Colorectal cancer was once considered a disease of older adults. Not anymore.
As gastroenterologists from two different Utah health care systems — University of Utah Health and Intermountain Health — we’ve seen firsthand how the face of this disease is changing. Patients coming through our doors aren’t just in their 50s or 60s — they’re in their 30s and 40s. Some are even younger.
We’re now seeing precancerous polyps in patients as young as their 30s — something that was far less common during our GI fellowship training. In fact, many younger adults likely already have polyps by the time they undergo a colonoscopy for symptoms. This stark reality underscores the urgency of earlier screening and awareness.
The statistics are alarming.
Cases of colorectal cancer in adults under 50 have risen nearly 50% in the past two decades. Many of these patients have no family history and no idea they’re at risk.
Too often, young adults with mild symptoms — like rectal bleeding — assume it’s just hemorrhoids. They delay seeking care, trying home remedies first. By the time they undergo a full evaluation, some are diagnosed with advanced colon cancer. We need to change that pattern by making it easier and safer for patients to speak up about symptoms sooner.
We think about the young mothers who are now being treated. One woman was diagnosed shortly after giving birth. She had no family history, no reason to suspect colon cancer — and yet, there she was, holding her newborn, facing a devastating diagnosis.
These stories are becoming too common. We cannot let this continue.
Awareness is our first line of defense. Screening guidelines have already changed — the recommended age to start screening is now 45, down from 50. But many people still don’t know. Every week, we remind patients: Screening starts at 45. Too many still think it’s 50.
This misconception is costing lives.
Unlike many other cancers, colorectal cancer is often preventable. When we detect and remove precancerous polyps early, we stop cancer before it starts. Screening can also catch cancer at an early, curable stage. But if patients don’t know they need to be screened — or if they ignore warning signs — we lose that opportunity.
Too many people assume they’re too young for colon cancer. Even when they do speak up, some doctors dismiss their concerns. It’s time to change that mindset.
What you need to know and do:
- If you have symptoms like rectal bleeding, unexplained weight loss or persistent changes in bowel habits — speak up.
- If you’re a doctor — listen.
- If you see blood in your stool, don’t assume it’s hemorrhoids. Tell your doctor. Advocate for yourself.
Screening is our best tool, but we must also make it more accessible. Utah ranks near the bottom in the country for primary care access, and some rural communities have screening rates as low as 35%. Nationally, we set a goal to reach 80% screening by 2018, but we’re still falling short. In some areas, rates are even declining.
The good news? There are options.
Some people hesitate to get screened because they don’t want a colonoscopy. But stool-based tests, like the FIT test, are also effective. For many, they’re a great alternative. The research is clear — when people are offered both options, more of them get screened.
Despite working in different health care systems, we’ve come together through Screen Utah, a statewide initiative facilitated by the One Utah Health Collaborative. This effort brings health care leaders and organizations together to expand access, increase awareness and make screening a priority in every community.
At the end of the day, our message is simple:
If you’re 45 or older, get screened. If you have symptoms, speak up. If you’re a doctor, listen.
We’ve seen too many lives changed — too many young patients diagnosed too late. Colorectal cancer is preventable, but only if we catch it in time.