Colon cancer rates are surging worldwide, especially among younger and relatively healthy people, making it more important than ever to know the signs of the disease and screen for it sooner. Early-onset colorectal cancer occurs in patients between 25 and 49 years old, and the current rate in most western and industrialized countries is 14 to 17 cases per 100,000 individuals.
“Colorectal cancer is the third-leading cause of cancer-related deaths in men and the fourth leading cause in women, according to the American Cancer Society,” Dr. Eric Yoon, MD, gastroenterologist at Manhattan Gastroenterology. “Unfortunately, as with many malignancies, symptoms are often absent or non-specific, such as fatigue or abdominal discomfort.”
“Colon cancer is tricky to diagnose because early stages often present with no symptoms,” Dr. Andrew Boxer, MD, gastroenterologist at Gastroenterology Associates of New Jersey, told Parade. “When symptoms do appear, they can overlap with other common gastrointestinal conditions like hemorrhoids, irritable bowel syndrome (IBS), or inflammatory bowel disease. Additionally, signs like fatigue or mild anemia might not immediately raise suspicion for cancer, delaying diagnosis until the disease is more advanced.”
It’s in part because the symptoms of colorectal cancer can be so vague that knowing the signs is so crucial—because the sooner you get medical attention, a diagnosis and treatment, the greater your chances of survival.
Find out what the three biggest colon cancer signs that gastroenterologists and colorectal surgeons say to look out for to keep yourself safe.
Related: The Early Colon Cancer Sign Most People Miss, According to Gastroenterologists
4 Colon Cancer Signs You Should Never, Ever, Ignore, According to Gastroenterologists and Colorectal Surgeons
1. Blood in stool
Gastroenterologists and colorectal surgeons agreed that blood in stool is a huge red flag (no pun intended).
“Blood in the stool—that might coat the feces or may be mixed in—can range from dark brown or black to red or maroon-colored,” Dr. Paul Johnson, MD, FACS, FASCRS, colorectal surgeon at Methodist Le Bonheur Healthcare told Parade.
Do not discount any blood, because this is a huge sign, docs agreed.
“Though a lot of people attribute small amounts of blood in their stool to common benign causes such as hemorrhoids, it is essential to always get this evaluated to ensure there is not something more serious such as a cancer,” Dr. Michelle Hughes, MD, gastroenterologist and medical chief of quality and safety, digestive health, at Yale New Haven Health, explained. “This is true no matter your age as early-onset colon cancer rates are on the rise and we are seeing patients in their 20s and 30s presenting with bleeding as the first sign of a cancer.”
Dr. David Clarke, MD, gastroenterologist and clinical assistant professor of gastroenterology emeritus at the Center for Ethics at Oregon Health & Science University, noted that bright red blood can be a sign of tumors near the anus, whereas darker blood can signal tumors developing further up the digestive tract.
Related: If You Have This Extremely Common Health Condition, It Could Raise Your Colon Cancer Risk By 30%
2. Changes in bowel habits
Persistent diarrhea and especially persistent constipation are both signs that something is up.
“You might notice diarrhea, constipation, or a feeling like you’re not fully emptying your bowels,” gastroenterologist Dr. Bianca Islam, MD, Ph.D., MSc., explained.
Thinner, ribbon-like stools can be a sign as well.
“While bowel habits can fluctuate from day to day, it is important to pay attention to trends and if something changes and becomes persistent beyond a few days,” Dr. Hughes advised. “Then it is time to get checked out by your primary care provider or gastroenterologist.”
Related: This Bathroom Issue Is a Common Sign of Colon Cancer, According to a GI Doc
3. Unexplained weight loss
“If you’re losing weight without trying, that’s a red flag worth discussing with your doctor,” Dr. Islam urges.
Dr. Boxer warns that unexplained weight loss can be a sign of advanced disease, making it even more urgent that you get checked out.
In case you don’t remember, the late, great Chadwick Boseman lost a tremendous amount of weight and was cruelly mocked on the Internet for it—until his shocking death in August 2020, when it was revealed he’d been secretly battling colon cancer for over a year. Let this be a lesson not just in empathy and compassion, but also in the importance of getting screenings when something doesn’t feel right.
