HONOLULU (HawaiiNewsNow) – Colorectal cancer is now the leading cause of cancer deaths among people younger than 50, according to a recent American Cancer Society study, and local gastroenterologists say they’re seeing more patients diagnosed before midlife.
“Most gastroenterologists have been noticing more colorectal cancer patients younger than 50,” said Dr. Timothy Swindoll, chief of gastroenterology at Hawai‘i Pacific Health.
The trend helped drive a change in national screening recommendations in recent years. Many guidelines now advise average-risk adults to begin colorectal cancer screening at 45, down from 50.
Swindoll said screenings matter because colorectal cancer often develops silently.
“The most common symptom of colorectal cancer is no symptoms at all,” he said.
Who should get screened — and when
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Adults 45 and older should talk with a health care provider about getting screened, Swindoll said.
People may need to start earlier if they have a family history of colon cancer or develop symptoms, he said.
Symptoms and treatment
When symptoms do occur, they can include rectal bleeding or changes in bowel habits — such as constipation or diarrhea — that last longer than a typical illness, Swindoll said.
Treatment depends on how early the disease is found.
If doctors identify precancerous polyps during a colonoscopy, they may be able to remove them during the procedure, Swindoll said, which can eliminate the need for additional treatment.
More advanced cancers often require surgery and may also involve radiation and chemotherapy, he said.
Colonoscopies: what to expect
Swindoll said colonoscopy remains the most thorough way to check for precancerous polyps.
While many people dread the test, he said the procedure itself is usually easier than patients expect.
“The actual colonoscopy is generally a pleasant nap for most people,” Swindoll said.
For many patients, he said, the most disliked part is the bowel preparation beforehand.
Historically, bowel prep often meant drinking a full gallon of cleansing liquid that many people found unpleasant, he said. But Swindoll said there are now options that may be easier to tolerate, including pill-based prep or regimens that use sports drinks such as Gatorade paired with a laxative.
“We can find an option that works best for you,” he said.
‘Don’t be embarrassed’
Swindoll encouraged people to bring up concerns about bowel habits, bleeding or family history with their doctor.
“Don’t be embarrassed to bring things up,” he said. “We’ve heard it all — there’s little that can shock or embarrass us.”
Having those conversations and getting screened on time can help catch cancers early — or prevent them altogether — when polyps are found and removed, he said.
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