Colon cancer in young adults: How you can protect your colon health in your 20s, 30s and 40s


by Clifford L Simmang, MD, MS

Jun 27, 2023

With the help of regular screenings, colon cancer is one of the most preventable and treatable types of cancer today. In general, cases of colon cancer are decreasing. But there’s one age group where cases are going up—for the last 20 years, we’ve been seeing an increase in colon cancer in younger adults.

Most young adults with an average risk of colon cancer don’t yet meet the guidelines for routine screening colonoscopy. But it’s still important for younger adults to be proactive about colon cancer prevention. If you’re in your 20s, 30s or early 40s, use these tips to help protect your colon health so you can stay well for many years to come.

Make healthy lifestyle changes

Currently, the most common explanation for the increase in colon cancer in young people is changes in lifestyle. First, people are eating more processed foods. To help decrease your risk, focus on eating healthy, fresh-cooked meals whenever possible. If you’re not sure where to start, a registered dietitian can help.

The other factor is a less active lifestyle. For entertainment or activity, people used to get out and do things, whereas now more people are staying at home. Find ways to get off the couch, go out and stay active.

Here are a few ideas to get you moving:

  • Try a new workout class. If that makes you nervous, take your spouse or a friend for morale support.
  • Find a hiking or biking trail near you.
  • Take advantage of free workout videos on YouTube. Try Pilates, strength training, cardio, yoga and more until you find your groove.
  • Make it a point to walk 10,000 steps every day. If you need some extra motivation, get a friend to join you.

Pay attention to digestive symptoms

The most important thing for young adults to know is that if you have symptoms, talk to your doctor. It’s common to have a temporary change in bowel habits or an episode of bleeding, but even a temporary change should be mentioned to your doctor.

The main GI symptoms that warrant a visit are:

  • Rectal bleeding
  • A persisting change in bowel habits, such as constipation or diarrhea

This is one reason it’s a good idea to have a primary care physician, even if you’re young and healthy. That way, you have someone to turn to when you have questions or worrying symptoms. Your primary care physician can refer to you a specialist, such as a gastroenterologist, for further care if needed.

Don’t have a primary care physician? Find a doctor near you today.

Advocate for yourself

Unfortunately, in younger adults, rectal bleeding is often presumed to be hemorrhoids. It may even be treated as hemorrhoids for a long time until it doesn’t get better or gets worse. Then, when a colonoscopy is performed, cancer is detected at a more advanced stage than it would have been earlier on.

If you report digestive symptoms but feel you’re not getting the thorough care you need, request a more thorough evaluation—especially if you have bleeding and persistent changes in bowel habits. The likelihood of colon cancer is low, but if you don’t look, you won’t know. Be an advocate for yourself, so you can have peace of mind about your health.

Know the age to start screening

A few years ago, the recommended age to start colon cancer screening was 50. With the increase in cases in younger adults, the screening age was lowered to 45. The US Preventive Services Task Force lowered the colon cancer screening age because an overabundance of literature and statistics now support the benefits of a younger person having colonoscopy screening.

Many people put off their colon screening because they are embarrassed or afraid of the procedure. But once you’ve had a colonoscopy, you’ll realize it’s not that big a deal. A colonoscopy with removal of polyps is the best way to stop cancer before it even starts.

However, there are other options for screening if you are considered at low risk of developing colon cancer. Learn more about your screening options, and talk to your doctor about which option is best for you.

Factor in your risks and family history

A screening colonoscopy starting at age 45 is recommended for those with an average risk. If you have risk factors for colon cancer, talk with your doctor earlier—it’s never too early to start talking about prevention.

We know that family history is a significant factor that increases the risk for colon cancer. People with a family history of colon cancer, or even colon polyps, should start their first colonoscopy at the age of 40.

If your family member’s tumor or polyp was detected before the age of 50, then you should start 10 years younger than whatever age they were. So, if they were diagnosed at the age of 48, then you should start at 38. If they were diagnosed at 40, then you should start at 30.

Take a proactive approach to colon health

In the end, making your colon health a priority can help you stay well throughout the next decades of your life. Remember, any ongoing symptoms, risk factors or family history mean you may need evaluation earlier than the routine screening age of 45.

Many younger people who catch colon cancer when it’s most treatable have symptoms like bleeding and insist that they be referred for a colonoscopy. If you’re experiencing symptoms, don’t just assume they will get better. Talk with your doctor and be proactive.

Learn more about digestive care or find a GI specialist near you. You can also download our free colorectal cancer treatment guide.

About the Author

Clifford L. Simmang, MD, MS, is a colon and rectal surgeon on the medical staff at Baylor Scott & White Medical Center – Grapevine. He serves as the hospital’s vice president of medical affairs and chief medical officer.

We make it easy.

Healthcare doesn't have to be difficult. We're constantly finding ways to make it easy so that you can get Better and stay that way.

Better tools make it easier

We all have different healthcare needs. Handle them your way with the MyBSWHealth app. Download the app today and take a hands-on approach to your healthcare.

Text Better to 88408