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4. Abdominal pain
Abdominal pain and cramping, especially pain or cramping that persists for more than a few days, means you should get checked out—especially if you’re feeling puffy as well.
“Abdominal pain as a symptom of colon cancer is usually dull ache or cramping sensation. Bloating or distension can also be associated with this pain,” Dr. Johnson notes.
(Distension is basically when you’re so bloated that your stomach puffs out. Some people may actually even appear pregnant when this happens.)
“Persistent discomfort in the abdomen, including pain, aches or cramps, is frequently reported and occurs due to partial blockage of the bowel by a tumor,” Dr. Clarke explained. “These symptoms can also be caused by other conditions, so it is essential to consult a doctor for proper evaluation.”
Dr. H. Richard Alexander, Jr., MD, FACS, chief surgical officer, at Rutgers Cancer Institute; system director of surgical oncology at RWJBarnabas Health and regional director of surgery for Monmouth Medical Center, an RWJBH Facility, adds, “If the colon cancer narrows the passageway of the colon then people can develop symptoms of crampy abdominal pain or bloating, particularly after eating.”
Related: New Research Says This Vegetable Could Cut Chances of Getting Colon Cancer—Plus 4 Other Ways to Reduce Your Risk
When Should I Get Screened for Colon Cancer?
Talk to your doctor about screenings if you’re 45 or older, or if you’re exhibiting any of the above symptoms or signs, regardless of your age.
“Any kind of screening is better than no screening—that includes Cologuard like you see on TV, or a colonoscopy,” Dr. Anne Mongiu, MD, PhD, FACS, FASCRS, colorectal surgeon and assistant professor of colorectal surgery at Yale School of Medicine, tells Parade. “There are many types of screening available and all are recommended to be completed at different intervals. Talk to your primary care provider or gastroenterologist to determine the best screening test for you.”
“See your primary care provider if you have any new or concerning symptoms,” Dr. Mongiu added. “Do not ignore symptoms like rectal bleeding, even if in small amounts or only some of the time, even if you are in your 20s, 30s or 40s.”
As for screening methods, Dr. Yoon notes, “Colonoscopy remains the gold standard, as it has the ability to both diagnose and remove polyps before they can develop into a malignancy. Other screening modalities, such as stool-based tests, can be utilized in the appropriate patients (e.g., those with history of polyps or colorectal cancer, bleeding hemorrhoids or inflammatory bowel disease) and those with barriers to having a colonoscopy. If they are positive, the next step would still be a diagnostic colonoscopy. However, always remember that the best screening test is the one that gets done.”
Other doctors agree.
“Colorectal cancer is often a slow-growing cancer as it can take a polyp up to five to 10 years to develop into cancer. The way nature has made our bodies is that things don’t start causing symptoms till they reach the tipping point,” Dr. Pashtoon Kasi, MD, MS, medical director of gastrointestinal medical oncology at City of Hope Orange County in Irvine, California, said. “However, I want to emphasize the importance of not delaying screening. In my clinic, I am seeing that patients are getting younger; including for example, patients under 45 who developed colorectal cancer despite having no known risk factors or noticeable symptoms; individuals in their 20s, 30s, and 40s who won’t have met the age for screening. Even in extreme cases, we are seeing colon cancer in the pediatric patient population and teenagers.”
“I often hear the misconception that people don’t think they need to be screened because they don’t have symptoms, but signs of colorectal cancer tend to appear when the cancer is in its later stages,” Dr. Kasi added. “Finally, in adults who do meet the age of screening for a colonoscopy, not everyone is getting them. Stool-based screening tests are also available, but due to practical considerations are often not completed. One big advancement to be aware of is blood based screening tests for early detection which are getting better over time. This may help fill the void of patients who didn’t want to do a colonoscopy given ease of getting it done since it’s a simple blood draw. It’s important to discuss these multiple screening options.”
