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Colorectal Cancer on the Rise in Young People: Should You Be Screened?

Dr. June Hsu, Colorectal Surgery

March 18, 2022

Colorectal Cancer on the Rise in Young People: Should You Be Screened?

Experts have lowered the recommended age to get screened and take action. 

Getting a colonoscopy is something many people put off even thinking about until the gray hairs start to set in and the kids are well off to college. The death of actor Chadwick Boseman, “Black Panther” to Marvel Universe fans, in 2020 was a tragic reminder that colon cancer does not just strike the elderly. Cases of young-onset colorectal cancer, in people in their 40s, 30s and even some in their 20s, have increased by 51% since 1994, according to the National Cancer Institute.

This sharp increase in the rise of colorectal cancer among young people has prompted the U.S. Preventive Services Task Force to recently lower to 45 the recommended age for average-risk people to start screening -- just four years after they set the guideline at age 50. A colonoscopy allows physicians to view the inside of the lower digestive tract up close, so that they may spot cancer in its earlier stage and intervene right away. When caught early, colon cancer is very treatable.

Know the signs

It’s not unusual for younger people to dismiss or misinterpret colorectal cancer clues as typical “stomach issues,” hemorrhoids and other less serious, and often more likely, conditions. The most common signs of colorectal cancer in younger patients include:

  • Blood in the stool
  • Change in stool or bowel movements
  • Difficulty in bowel movements
  • Bleeding from the rectum
  • Abdominal pain and cramping

It’s important to see a doctor if you notice any of these changes, so that you can be put on the best treatment path.

Be aware of the risks

Despite all of this, age still is the #1 risk factor for colorectal cancer. The second biggest factor is a history of colorectal polyps as determined by a previous colonoscopy – we know from historical data that polyps can turn into cancer over time. An increase in colonoscopies in the over-50 age group, and being able to spot these polyps and remove them before they turn into something worse, is one of the reasons the rates of colon cancer in people over 50 have actually gone down.

Everyone, no matter their age, can lower their risk by eating a normal, balanced diet, which includes lots of fiber and water to move food through the digestive system easily, and by getting plenty of exercise. Quitting smoking may reduce risk as well.

But by far, a colonoscopy is the gold standard in spotting and diagnosing an issue before it turns life-threatening. Stool DNA testing and bloodwork may indicate an abnormality, but it won’t tell you if you have a polyp or precancerous lesion.

Knowing that colonoscopies can help prevent and eliminate polyps and cancers down the road should make scheduling the test a lot more bearable. With improvements in the procedure and the day-before prep involved, there’s no reason to put it off.

Dr. June Hsu

Dr. June Hsu is a colorectal Surgeon practicing in White Plains. She sees patients for a wide range of diseases of the colon, rectum and anus, including fistulas, hemorrhoids, diverticular disease, as well as cancers of the colon, rectum and anus. To make an appointment, call 914-949-5860.

White Plains Hospital was awarded a three-year accreditation from the National Accreditation Program for Rectal Cancer, making it one of 16 hospitals in the country, and just one of two in New York, to be accredited for its commitment to excellence in the care of rectal cancer.