Lowcountry Medical Group Specialty Care.

Early Signs of Colorectal Cancer in Young Adults

One of the difficulties in relying on symptoms to determine when to see a doctor is that colorectal cancer often doesn’t have symptoms until the disease is advanced.

“The bad thing about colon cancer and colon polyps is that they’re asymptomatic until they’re not,” Dr. Sciarra says. “Unless you have bleeding or a bowel obstruction, you may not know you have these polyps until seeking medical attention.”

While blood in the stool is one early warning sign of colorectal cancer, there are others. A study published in the Journal of the National Cancer Institute identified four common symptoms that often appear in adults younger than 50 with colorectal cancer. Those were:

• Abdominal pain
• Diarrhea
• Iron-deficiency anemia
• Rectal bleeding

Almost 20% of adults in the study who had colorectal cancer before age 50 had one or more of these symptoms. The symptoms appeared three months to two years leading up to their diagnosis.

If you have one of these symptoms, your doctor can recommend a colonoscopy, even if you don’t qualify for a screening colonoscopy, and potentially identify the disease before it has a lasting impact on your life.

“I’ve said to patients as young as 28 who come in because of rectal bleeding that ‘The day you bled was the luckiest day of your life, and the second luckiest is when you came in to have it examined with a colonoscopy. If these polyps had remained symptom-free, you could have ended up with a problem by the time you’re 45 and got a colonoscopy screening,’” Dr. Sciarra says.

Read More: Colon Cancer Symptoms: How to Recognize a Potential Problem

Colorectal Cancer Screenings Save Lives

Even though patients can develop colorectal cancer in their 30s and early 40s, Dr. Sciarra encourages everyone to begin screening at the recommended age of 45. You may need to start screening earlier if you have risk factors such as:

• Being Black, American Indian, Alaska Native or of Eastern European descent
• A family history of colorectal cancer
• A history of inflammatory bowel disease
• Hereditary conditions that increase your risk of the disease

Even if you don’t have a family history of colorectal cancer, Dr. Sciarra mentions that family histories start somewhere.

“Everybody says, ‘Well, I have no family history of this. I can’t believe it,’” he says. “Well, maybe you’re the beginning of a family history.”

Colonoscopies are considered the gold standard for colorectal cancer screening tests because they allow doctors to identify and remove cancer all at once. During these procedures, your doctor uses a thin tube outfitted with a camera to view your entire colon and rectum. If the doctor finds any polyps, they can be removed before possibly becoming cancerous.

Other screenings include stool-based screenings, in which a sample of your stool is analyzed for blood or DNA mutations in cancer cells. These tests don’t require the same prep as a colonoscopy, but they can be less accurate and typically need to be done more often. Plus, if one of these tests reveals something suspicious, you will likely need a colonoscopy to confirm the results.

Read More: How to Prep for A Colonoscopy

Take Charge of Your Colorectal Cancer Risk

Although you can’t change your family history, race or genetics, you can take steps to potentially reduce your colorectal cancer risk with a healthy lifestyle. The following steps have a positive impact on colorectal cancer risk:

• Eating a diet rich in fruits, vegetables and whole grains and low in red and processed meats
• Exercising regularly
• Limiting alcohol to one drink a day for women and two per day for men
• Maintaining a healthy weight
• Quitting smoking

You don’t have to change everything all at once. Making one change at a time goes a long way toward a healthier you. Lean on your care team, friends, family and digital solutions to keep you accountable for your health and help make these changes a little easier. Each step you take can also give you peace of mind, knowing that you’re doing what you can to lower your risks of colorectal cancer.

If you’re age 45 or older, speak with your primary care provider about scheduling your colonoscopy. If you’re younger than 45, find a primary care provider accepting new patients who can help you evaluate your risk for colorectal cancer.