Colon cancer is becoming a growing concern for younger adults in the United States. Cases among people under 50 have been rising, and the disease is now a leading cause of cancer death in this age group.
This trend is especially troubling because colorectal cancer, which includes cancers of the colon and rectum, can often be prevented. It usually develops slowly, sometimes over many years, giving doctors a valuable window to find and remove abnormal growths before they become cancer.
Many colon cancers begin as small growths called polyps on the inner lining of the colon or rectum. Most polyps are harmless, but some can slowly change into cancer. Screening can find these growths early, and some tests allow doctors to remove them before cancer develops.
Yet a nationwide survey commissioned by the Colorectal Cancer Alliance suggests that many Americans do not understand how accessible screening has become. About half of those surveyed did not know that some colorectal cancer screening tests can be completed at home.
At-home stool tests usually require a person to collect a small stool sample and send it to a laboratory. Depending on the test, the laboratory may look for hidden blood or DNA changes that could be linked to cancer or precancerous growths.
The survey also found broader confusion about screening choices. About 37% of respondents did not know about all the available ways to screen for colorectal cancer.
Screening options can include colonoscopy, stool-based tests, CT colonography and flexible sigmoidoscopy. Different tests are suitable for different people, so patients can discuss their options with a healthcare professional.
Awareness could make a major difference. More than nine in ten survey participants said they would be more likely to get screened if they knew screening could help prevent colorectal cancer.
Dr. Richard Wender, a medical adviser to the Colorectal Cancer Alliance and a professor at the University of Pennsylvania, said finding colorectal cancer early greatly improves the chances of successful treatment. Better conversations between patients and healthcare professionals could therefore help save lives.
The survey also raised concerns about younger adults having digestive symptoms dismissed. About one-third of respondents said a healthcare provider had dismissed such symptoms at some point, and the figure increased to 45% among people younger than 45.
Colorectal cancer may cause no obvious symptoms in its early stages. When warning signs do occur, they can include blood from the rectum, lasting changes in bowel habits and unexplained weight loss. Symptoms like these deserve medical attention even in younger adults.
Fear and cost were also common barriers to screening, with nearly half of respondents identifying them as concerns. Some people may fear a colonoscopy or worry about medical bills, while others may simply be unsure which screening test they need.
Even home testing can cause confusion. About 59% of respondents did not know that a positive result from an at-home stool test generally needs to be followed by a colonoscopy so doctors can examine the colon more closely.
Current U.S. guidelines generally recommend that adults at average risk begin colorectal cancer screening at age 45. Some people may need earlier or more frequent screening because of factors such as family history, certain inherited conditions or inflammatory bowel diseases.
The nationwide online survey was conducted by Wakefield Research for the Colorectal Cancer Alliance and included 1,000 U.S. adults surveyed during November and December. The findings were released by the Colorectal Cancer Alliance and highlight a major gap between the screening tools now available and what many people know about them.
The message is encouraging as well as concerning: many of the tools needed to prevent colorectal cancer already exist. Helping more people understand their screening choices, while taking symptoms in younger adults seriously, could allow more cancers to be prevented or found when treatment is most effective.
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