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Common Early Warning Signs for Colorectal Cancer in Young Adults 

Often, colorectal cancer (CRC) doesn’t cause symptoms until it grows or spreads. It is often harder to detect in the younger population who might ignore symptoms due to lack of insurance coverage, and because they are not yet eligible for screening because of their younger age. However, findings from a recent study might provide some clues to identifying the early onset of CRC among young adults not old enough to qualify for CRC screening. 

Those under 45 may not have insurance coverage for any form of CRC screening—colonoscopy, FIT, or FOBT—because the recommended age to start screening for CRC is 45 years. According to the American Cancer Society, 2,001,140 new cases of cancer are projected in the U.S. in 2024,152, 810 of which may be CRC. Another concerning statistic is the 2% rise in the annual CRC incidence rate among young adults (ages <55 years). 

Paying Attention to The Early Signs

The study identified 4 red-flag signs and symptoms occurring at least three months before diagnosis that were associated with a subsequent risk of early-onset CRC:

  • Abdominal pain 
  • Rectal bleeding 
  • Diarrhea
  • Iron deficiency anemia 

A total of 5,075 early-onset CRC cases and 22,378 controls were included in the study. 63% of the cases were diagnosed with CRC. The authors found that in the study population:

  • Abdominal pain and rectal bleeding were the most common symptoms
  • Abdominal pain was associated with a 34% higher risk of early-onset CRC 
  • Signs of rectal bleeding had the greatest association with developing CRC 

Diarrhea and iron deficiency anemia were also identified as a common symptom but did not have a high association with CRC.

Having one, two, or three of these warning signs and symptoms were linked to a 1.9-, 3.6-, and 6.5-fold higher risk of developing CRC, respectively. These correlations were stronger for rectal cancer and young-onset cases (average 43 years).

Despite the possibility that this study helped focus on the early warning signs and symptoms of CRC, it is crucial to remember that the signs and symptoms described above can also be the result of other health conditions such as inflammatory bowel disease, hemorrhoids, irritable bowel syndrome, or infections. In order to properly identify and treat the condition, it is important to see a doctor and get screened if you are experiencing any of those symptoms.

 

Emmanuel Olaniyan is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

Picture credit: Muhammad Daudy on Unsplash

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Race and Gender Impact CRC Diagnostic Testing Among Young Veterans With Iron-Deficiency Anemia

By Parker Lynch

The Veterans Health Administration recently conducted a retrospective study of data on veterans who received care between 1999 and 2019. This study included US veterans between the ages of 18 and 49 with diagnoses of iron-deficiency anemia (IDA) and/or hematochezia. When examined for their diagnostic testing completion rate and the time to diagnostic testing, race and gender were found to result in disparities.

Study Outcomes and Findings

For those with IDA, diagnostic test completion was characterized by whether or not these individuals had received bidirectional endoscopies (a procedure that includes both a colonoscopy and an upper endoscopy). For those with hematochezia, diagnostic test completion was defined as either receiving a colonoscopy or sigmoidoscopy (a less-invasive procedure in which the lower part of the large intestine is examined, rather than the entire organ).

Candidates were also evaluated with respect to age, sex, race, ethnicity, and hemoglobin test value.

Out of Among the 59,169 veterans with IDA:

  • 37,719 were aged 40 to 49 years
  • 28,667 were women
  • 24,480 were black
  • 4,161 were Hispanic
  • The estimated cumulative diagnostic test completion rates were 7% at 60 days and 22% at the end of the two years as per the evaluation period.

 

Out of the 189,185 veterans with hematochezia:

  • 106,730 were aged 40 to 49 years
  • 86.5% were men
  • 4,4939 were black
  • 17,317 were Hispanic
  • The estimated cumulative diagnostic test completion rates were 22% at 60 days and 40% at the end of the two years.

The study found very low diagnostic testing among both veterans with IDA as well as those with hematochezia. Additionally, black, Hispanic, and female veterans were less likely to receive testing than their white male counterparts.

This testing is vital to detecting and treating early onset colorectal cancer (CRC), so the low levels are concerning for healthcare professionals and researchers and may have resulted in missed opportunities for early diagnosis of CRC.

Veterans’ Inadequate Health Coverage

This study raises questions around why many veterans aren’t receiving the preventative screenings they need. A 2020 study conducted by Harvard and Public Citizen found that 1.53 million veterans nationwide were uninsured. On top of this, 1 in 12 veterans (approximately 2 million individuals) go without vital physician care annually due to the associated cost.

An estimated 9 million veterans are registered with the Veterans Health Administration, but not all of them are eligible for VA healthcare coverage. This leaves a lot of veterans (many of whom have chronic conditions) unable to receive adequate care, unless they are directly paying out of pocket or have the means to purchase private insurance.

Should veterans have proper health care coverage, there would hopefully be a substantial increase in the amount of diagnostic testing that is completed, and therefore a decrease in the national incidence rate of early onset CRC.

 

Parker Lynch is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

Image credit: Clker-Free-Vector-Images from Pixabay.

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Crohn’s Disease, Ulcerative Colitis, and Colorectal Cancer: How Different Are They?

Image credit: Gordon Johnson from Pixabay

 

There have been moments where we have experienced a symptom and attributed it to a completely different disease or condition than it ended up being. There are infographics to help acknowledge the similarities and simultaneously clarify distinct differences across the common cold, flu strains, and COVID-19. Since there is much overlap and potentially confusion that can arise regarding symptoms of Crohn’s disease, ulcerative colitis, and colorectal cancer, we have created infographics to help visualize commonalities as well as distinguish their disparate characteristics. 

We hope that these graphics will provide a clearer picture of symptoms that are unique to specific conditions and diseases and where and how they manifest in our body.

 

 

Sources:

  1. Colon cancer vs. ulcerative colitis (UC) symptoms & signs. eMedicineHealth. April 2, 2020. Accessed November 8, 2023. https://www.emedicinehealth.com/colon_cancer_symptoms_vs_ulcerative_colitis/article_em.htm.
  2. Crohn’s disease and colon cancer: What you need to know. HealthMatch. October 15, 2021. https://healthmatch.io/colon-cancer/crohns-disease-and-colon-cancer#overview.
  3. Colon cancer. Mayo Clinic. July 27, 2023. https://www.mayoclinic.org/diseases-conditions/colon-cancer/symptoms-causes/syc-20353669.
  4. Colorectal cancer – symptoms and signs. Cancer.Net. June 1, 2022. https://www.cancer.net/cancer-types/colorectal-cancer/symptoms-and-signs.
  5. Colorectal cancer signs and symptoms: Signs of colorectal cancer. Signs of Colorectal Cancer | American Cancer Society. June 29, 2020. https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/signs-and-symptoms.html.
  6. Colorectal cancer: Symptoms and diagnosis. Colon Cancer Foundation. December 1, 2022. https://coloncancerfoundation.org/colorectal-cancer-symptoms-diagnosis-and-treatment/.

 

Vanessa Seidner is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

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