Researchers have identified four important signs and symptoms that signal an elevated risk of early-onset colorectal cancer, according to a new study.
These red flags may be key to earlier detection and diagnosis of early-onset colorectal cancer among younger adults. The number of young adults with colorectal cancer has nearly doubled in recent years.
- Abdominal pain
- Rectal bleeding
- Diarrhea
- Iron deficiency anemia
“It’s also crucial to spread awareness among primary care doctors, gastroenterologists, and emergency medicine doctors,” Cao says. “To date, many early-onset colorectal cancers are detected in emergency rooms, and there often are significant diagnostic delays with this cancer.”
In this study, Cao, with first author Cassandra D. L. Fritz, an assistant professor of medicine in the division of gastroenterology, and co-first author Ebunoluwa Otegbeye, a general surgery resident, analyzed cases of early-onset colorectal cancer and matched controls using the IBM MarketScan Commercial Database, a big-data tool that provides longitudinal, de-identified information based on health insurance claims data from about 113 million insured adults ages 18 to 64.
Individuals born in 1990 have double the risk of colon cancer and four times the risk of rectal cancer compared with young adults born in 1950. That trend has prompted the National Cancer Institute, American Cancer Society, American Gastroenterological Association, and other professional societies to prioritize research on identifying risk factors and improving early detection. In 2021, the U.S. Preventive Services Task Force lowered the recommended age for colorectal cancer screening from 50 to 45.
According to the American Cancer Society, although the death rate from colorectal cancer has been dropping for several decades in older adults due to regular colonoscopies and improved treatment, more younger people are diagnosed with the disease at advanced stages, and many are dying of the disease.
Such a shift suggests urgency in recognizing symptoms as early as possible.
“Since the majority of early-onset colorectal cancer cases have been and will continue to be diagnosed after symptom presentation, it is crucial to recognize these red-flag signs and symptoms promptly and conduct a diagnostic work-up as soon as possible,” Cao says. “By doing so, we can diagnose the disease earlier, which in turn can reduce the need for more aggressive treatment and improve patients’ quality of life and survival rates.”
The National Center for Advancing Translational Sciences, the National Cancer Institute, and the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health funded the work.