Colorectal Cancer in Young Adults: What To Know
- With more colorectal cancer cases being detected in adults under age 50, screening guidelines have changed. It is now recommended that most people begin colorectal cancer screening with colonoscopy at age 45.
- People with risk factors such as a family history may need to begin screening earlier and should discuss a plan with their doctors.
- The best and most complete way of screening is a colonoscopy every 10 years.
- Researchers are still searching for answers about why cases are increasing in younger adults. Diet, environmental exposures, and microplastics are being studied, but no single cause has been confirmed.
- Symptoms that could be linked to the disease, such as changes in bowel habits, blood in stool, and unexplained weight loss, should be evaluated by a doctor.
“Although we’re doing better at fighting cancer across the board in the United States, there’s one cancer that is actually increasing,” says Dr. Nicholas Hornstein, a medical oncologist at Northwell Health’s Lenox Hill Hospital who focuses on gastrointestinal cancers. “It’s colorectal cancer, and it’s increasing in young patients — those under the age of 50.”
Read MoreScreening Recommendations
A major change in recent years is that the recommended age to begin routine colorectal cancer screening has been lowered.“Screening guidelines have reduced the minimum age for colonoscopy to 45,” Dr. Hornstein explains.
A colonoscopy remains the most widely used screening tool and is considered the gold standard. During the procedure, doctors insert a small camera into the rectum to examine the colon and look for tumors or precancerous growths. The best and most complete way of screening is a colonoscopy every 10 years.
Those who have an increased risk of developing colon cancer due to family history may need to begin screening earlier. A general rule of thumb is to get screened 10 years prior to the family member’s age of diagnosis to make sure any growths or cancers are caught early.
While colonoscopy is still considered the most important screening tool, there are others that can help detect cancer earlier as well, Dr. Hornstein says.
Other screening options include:
- Stool-based tests, such as Cologuard
- Blood-based screening tests, which are becoming more advanced
“No test is perfect,” Hornstein says. “But these tools are getting better and can help serve as a first-line barrier to detect things like colon cancer early.”
What’s Behind The Spike In Cases?
Many younger adults are curious about why colorectal cancer is becoming more common in their age group, and what steps they can take to reduce their risk. Right now, researchers don’t have a clear answer, Dr. Hornstein says.
Scientists are exploring several possible explanations, including western dietary patterns, environmental exposures, and even microplastics. However, none of these theories have been proven to directly cause the increase.
“There are a lot of hypotheses out there,” Dr. Hornstein explains. “But we don’t have the causal evidence yet to say this is exactly what’s driving the rise.”
Research studies across the country are now collecting blood and stool samples from patients with early-onset colorectal cancer to better understand what might be happening.
Symptoms & Screening: What To Know
While researchers search for answers, doctors say patients can take important steps right now. The first is simply to stay up to date with screening, especially once you reach age 45.
Next, don’t ignore new symptoms. Colon cancer symptoms can include:
- Changes in bowel habits (diarrhea or constipation)
- Blood in stool
- Lingering abdominal discomfort
- Unexplained weight loss
- Persistant fatigue
Younger patients are sometimes told their symptoms are caused by hemorrhoids or something minor, Dr. Hornstein says, but persistent symptoms should always be evaluated.
“If you’re having symptoms, see your doctor — and advocate for yourself,” he says. “Don’t just go away and deal with these symptoms quietly … Make sure someone is really investigating what’s going on.”
Colorectal cancer is often very treatable when caught early, which is why doctors emphasize screening and paying attention to warning signs.
Even though researchers are still working to understand why more young people are developing the disease, one message is already clear: early detection can save lives.
Questions To Ask Your Doctor
- When should I begin colon cancer screening based on my risk factors?
- Do you recommend stool-based or blood-based screening tests?
- How often will I need to be screened?
- What are the next steps if something is detected during colonoscopy?
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