Related: Brooks Bell, Diagnosed With Colon Cancer at 38, Helped Convince Ryan Reynolds to Get a Colonoscopy and Wants You To Be Next
Is Colon Cancer Treatable?
Yes!
“Early detection is critical,” Dr. Omar Khokar, MD, gastroenterologist at OSF Healthcare in Bloomington, Illinois, told Parade. “If we catch it early enough before the cancer cells enter the bloodstream, colorectal cancer is very treatable.”
Dr. Mongiu noted, “The outlook for people with colorectal cancer depends a lot on how early the cancer is found and other medical diagnoses the person may have.” She also provided general survival rates for each, but noted that every case, person and patient are different: “For colon cancer, if the cancer is caught early and is only in the colon, about 91% will live at least five more years. If the cancer has spread to nearby areas, about 73% will live at least five more years. If the cancer has spread to distant parts of the body, like the liver or lungs, about 13% will live at least five more years. For rectal cancer, the survival rates are similar. If it’s localized, about 90% will live at least five more years. If the cancer has spread to nearby areas, about 74% will live at least five more years. If it’s spread far away, about 18% will live at least five more years.”
Treatment methods vary depending on the stage of colorectal cancer detected. For some, polyps can be detected and removed during a colonoscopy, while others may need surgery.
“For more advanced stages, treatment may involve chemotherapy, radiation, or newer targeted therapies, depending on the specifics of the cancer,” Dr. Islam says. “My role is to identify the cancer early and connect patients with the right specialists, whether that’s a surgeon, oncologist or radiation therapist. The earlier we act, the better the outcomes tend to be.”
Related: 5 Ways to Reduce Your Risk of Colon Cancer
How Can I Lower My Risk of Colon Cancer?
Maintain a healthy weight.
“Keeping a healthy weight is important because obesity is a risk factor for colon cancer,” Dr. Clarke told us.
Eat a healthy diet.
“A diet full of vegetables, fruits, whole grains and reduced red meat and processed foods is advised,” Dr. Yoon advises.
“Diets high in red and processed meats and cooking meats at very high temperatures can increase the risk of colorectal cancer,” Dr. Mongiu concurred, “whereas eating plenty of fruits, vegetables, whole grains and other fiber-rich foods can help lower it.”
Dr. Clarke also recommends foods high in antioxidants and omega-3 fatty acids. We know you’ve heard it before, but the Mediterranean diet is a great option.
Related: Here’s Exactly How Long It Takes to See Benefits From the Mediterranean Diet
Know your family history of colon cancer.
“Learning your family history is crucial to establishing your risk profile and when your screening should begin,” Dr. Khokar advises. If you’re under 45 but have a family history of colorectal cancers, you’ll likely want to start screenings earlier, depending on advice from your physician.
Avoid vices.
Dr. Yoon advises that smoking, chewing or vaping tobacco, as well as alcohol consumption, may increase your risk of colon cancer. We already know they all increase your risks of several other cancers, so let this be the nudge you need to get help quitting if you need it.
Related: This Trail Mix Staple Fights Colon Cancer
Get regular colon cancer screenings.
We’ll say it again! If you’re at average risk for colon cancer, you should get a colonoscopy every 10 years once you turn 45. If you’re higher risk, you’ll want to start screenings earlier and get them every five years.
“Colon cancer is highly treatable when caught early, with survival rates exceeding 90% for localized disease,” Dr. Boxer says. “Advances in screening and treatment have significantly improved outcomes, making early detection critical for success.”
Up Next:
Related: The One Thing Colon Cancer Doctors Say You Should Never, Ever Do
Sources
- Dr. H. Richard Alexander, Jr., MD, FACS
- Dr. Andrew Boxer, MD
- Dr. David Clarke, MD
- Dr. Michelle Hughes, MD
- Dr. Bianca Islam, MD, Ph.D., MSc.
- Dr. Paul Johnson, MD, FACS, FASCRS
- Dr. Pashtoon Kasi, MD, MS
- Dr. Omar Khokar, MD
- Dr. Anne Mongiu, MD, PhD, FACS, FASCRS
- Dr. Eric Yoon, MD
