Because younger adults are less likely to be screened, their symptoms are often dismissed or misattributed, which can then lead to later diagnosis. Dr. Kasi recommends planning ahead.
“For most people at average risk who feel well, the current US guidance is to start routine colorectal cancer screening at age 45,” he said. “But as a medical oncologist, I think your 30s are a great time to get proactive about risk assessment: know whether your family members have had colorectal cancer, and tell your doctor if you have an inflammatory bowel disease like Crohn’s or ulcerative colitis, a known hereditary syndrome like Lynch syndrome, or a history of abdominal or pelvic radiation. Those factors can move screening earlier and/or make colonoscopy the preferred test.”
However, those with a strong family history of the disease should be screened sooner. “Start screenings around age 40 or 10 years before the youngest diagnosis in a first-degree relative, whichever comes first,” he said. Individuals belonging to certain ethnicities should also be screened earlier, as instances of colorectal cancer are highest in Indian American and Alaska Native individuals, according to the American Cancer Society.
Dr. Kasi also pointed out that newer non-invasive stool-based or blood-based screening tests are available. “They are not meant to replace the colonoscopy procedure but can serve as an adjunct tool and another non-invasive lens with these novel tests often referred to as ‘liquid biopsies’ for screening and early detection.”