HCA Midwest Health - September 22, 2020

There's been news lately of U.S. colorectal cancer rates in younger patient rising. But that's not necessarily bad news, according to Dr. Benyamine Mizrahi, a colorectal surgeon that performs colonoscopies and robotic surgery in HCA Midwest Health hospitals across the Kansas City region.

“It's because there's more awareness,” said Dr. Mizrahi. “Colon or rectal cancer used to be thought of as an older person's disease, so if a young person had signs like bleeding, they were thinking ‘it's just hemorrhoids' and they didn't take it seriously. Now we have more screening, earlier detection.”

So the rising rates in young people may be caused by cancer being detected much earlier than in the past. Which would be great news—the earlier colorectal cancer is diagnosed and treated the better the outcomes usually are.

That proactive trend certainly seems to be the case in the Kansas City area. “I'm definitely seeing an increase in patients that are younger,” said Dr. Mizrahi. “They go to their primary care doctor, to social media or to the internet and they find a specialist. They come in and say ‘this might be nothing but I'm bleeding and I've been bleeding for a year'.”

While early detection is likely at least part of the reason for the increase in colon cancer rates in younger people, it's probably not the whole story.

“We are seeing a lot more sporadic younger patients with aggressive cancer and I feel like we don't know why that is the case,” said Dr. Lina O'Brien, a leading colorectal and robotic surgeon in the region and a colleague of Dr. Mizrahi.“The majority are usually diagnosed over the age of 50 but we've had some cases where we're operating on people who are really young.”

All of which begs the question—when should you get tested?

The age to get a screening colonoscopy

The best way to find (and even prevent) colon cancer is with a screening colonoscopy. Doctors can find any cancer that is present and also remove polyps (growths in the intestinal lining that may be harmless now, but can become cancerous if not removed).

So, at what age should you get your first colonoscopy? The answer depends on whether or not you are having any symptoms.

“If patients are having absolutely no symptoms and there's no family history, I'd go with the current American Cancer Society recommendations of starting at the age of 45,” said Dr. O'Brien.

With a family history of colon cancer, both Drs. O'Brien and Mizrahi recommend to start screening 10 years earlier than the age your family member was diagnosed. So if your dad was diagnosed with colon cancer at age 50, then you should get a screening colonoscopy at age 40.

These guidelines are only if you are having absolutely no symptoms. If you are showing any symptoms of colon cancer, see a doctor right away.

Signs & symptoms of colorectal cancer

“Sometimes people have been having symptoms for many, many years that they've attributed to hemorrhoids,” said Dr. O'Brien. “Really, they should have been getting some sort of diagnostic colonoscopy earlier.”

Here are the signs to be on the lookout for:

  • Any sign of bleeding. Rectal bleeding will be bright red. Blood in your stool will appear as dark or black stool.
  • Any change in bowel habits that lasts for more than a few days. This could be diarrhea, constipation, stool shape or appearance or any other factor.
  • A feeling like you need to move your bowels that is not relieved when you do have a bowel movement.
  • Abdominal cramps or pain.
  • Weakness or fatigue.
  • Unexplained weight loss.

Colorectal cancer often causes bleeding, but blood isn't always easy to see in stool. So, the first sign for many people is low red blood cell counts (anemia).

These symptoms can be related to many other conditions as well—but all of them should be evaluated by a physician, so don't hesitate to schedule an appointment. To find a qualified physician near you, use our free service at 1-800-386-9355 or visit our online physician finder. You can also talk to a registered nurse 24 hours per day, 7 days per week, free of charge at the same number.

“If you have signs and symptoms that warrant further work-up, I don't care how old you are... see a doctor,” said Dr. Mizrahi. “Colon cancer is indiscriminate of age.”

Leaders in detection & treatment

“It's so important to go out and get your screening colonoscopy,” said Dr. O'Brien. “Not enough of the population is doing that. And that would really prevent a lot of cancers, and hopefully prevent you from even needing surgery.”

Colonoscopies are not the only screening tool for colon cancer. Depending on your personal and family history, and other risk factors, your physician may recommend one of these other tests instead of, or in addition to, a colonoscopy:

  • Stool tests to detect for blood or DNA changes that might indicate cancer.
  • Flexible sigmoidoscopy—similar to a colonoscopy but examines the lower colon only.
  • Virtual colonoscopy (or CT colonography) – a CAT scan performed after the colon is filled with air (to produce better images).

If you or a loved one are facing a colon cancer diagnosis, you can be reassured that the most progressive treatment options and most experienced surgeons are available right here in the Kansas City area at Sarah Cannon Cancer Institute HCA Midwest Health. Sarah Cannon at Menorah Medical Center, also offers one of the country's leading Colorectal Robotic Surgery programs.

Learn more about Sarah Cannon's mission to redefine cancer care and patient resources like askSARAH – a 24/7 nurse call line for cancer-related questions (844) 482-4812.