Expect Questions About Colorectal Cancer Among Younger Adults

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It is both the patient’s and the physician’s responsibility to be on high alert to the symptoms.
— Mohamed E. Salem, MD

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Publicity surrounding a recent study showing a sharp increase in colorectal cancer among young people, even those in their 20s,1 may result in increased patient visits and questions. Among people aged 20 to 39, colon cancer rates have increased 1% to 2.4%, and rectal cancer rates have increased 3.2% per year.

“It is both the patient’s and the physician’s responsibility to be on high alert to the symptoms,” gastrointestinal oncologist Mohamed E. Salem, MD, stressed. Adapting watchwords he often sees in airports, Dr. Salem tells his patients, “if you feel something, say something.” He is Assistant Professor of Clinical Medicine, Associate Fellowship Program Director, Division of Hematology and Oncology, at Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC.

“I always tell my patients, colon cancer is like a family name,” Dr. ­Salem said. “Every individual [with the disease] is like a brother or sister; they share the family name, but each one has his or her own unique characteristics that may influence the cancer behavior and response to therapy.”

Signs and Symptoms

On its website, the American Cancer Society lists the following symptoms of colorectal cancer that patients should be aware of and bring to the attention of their physician:

  • Change in bowel habits (eg, diarrhea, constipation, or narrowing of the stool) that lasts for more than a few days
  • Feeling the need for a bowel movement even after the bowels are emptied
  • Rectal bleeding
  • Dark stools or blood in the stool
  • Cramping or abdominal pain
  • Weakness or fatigue
  • Unintended weight loss.

The American Cancer Society points out that “many of the symptoms of colon cancer can also be caused by something that isn’t cancer, such as infection, hemorrhoids, irritable bowel syndrome, or inflammatory bowel disease.”2 Results of the recently released study on the rising incidence of colorectal cancer among young people, however, raise the index of suspicion that a symptom could indicate colorectal cancer and should not be dismissed merely because a patient is young. ν

Disclosure: Dr. Salem reported no potential conflicts of interest.


1. Siegel RL, Fedewa SA, Anderson WF, et al: Colorectal cancer incidence patterns in the United States, 1974-2013. J Natl Cancer Inst 109:djw322, 2017.

2. Simon S: Signs and symptoms of colon cancer. American Cancer Society, March 7, 2017. Available at Accessed March 22, 2017.

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