4 Potential Red Flags for Early-Onset Colorectal Cancer

If you’re under 50 years old and experiencing symptoms such as anemia, bloody stool, diarrhea, and stomach pain, you may want to get screened for colorectal cancer.

Knowing the symptoms that may be red flags for colon cancer, as well as when to get screened, is key to early detection and successful treatment.

Anemia

Bloody Stool

Diarrhea

Abdominal Pain

“Everyone, regardless of age, should recognize that symptoms such as ongoing abdominal pain and rectal bleeding, as well as lab tests showing anemia, could be a sign of colorectal cancer,” Dr. Liang says. “If you have any of these symptoms, you should talk to a physician.”

• Colonoscopy In this common procedure, a doctor will insert a long, flexible tube in your rectum and use a video camera to inspect your large intestine for polyps or abnormalities. It requires a clean colon, and preprocedure preparation is necessary. If the procedure shows no abnormalities, you likely can wait 10 years before another colonoscopy. A virtual colonoscopy, similar to a CT scan, also may be available, although less commonly used. Virtual colonoscopies are recommended every five years.
• Sigmoidoscopy Similar to a colonoscopy, this procedure examines only the lower left side of your colon, rather than the whole thing.

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   Sigmoidoscopies are recommended every five years, although they aren’t commonly used in the United States.

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• Multitargeted Stool DNA and RNA Tests A stool sample is tested to see if DNA or RNA changes may indicate colon cancer. It is less effective in discovering polyps than a colonoscopy. Examples of these include Cologuard and Colosense. These tests are recommended every three years. Stool samples can be collected at home.
• Fecal Immunochemical Test (FIT) This stool test checks for hidden blood from the lower intestines. It involves no bowel prep but is recommended yearly. The stool sample can be collected at home.
• Guaiac-Based Fecal Occult Blood Test (gFOBT) Like the FIT, the gFOBT looks for hidden blood in stool. It involves some dietary changes leading up to the test and is recommended yearly.
• Blood Test The only FDA-approved blood test is the Shield test. It’s recommended at least every three years, although it’s not yet clear how often the blood test should be repeated for best efficacy. This is not a preferred screening method, as it’s not as sensitive as the other screening tests and is more likely to miss precancerous growths.

Colonoscopies are the gold standard for colorectal cancer screening, so if you receive abnormal results on any of the other screening tests, it’s likely that your doctor will recommend a colonoscopy to follow up.

Symptoms of colorectal cancer are not the same as a diagnosis. And seeing a doctor won’t necessarily lead to an invasive screening test, says Samir Gupta, MD, a gastroenterologist and professor of medicine at the University of California, San Diego.

“In many cases, a patient and doctor may decide that a diagnosis other than colon cancer is the likely cause and move forward with a diagnosis and treatment plan that does not include colonoscopy,” Dr. Gupta says.

If this treatment works within a month or two, additional cancer screening may not be necessary, he says.

“If the original treatment plan is not working, and symptoms persist, then colonoscopy should be strongly considered to rule out colorectal cancer,” Gupta says.

Additional reporting by Tony Stasiek.