A new study has shown stark results
A recent study has revealed that patients who reported rectal bleeding and subsequently underwent a colonoscopy were 8.5 times more likely to be diagnosed with colorectal cancer. The research emphasised the importance of not ignoring such symptoms, even in the absence of a family history or if individuals do not meet the criteria for routine checks.
The link was particularly strong among patients under the age of 50, with 70% having no family history of the condition. Remarkably, 88% of those who had a colonoscopy did so due to their symptoms rather than as part of a routine check-up.
Senior author Sandra Kavalukas, a colorectal surgeon at the University of Louisville School of Medicine in Kentucky, stated: “If they’re 35 and they come in with rectal pain, they probably don’t need a colonoscopy. But if they come in with a bleeding complaint, they are 8.5 times more likely to have a colorectal cancer.”
She added: “This research lends support to the question of who does or doesn’t warrant a colonoscopy: if you have a person below the screening age with rectal bleeding, you should seriously consider a colonoscopy.”
In the US, guidelines recommend routine colonoscopy screenings from the age of 45 for people without a family history of the disease. Meanwhile, on the NHS, bowel cancer screening tests are offered to individuals aged 50 to 74.
The research, set to be presented at the American College of Surgeons Clinical Congress 2025 in Chicago this weekend, aims to address a gap in healthcare for symptomatic young adults who are not eligible for routine screening but face rising colorectal cancer rates.
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The study examined 443 patients under the age of 50 who underwent a colonoscopy from 2021 to 2023 at the University of Louisville Health System. Of these, 195 participants were diagnosed with early-onset colorectal cancer and 248 had normal results.
Shockingly, only one in 10 of these confirmed cancer cases had genetic markers or a family history of the condition. Those diagnosed with early-onset colorectal cancer were also significantly more likely to be former smokers.
The research team is now embarking on a larger study and hope to develop a ‘risk score calculator’ to help clinicians and patients recognise their risk outside of current criteria like family history.
Colorectal cancer, also known as bowel cancer, is the fourth most common cancer in the UK and has a 53.9% survival rate for 10 years or more according to Cancer Research UK. However, the charity also highlights that 54% of cases are preventable.
Common causes of the disease include an unbalanced diet featuring too much processed meat, alcohol and smoking with little fibre and physical activity. Being overweight and obese contributes to around 11% of cases in the UK.
Symptoms of colorectal cancer can include:
- Bleeding from the rectum or blood in your poo
- Change in your normal bowel habit, such as looser poo, pooing more often or constipation
- Lump in your back passage or tummy
- Feeling of needing to strain in your back passage (as if you need to poo), even after opening your bowels
- Losing weight when you haven’t been trying to
- Pain in your abdomen or back passage
- Tiredness and breathlessness
- Bowel obstruction causing cramps, bloating, constipation and being sick