Back to All News

Under 50? What you need to know about colon cancer risk and prevention


In recent years, doctors have noticed an unsettling trend: an increase in the number of people under the age of 50 who are being diagnosed with colon or rectal cancer. While this trend is alarming, there is good news: colon cancer can be prevented entirely or at least caught early, when it’s easier to treat.

Much of the world became painfully aware of this recent trend when Hollywood’s Chadwick Boseman died tragically at the age of 43 from colon cancer. For many, the question became: what can I do to keep this from happening to me and my loved ones?

How can I prevent colon cancer?

In order to ensure that you can go on to live a longer and healthier life, you must be aware of your family history and be on the lookout for key symptoms. Washington University colorectal surgeon Radhika Smith, MD, who treats colon cancer patients at Siteman Cancer Center, emphasizes the importance of knowing family history of colorectal cancer.

“If anybody in their family has a history of malignancies, especially at a young age, that really should prompt them to seek medical attention. This will allow them to ensure that there’s nothing with their family genes that could increase their risk,” she said.

It is important to be aware of your family history when it comes to taking charge of your health. At the same time, it is just as important to keep an eye out for signs of potential problems.

“Colorectal cancer doesn’t frequently strike young people. However, when you experience symptoms, you never want to ignore them,” says Smith. “You always want to have them evaluated. Make sure that you’re protecting yourself and doing all you can to give attention to any underlying issues you might have.”

Identifying symptoms is essential for effective treatment for colorectal cancer.

It is also important to note that certain genetic syndromes create hereditary risks for colorectal cancer, including Lynch syndrome and FAP. Additionally, Crohn’s disease and ulcerative colitis may potentially increase risk.

What symptoms should I look out for?

When it comes to identifying symptoms prior to diagnosis, it can be a bit tricky. This is because there are routine issues (such as constipation and diarrhea), and then there are alarm symptoms.

“If you have run-of-the-mill constipation, you should address it with changes in the food you eat, fiber supplements, and be sure to take in 64 ounces of an uncaffeinated beverage. If that doesn’t fix it, then you should go see a provider,” says Smith. “Most young people don’t know how to really fix constipation, so engaging a doctor is important.”

Because many young people eat low-fiber diets, they experience constipation, which then becomes their norm. This is why it’s important to stay on top of your health from a young age. It will allow you to be able to identify potential issues in the future.

Constipation can, of course, be just that – constipation. However, it also can be a sign of a larger issue. Here are some symptoms that may be more concerning:

  • Rectal bleeding
  • Change in stool caliber
  • Weight loss
  • Constipation or diarrhea
  • Abdominal pain
  • Fatigue or tiredness

How do I speak with my provider about my concerns?

It can feel uncomfortable to bring up colorectal health concerns with your provider. While this might be the case, doing so is the only way to be proactive when it comes to your health.

“At the end of the day, you just need to remind yourself that every provider at Siteman and at Washington University really just wants to help people,” says Smith. “You won’t feel any sort of judgment. You just need to be honest about the symptoms you’re experiencing. Most of the time, you will simply need to make minor changes in your diet. This can have a huge impact on your overall bowel function and improve your quality of life. But in some rare cases, this may also save your life.”

Early intervention can prevent many problems down the road. All you need to do is take charge of your health and be honest with your provider.

If a larger issue does happen to arise in the future that needs to be addressed, there are many effective treatment options. These colon cancer treatments and colon cancer surgeries can prolong and improve your quality of life.

At what age should I have my initial colon cancer screening?

Siteman recommends that you have your initial screening at age 45, but there are some factors that can lower that recommendation. If you have a first-degree family member who has had colorectal cancer, you should get tested 10 years before the age of their diagnosis. In this case, you should be tested at 5-year surveillance intervals following your initial screening. However, if you experience any symptoms, you should get screened, regardless of your age.

Smith underlines the importance of symptom surveillance.

“If you have any symptoms that concern your doctor, even if they’re minor, you should get a colonoscopy. Then you can go forward with a clean bill of health, knowing this is your baseline. If you have a departure from that baseline down the road, you’ll know it’s time for more medical attention.”

What healthy practices can I bring into my life to avoid future colon risks and issues?

Looking out for symptoms and establishing a relationship with your provider are key elements to taking charge of your health. Additionally, there are many healthy habits that you can adopt before and after symptoms arise. These include:

  • A high-fiber diet with low amounts of processed foods and smoked meats
  • Exercise
  • Normal weight
  • Avoiding excessive amounts of alcohol
  • Avoiding tobacco
  • Knowing your family history so that you can be on a proper colorectal surveillance program