Colorectal Cancer Is Affecting Younger People. When Should You Get Screening?

Colorectal cancer is the third most common cancer type diagnosed in the United States in both men and women, with around 150,000 new cases diagnosed per year. Overall, the numbers of people diagnosed with the disease is falling slightly, but increasing by about 2% every year in people under the age of 50.

There have been some recent cases of young, high-profile people who have lost their lives to colorectal cancer, such as Chadwick Boseman who died at the age of 43 last year. The American Cancer Society currently recommends regular screening starting at age 45 for healthy people, but anyone with concerning symptoms at any age should consult a physician sooner.

Forbes Health interviewed an oncologist and a survivor of young onset colorectal cancer to talk about symptoms, screening and awareness of the disease.

Andrea Cercek, MD, is a member of the Stand Up To Cancer Colorectal Cancer Dream Team and Medical Oncologist, at Memorial Sloan Kettering Cancer Center in New York.

Is colorectal cancer something that younger people should be concerned about?

“Unfortunately, the answer is yes. Colorectal cancer has been steadily rising in young adults since the mid 1990s. The reason behind this is unknown and several things including diet and environmental factors are under investigation. This rise is the reason that the screening age has been lowered to 45,” said Cercek.

What symptoms should they be watching out for?

“The most important thing is to report any persistent symptoms such as rectal bleeding or bright red blood per rectum, abdominal pain, change in bowel habits and unexplained weight loss to your doctor and discuss if you need a colonoscopy,” said Cercek

Are there any particular patient groups who should be recommended for earlier screening due to risk factors such as family history, other health conditions?

“People with a known medical condition such as inflammatory bowel disease or a known genetic predisposition are recommended to start screening at a younger age. Additionally, those with a known family history are generally recommended to begin screening at an age 10 years younger than their affected relative — but the most important thing is to discuss the age of screening with your health care provider if you have a family history,” said Cercek.

People might be embarrassed to go to their doctor about some of the common symptoms of colorectal cancer, what would you say to them?

“No one should be embarrassed to talk about any symptoms, including gastrointestinal symptoms with their doctor. The most important thing to know about colon cancer is that it can be prevented and that the outcomes are very good if it is caught early. And in many people these symptoms can lead to a colonoscopy which could be life-saving,” said Cercek.

Allison Rosen, M.S. is a Stage 2 colorectal cancer survivor who was diagnosed when she was 32. She is a passionate patient advocate and Project Director at University of Texas Health Science Center at Houston in the Center for Health Promotion and Prevention Research.

What were your symptoms leading up to your diagnosis? 

“The symptoms included abdominal pain, severe fatigue, unexpected weight loss (which I thought was from all the Zumba I was doing), rectal bleeding, change in my bowel habits and the feeling of heartburn and that food was getting stuck inside me,” said Rosen.

What was your awareness of colorectal cancer like before you were diagnosed yourself? Did you know it could affect younger people? 

“Minimal. I was very naïve, like so many others are, and thought only on older men got colorectal cancer. I had Crohn’s disease but was not aware that this placed me at increased risk,” said Rosen.

Do you think there's been an increase in awareness about younger-onset colorectal cancer in recent years?

“Yes, when the American Cancer Society lowered the screening age to 45 this helped create awareness in the community. I don’t know if it is because I am such a passionate advocate, but as an early age onset survivor, with March being colorectal cancer awareness month, I hear more and more stories from young survivors, patients, and caregivers. I was deeply saddened by the passing of Chadwick Boseman. But I am grateful that his family was willing to release the fact that he had colorectal cancer. He was an iconic superhero and when he passed due to colorectal cancer, this stimulated a conversion on the subject. His death opened people’s eyes to the fact that anyone can get colorectal cancer, even superheroes,” said Rosen.

What would you still like to see done? 

“I would like for all awareness campaigns related to colorectal cancer to always include the younger patients, survivors, and caregivers. If you have a colon you are at risk and the more we can change what the public sees as the face of this disease the more people will realize that you are never too young for colorectal cancer,” said Rosen.

Many people may be reluctant to go to their doctor with some common colorectal cancer symptoms due to embarrassment, what would you say to them? 

“I would simply say that talking to your doctor about something you do everyday should not be embarrassing. colorectal cancer is preventable with screening, but a doctor cannot do anything if you are younger than 50, unless you speak up. Your health is in your own hands and when something does not seem right most likely it isn’t, so speaking to your doctor has the potential to save your life,” said Rosen.