Four 'Red Flag' Signs of Colorectal Cancer in Young Adults

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Four "red flag" signs and symptoms associated with an increased risk of early-onset colorectal cancer have been identified by researchers at Washington University School of Medicine in St. Louis. This important finding may be key to earlier detection and diagnosis of early-onset colorectal cancer among younger adults.

The new colorectal cancer diagnoses in people under 50 years of age are rising at an alarming rate. The four symptoms-abdominal pain, rectal bleeding, diarrhea, and iron deficiency anemia-were identified in a new study published in the Journal of the National Cancer Institute.

Study Identifies 4 'Red Flag' Symptoms of Colon Cancer in Younger People

This is the result of studying de-identified health insurance data on more than 5,000 patients with early-onset colorectal cancer that occurs before a person turns 50 in the period between three months and two years before diagnosis.

‘Symptoms such as stomach pain, rectal bleeding, diarrhea, and iron deficiency anemia show up as early as two years before a colorectal cancer diagnosis in younger people.’

They found that having a single one of the symptoms almost doubled the risk; having two symptoms increased risk by more than 3.5 times; and having three or more boosted the risk by more than 6.5 times.

Colorectal cancer is not simply a disease affecting older people; younger adults should also be aware of and act on these potentially very telling signs and symptoms - particularly because people under 50 are at low risk, and they do not receive routine colorectal cancer screening ().

It is also crucial to spread awareness among primary care doctors, gastroenterologists, and emergency medicine doctors. To date, many early-onset colorectal cancers are detected in emergency rooms, and there often are significant diagnostic delays with this cancer.

Two symptoms in particular - rectal bleeding and iron deficiency anemia, a condition in which there are not enough healthy red blood cells to carry oxygen - point to the need for timely endoscopy and follow-up ().

In this study, researchers analyzed cases of early-onset colorectal cancer and matched controls using a big-data tool that provides longitudinal, de-identified information based on health insurance claims data from about 113 million insured adults ages 18 to 64.

Seeking Clues to Early-onset Colorectal Cancer

It usually takes about three months to get a diagnosis from the time a person first goes to the doctor with one or more of the red-flag signs and symptoms they have identified. But in this analysis, we found that some young adults had symptoms for up to two years before their diagnoses.

That may be part of the reason many of these younger patients had more advanced diseases at the time of diagnosis than what we normally see in older people who get screened regularly.

Obesity, prolonged sitting, metabolic syndrome, diabetes, sugar-sweetened beverages, and other risk factors may contribute to the rising incidence of early-onset colorectal cancer.

According to the American Cancer Society, although the death rate from colorectal cancer has been dropping for several decades in older adults due to regular colonoscopies and improved treatment.

But more younger people are diagnosed with the disease at advanced stages, and many are dying of the disease. Such a shift suggests urgency in recognizing symptoms as early as possible.

Since many early-onset colorectal cancer cases have been and will continue to be diagnosed after symptom presentation, it is crucial to recognize these red-flag signs and symptoms promptly and conduct a diagnostic work-up as soon as possible.

By doing so, they can diagnose the disease earlier, which in turn can reduce the need for more aggressive treatment and improve patients' quality of life and survival rates.

References:

1. Increasing Incidence of Early-Onset Colorectal Cancer - (https:pubmed.ncbi.nlm.nih.gov/35443109/)
2. Red flags indicate risk for early-onset colorectal cancer - (https:medicine.wustl.edu/news/red-flags-indicate-risk-for-early-onset-colorectal-cancer/)

Source: Eurekalert