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Health Matters: Colon cancer in younger adults on the rise

Don’t assume screening isn’t for you because of your age or the “ick” factor, says Madelyn Fernstrom, NBC News’ health editor.
Doctor writing on clipboard in clinic
Colorectal cancer, after all, is the second most common cause of cancer deaths in the United States.Wavebreakmedia / Getty Images/iStockphoto

When Americans are presented with the opportunity to screen for colorectal cancer, many squeamishly say, “I’ll worry about it when I’m older.”

In honor of Colon Cancer Awareness Month, let’s push pause on that notion. While studies have previously shown that colon cancer is mostly detected in men and women over 50, the numbers are changing. In fact, more adults in their 20s and 30s are being diagnosed with the disease. And one in 24 women will be diagnosed with colon or rectal cancer at some point in her life.

A study by Colorectal Cancer Alliance found that almost two-thirds of patients under age 50 wait three to 12 months before seeing a doctor with symptoms. And when these younger patients are finally diagnosed, most cases of colorectal cancer are advanced – either Stage III or Stage IV.

That’s not surprising if people are waiting months, or even years, without taking action. Colorectal cancer, after all, is the second most common cause of cancer deaths in the United States.

And while that’s a scary statistic, one of the best preventive measures you can take for colon cancer is screening. When to begin depends on your personal health, family history and symptoms.

Recommendations for an initial colonoscopy (the gold standard of screening) has dropped from age 50 to age 45 for people with average risk. For those with added risk factors, including a family history of colon cancer or polyps, it might be even earlier. And for those with symptoms, it’s worth a visit to your doctor to see if screening makes sense. The bottom line: Don’t assume screening isn’t for you because of your age or the “ick” factor.

Warning signs of colon cancer:

-Rectal bleeding (appearance of any color or blood in the stool)


-Abdominal pain, cramping or discomfort

-Change in bowel habits (constipation, diarrhea, thinner stools)

-Unexplained weight loss

Experiencing one or more symptoms (especially if you’re feeling progressively worse) should trigger a visit to your doctor.

The next step is determining the best screening method for you. It’s been said that the best one is the one you’ll agree to do! And remember, none of these screenings are as bad as they might seem in your imagination.

Screening tests for colon cancer:

There are several different detection tests. Here are some your doctor may suggest:


This is the most frequently recommended procedure, done every 10 years for people at average risk. It requires a bowel cleanse 24 hours before the test. While still not pleasant, the prep has improved and is manageable for most people. During this screening, not only are cancers detected, any suspicious pre-cancerous polyps can be removed during the procedure too.

Fecal Blood Testing (FIT)

This is an immunological test, done yearly on a stool sample. It checks for blood in the stool, one possible sign of colorectal cancer. It’s not generally considered preventive, however, because it doesn’t reliably detect polyps.


This test uses markers for abnormal DNA in the stool (as an index of cancer) done every three years on a stool sample. While better at detecting polyps, it is more reliable for advanced pre-cancerous polyps and other cancers.

While there are multiple risk factors that we cannot control – like a family history of colon cancer or polyps, significant digestive diseases (like Crohn’s disease or colitis) or just getting older — there are definite steps you can take to reduce your risk.

Studies continue to show a reduced risk of colorectal cancer is associated with being physically active, maintaining a healthy weight, limiting alcohol intake, not smoking and limiting red and processed meats.

Madelyn Fernstrom, Ph.D. is the NBC News Health Editor. Follow her on Twitter @drfernstrom.

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