I want to talk about what younger patients—and their doctors—are missing.
Because colorectal cancer is no longer just a disease of older adults.
Rates of early-onset colorectal cancer (EOCRC)—diagnosed before age 50—are rising. And one of the biggest problems isn’t just that it’s happening.
It’s that we’re missing it.
Because when you’re in your 30s or 40s, symptoms often get dismissed as hemorrhoids, IBS, stress, or diet.
Here are the five symptoms you should never ignore.
This is the most common—and most overlooked—symptom.
Patients are often told:
“It’s probably hemorrhoids.”
And sometimes it is. Technically, about 89% of the time, bleeding is because of anorectal/hemorrhoidal disease.
But persistent bright red bleeding—especially if it’s new, recurrent, or mixed with stool—needs evaluation. My rule of thumb— if it doesn’t stop in 7 days, go see someone in person. Most hemorrhoid bleeding stops in 3-4 days.
Red flag: bleeding that doesn’t go away.
Your body has a baseline.
Colon cancer can disrupt it.
Look for:
New constipation
New diarrhea
Alternating patterns
Narrower stools
Different color stools— like black, tarry stools, which can be a sign of a right-sided tumor.
Feeling like you’re not fully emptying
If something changes and stays changed, that matters.
Not all bleeding is visible.
Slow, chronic blood loss from a tumor can lead to:
Fatigue
Weakness
Shortness of breath
Dizziness
In younger adults, unexplained iron deficiency = find the source. Get a colonoscopy.
This is often vague and easy to dismiss.
But persistent:
Cramping
Pressure
Bloating
can signal partial obstruction or inflammation.
Red flag: pain that doesn’t behave like your usual GI symptoms.
If you’re losing weight without trying, pay attention.
Cancer can alter metabolism and appetite.
Even subtle, gradual weight loss can be a clue.
Because they overlap with common conditions:
Hemorrhoids
IBS
Stress-related gut symptoms
Diet changes
But here’s the difference:
Common conditions fluctuate. Cancer tends to persist.
If you remember one thing, it’s this:
You are not too young for colon cancer.
Persistent symptoms deserve evaluation—regardless of age.
Most of the time, it won’t be cancer.
But when it is, catching it early changes everything.
References
Siegel RL, Miller KD, Jemal A. Cancer statistics. CA Cancer J Clin. 2024.
Nguyen LH et al. Early-onset colorectal cancer epidemiology. Gastroenterology. 2020.
American Cancer Society. Colorectal cancer facts & screening guidelines.
Fong C. EOCRC symptom awareness series. Constipation Nation.
