Doctors across the country are seeing more patients in their 30s and 40s – and even some in their 20s – diagnosed with colon cancer.

The trend is both surprising and concerning, especially since experts don’t fully understand why it’s happening.

Rising cases among younger patients

Colon and rectal surgeon Rishi Batra, MD, says he’s seeing more cases of colon cancer in patients under 50. This increase isn’t limited to one region. “We’re seeing this trend not across just the country, but across the world,” Dr. Batra says.

The rise in younger patients has led some medical centers to create special programs just for early-onset cancers. These programs also recognize that younger patients have different needs than older ones, especially when it comes to fertility concerns.

Why is this happening?

The honest answer is that doctors don’t know for sure. “The challenging thing is, we don’t really know why,” Dr. Batra says. 

Several factors may be contributing to the increase:

• Better detection: Doctors are more aware of the problem and take symptoms more seriously in younger patients.
• Earlier screening: The recommended screening age dropped from 50 to 45 in recent years.
• Genetics: Family history plays a significant role.
• Lifestyle factors: Diet, obesity, alcohol and smoking may increase risk.
• Gut health: Changes in gut bacteria may be involved.

“It’s probably multifactorial,” Dr. Batra says, meaning multiple causes are likely working together.

Warning signs to watch for

Young adults should pay attention to these symptoms:

• Rectal bleeding: This is the most important warning sign and should never be ignored.
• Unexplained weight loss.
• Fatigue.
• Changes in bowel habits: Going from constipated to having diarrhea, or the opposite.

“The cause of rectal bleeding should always be checked out,” Dr. Batra says. “For a long time, bleeding in a young person was assumed to be from a hemorrhoid and or often ignored. There are certainly other causes of rectal bleeding that are not cancerous such as anal fissures and hemorrhoids, but it should always be evaluated.”

Pain is not typically an early sign of colon cancer, so don’t wait for pain to develop before seeking medical attention.

Screening options

Colorectal cancer screening helps detect cancer early and can be lifesaving. Screening options include:

• Colonoscopy: The gold-standard screening method.
• Cologuard®: A mail-in stool DNA test that can detect advanced cancers and polyps.

Dr. Batra notes that Cologuard® is not for high-risk individuals, such as those with a family history of colon cancer. Also, if Cologuard® results are positive, a colonoscopy is still needed.

Colonoscopy has a major advantage: “It’s not only diagnostic, but it’s also therapeutic, meaning we can remove the polyps and address them all at the same time,” Dr. Batra says.

When to get screened

Standard screening begins at age 45. If no polyps are found, the next screening should be in 10 years.

Family history changes everything. If a close family member had colon cancer, screening should start 10 years before that person’s age at diagnosis. “If you have a family member that had colon cancer at 40, you should be having a colonoscopy at 30,” Dr. Batra says.

The good news about treatment

Despite the concerning trends, there’s reason for hope. “As long as we catch it early and we give them the treatment that they need, which is typically surgery for colon cancer, and then sometimes chemotherapy afterwards, they can live a long, healthy life,” Dr. Batra says.

“It’s not a cancer you want, obviously, but at the same time it’s very treatable,” he adds. “Not everybody presents with Stage 4, which is good, and a lot of times these are still treatable tumors.”

Treatment involves a team approach with multiple specialists, including surgeons, medical oncologists, radiation oncologists, radiologists and pathologists all working together.

Reducing your risk

The most important step is not ignoring symptoms. “Take every sort of bleeding seriously enough to at least see your primary care physician,” Dr. Batra says.

If your provider thinks further testing is needed, they can refer you to a colorectal surgeon or gastroenterologist for a colonoscopy.

Don’t fear a colonoscopy

Some people avoid colonoscopies because they think they will be unpleasant. Dr. Batra wants to change that perception.

“It’s not as miserable as a process as people may think,” he says. “It’s a pretty in-and-out thing. People prep, and we finish the procedure, and they go home the same day. It’s not a very onerous thing. We do our best to make the process as easy as possible.”

The procedure has gotten more attention recently as celebrities like actor Chadwick Boseman, who died of colon cancer at age 43, have brought awareness to the disease.

Your next steps

Colon cancer in young people is a real and growing concern, but early detection saves lives. Don’t ignore symptoms, especially rectal bleeding. 

“The sooner we detect it, the better the treatment can be,” Dr. Batra says.

Talk to your doctor about any symptoms, family history and when you should start screening.