4 Potential Red Flags for Early-Onset Colorectal Cancer

If you’re under 50 years old and experiencing symptoms such as anemia, bloody stools, diarrhea, or stomach pain, you may want to get screened for colorectal cancer.
Knowing the symptoms that may be red flags for colon cancer, as well as when to get screened, is key to early detection and successful treatment.
Colorectal Cancer Symptoms in Younger Adults
Anemia
Iron-deficiency anemia occurs when your body does not have enough iron to produce red blood cells. These cells are important for removing carbon dioxide from your body and carrying oxygen to your tissues. When you are anemic, you may feel tired and out of breath.
Bloody Stools
Diarrhea
Abdominal Pain
“Everyone, regardless of age, should recognize that symptoms such as ongoing abdominal pain and rectal bleeding, as well as lab tests showing anemia, could be a sign of colorectal cancer,” Dr. Liang says. “If you have any of these symptoms, you should talk to a physician.”
Who Should Be Screened for Colorectal Cancer?
- Colonoscopy In this common procedure, a doctor will insert a long, flexible tube in your rectum and use a video camera to inspect your large intestine for polyps or abnormalities. It does require a clean colon, and pre-procedure preparation is necessary. If the procedure shows no abnormalities, you likely can wait 10 years before another colonoscopy. A virtual colonoscopy, similar to a CT scan, also may be available.
- Sigmoidoscopy Similar to a colonoscopy, this procedure examines only the lower left side of your colon, rather than the whole thing.
- Stool DNA Test A doctor will examine a stool sample to see if DNA changes may indicate colon cancer. It is less effective in discovering polyps than a colonoscopy. Additional tests may be necessary if the test shows potential issues.
- Fecal Blood Test Your stool will be analyzed in a lab to see if it contains blood. This test also does not always uncover polyps or cancer, and a follow-up test may be necessary.
7 Ways to Prevent Colon Cancer
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Don’t Jump to Conclusions
Symptoms of colorectal cancer are not the same as a diagnosis. And seeing a doctor won’t necessarily lead to an invasive screening test, says Samir Gupta, MD, a gastroenterologist and professor of medicine at the University of California, San Diego.
“In many cases, a patient and doctor may decide that a diagnosis other than colon cancer is the likely cause and move forward with a diagnosis and treatment plan that does not include colonoscopy,” Dr. Gupta says.
If this treatment works within a month or two, additional cancer screening may not be necessary, he says.
“If the original treatment plan is not working, and symptoms persist, then colonoscopy should be strongly considered to rule out colorectal cancer,” Gupta says.
The Takeaway
- Colorectal cancer is the most deadly cancer among men under 50 and No. 2 among women under 50.
- Symptoms that are red flags include anemia, bloody stools, diarrhea, and abdominal pain.
- Cancer screenings are recommended once you turn 45 — or sooner, if you have additional risk factors.
- Colonoscopies are the most common screening for polyps and cancerous tumors in the colon.
Resources We Trust
- Mayo Clinic: Colon Cancer Screening: Weighing the Options
- American Cancer Society: American Cancer Society Guideline for Colorectal Cancer Screening
- American College of Surgeons: Clinicians Struggle to Understand Dramatic Rise in Early Onset Colorectal Cancer
- Centers for Disease Control and Prevention: Colorectal Cancer
- Yale Medicine: Colorectal Cancer: What Millennials and Gen Zers Need to Know
Additional reporting by Tony Stasiek.
- Fritz CDL et al. Red-flag signs and symptoms for earlier diagnosis of early-onset colorectal cancer. Journal of the National Cancer Institute. August 2023.
- Siegel RL et al. Cancer statistics, 2024. CA: A Cancer Journal for Clinicians. January 17, 2024.
- Peregrin T. Clinicians Struggle to Understand Dramatic Rise in Early Onset Colorectal Cancer. American College of Surgeons. December 4, 2024.
- Vuik FE et al. Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years. Gut. 2019.
- Key Statistics for Colorectal Cancer. American Cancer Society. April 28, 2025.
- Díaz-Gay M et al. Geographic and age variations in mutational processes in colorectal cancer. Nature. April 23, 2025.
- Colorectal Cancer Signs and Symptoms. American Cancer Society. January 29, 2024.
- Can Diarrhea be a Symptom of Colon Cancer. Mercy Medical Center. July 8, 2022.
- Jones V. Cancer in the sigmoid colon: What it means when colon cancer is on the left side. MD Anderson Cancer Center. February 14, 2024.
- American Cancer Society Guideline for Colorectal Cancer Screening. American Cancer Society. January 29, 2024.
- Colon Cancer Screening: Weighing the Options. Mayo Clinic. January 8, 2025.
- Colorectal Cancer Screening Tests. American Cancer Society. February 28, 2025.

Daniel Landau, MD
Medical Reviewer
Daniel Landau, MD, is a distinguished board-certified hematologist-oncologist with a career that has spanned two eminent institutions: the Orlando Health Cancer Institute and the Medical University of South Carolina. With a specialized interest in genitourinary oncology and hematology, he has been at the forefront of managing both benign and malignant conditions.
Dr. Landau is a pioneering figure in integrating advanced technology into oncology, having served as a director of telemedicine services. Under his leadership, multiple innovative systems have been designed and piloted, all with a singular focus: enhancing the patient experience.
Beyond his clinical and technological endeavors, Landau is deeply committed to medical education. He has dedicated significant time and expertise to nurturing the skills of medical students, residents, and fellows, ensuring that the flame of knowledge and compassion burns bright in the next generation of oncologists.
