How Should Younger Adults Think About Colorectal Cancer?

How can I prevent colorectal cancer?

Colorectal cancer is the third most common cancer in the U.S., but it’s also one of the most preventable. Many cases of colon and rectal cancer could be avoided with regular screening and certain lifestyle adjustments.

While some risk factors for colon cancer are out of our control (like family history), there are other risk factors that we can change. Certain lifestyle behaviors are known to increase colon cancer risk. These include:

  • Not getting screened
  • Being overweight
  • Eating a diet that’s high in red and processed meat
  • Not getting regular exercise
  • Drinking alcohol (zero is best!)
  • Smoking
  • Not getting enough calcium, vitamin D and folate

It’s important to note that having a risk factor, or even multiple risk factors, doesn’t mean that you will get colorectal cancer, and some people who get diagnosed may not have any known risk factors.

Who is at risk for young-onset colorectal cancer?

Many of the risk factors for young-onset colorectal cancer are the same for colorectal cancer in older adults. These include:

  • Having a family history of polyps or colorectal cancer
  • Having an inherited genetic disorder, such as Lynch syndrome or familial adenomatous polyposis (FAP)
  • Being Black or African American
  • Having certain health conditions, such as Crohn’s disease, ulcerative colitis or type 2 diabetes
  • Being overweight or obese
  • Not being physically active
  • Eating a diet high in red and processed meats
  • Smoking
  • Moderate to heavy alcohol consumption
How can I prevent young-onset colorectal cancer?

There are a number of healthy habits you can adopt to reduce your risk of colorectal cancer. These include:

  • A high-fiber diet with low amounts of processed foods and smoked meats
  • Exercise
  • Maintaining a healthy weight
  • Avoiding excessive amounts of alcohol
  • Avoiding tobacco
  • Knowing your family history

Learn more about Siteman’s 8 Ways to Prevent Colon Cancer.

Getting screened for colorectal cancer

In 2021, the U.S. Preventive Services Task Force officially lowered the recommended screening age from 50 to 45 due to the recent rise in colorectal cancer cases among younger adults. Colorectal cancer is highly treatable and can often be cured when caught early. Regular screening is key to preventing colon cancer or finding it in its early stages.

People at average risk should begin regular screening at age 45 and continue regular screening through age 75 with either a high-sensitivity stool-based test or a visual exam of the colon and rectum. People at higher risk may need to begin screening before age 45, be screened more often and/or undergo specific tests. Talk with your provider about your individual risk.

Types of tests

There are five types of tests that may be used to screen for colorectal cancer:

  • Fecal occult blood test
  • Sigmoidoscopy
  • Colonoscopy
  • Virtual colonoscopy
  • DNA stool test

Talk with your provider about which test might be right for you.

Does health insurance cover screening?

When the Affordable Care Act (ACA) was passed, it made preventive care – including colorectal cancer screenings – free of charge to patients covered by private insurance and Medicare plans that started on or after September 23, 2010. In most cases, there should be no out-of-pocket costs for these tests.

It’s important to note that even if your insurance plan covers the cost of screening tests, it may not cover the screening tests according to the ACS recommended screening schedule. Be sure to check with your insurance carrier before getting screened to verify which tests are covered under your plan and how often you can get screened.

Learn more about insurance coverage for cancer screenings.

Should I get a colonoscopy?

While colonoscopy was once considered the gold standard of colorectal cancer screening, other screening methods – like stool-based tests – can be just as effective. The major benefit of the colonoscopy is that polyps, which are frequently found, can be removed during the procedure, and polyp removal can actually prevent cancer. Each test has risks and benefits, and the best test for you depends on your individual needs. Talk to your doctor about your screening options and which test would be right for you.

What is a polyp? If I have one, does that mean I’m going to get colorectal cancer?

A polyp is a small growth that forms on the lining of the colon or rectum. Most polyps are harmless, but some can develop into cancer over time. Regular screening tests are important because they can find polyps in their early stages, when they’re easier to remove. Only a small percentage of polyps develop into cancer, but nearly all colorectal cancers start out as polyps.

If you have a polyp, it doesn’t mean that you will get colorectal cancer. Still, your doctor will recommend removing any polyps that are found. Removing polyps early ensures that they won’t turn into cancer later.

Symptoms of colorectal cancer

In its early stages, colorectal cancer doesn’t typically cause symptoms. When symptoms do appear, they are often brushed off as run-of-the-mill digestive issues.

The main symptoms of colorectal cancer include:

  • Blood in stool
  • Narrowing of stool
  • Change in bowel habits, such as constipation or diarrhea
  • Frequent gas pain or cramps
  • Loss of appetite

If you’re experiencing any of these symptoms, it doesn’t mean that you have colorectal cancer. In fact, many of these symptoms may be caused by benign conditions. Still, if you experience any of these symptoms and they don’t go away, make an appointment to see your primary care provider.

Hereditary cancer and genetic testing

Having a family history of colorectal polyps or cancer means that you are at higher risk of developing colorectal cancer yourself. If you have a family history of colorectal polyps or cancer, consider speaking with a genetic counselor to determine how likely it is that you have a family cancer syndrome. If a gene mutation is found, there may be steps you can take to help reduce your risk of colorectal cancer, such as starting routine screening at an earlier age.

Genetic testing can also provide insight into why a patient developed colorectal cancer and can help providers tailor treatment to that patient’s specific cancer.

While genetic testing may provide answers about your colorectal cancer risk, it may not be right for everyone. Genetic testing isn’t perfect and it may not provide the answers you’re looking for. This is why it’s important to meet with a genetic counselor before the actual test – your counselor will be able to explain the risks and benefits of genetic testing and what the results might mean.

If genetic testing is something you want to pursue, your primary care provider can refer you to a genetic counselor.