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The unexpected death of award-winning actor and playwright Chadwick Boseman at 43 to colon cancer in 2020 put a spotlight on a disease usually associated with older adults. According to experts, while the rates of colon cancer among older adults have dropped significantly over the past two decades—thanks to screening protocols like colonoscopies—it is concerning that younger patients are not getting the screenings they need.

“For the last 20 years, we’ve seen a steady increase in the number of individuals who develop colorectal cancer before the age of 50,” explained Xavier Llor, MD, Ph.D., medical director of the Colorectal Cancer Prevention Program at Smilow Cancer Hospital and Professor of Medicine, Yale School of Medicine.

Given the increasing colorectal cancer rates among younger people, the American Cancer Society now recommends people at average risk of colorectal cancer begin regular screening at age 45. Some patients with a family history of colon cancer or inflammatory bowel disease may need to get screened earlier as well.

Doctors often can do more when colorectal problems are diagnosed early, said George Yavorek, MD, medical director of colon and rectal surgery at Lawrence + Memorial Hospital. His message to anyone, whether or not they have a family history of colorectal problems: Never miss a routine colonoscopy screening. “It's heartbreaking to see someone who is in their late 50s or early 60s, and never had a colonoscopy, show up with advanced colon cancer. Colonoscopy screenings can prevent cancer or at least catch it at an earlier stage when it is much more curable,” he said.

During a colonoscopy, a doctor uses a colonoscope, a long, flexible tube with a tiny video camera at the tip, to check for abnormal tissue in the large intestine. Sometimes, a small growth, called a polyp, can form on the inner wall of the colon or rectum. Although many polyps are benign (not cancerous), some do become cancerous. In some instances, polyps can be removed during the colonoscopy to prevent the possible progression of cancer.

While patients may feel uneasy about having a procedure of any kind, physicians urge people not to let nerves deter them from getting the screening they need. Though most patients say preparing for the procedure is the hardest part—which includes a clear liquid diet and laxatives the day before—during the colonoscopy itself, patients are sedated and feel no pain.

No matter your age, it’s important to know common colorectal cancer symptoms. Most people don’t have any symptoms in this cancer’s early stages. The most common symptom is a change in bowel habits. You may notice blood in the stool, weight loss and abdominal pain or develop anemia. If you experience any of these signs, consult a physician.

Care for colorectal cancer has changed dramatically with the use of minimally invasive surgeries, according to Dr. Yavorek. “The outcomes, in terms of cancer survival, are equal to open surgery, but the length of stay and patient satisfaction are better,” he said. Results are also improving as different specialists collaborate on plans of care that may include such treatments as chemotherapy, radiation, and biologic medicines, he explained.

Dr. Llor advises everyone to speak with their doctor about screening for colon cancer. "Colorectal cancer screening saves lives, so please have your cancer screening,” he said.

Studies show that habits related to diet, weight and exercise are strongly linked to colorectal cancer risk. Here are some habits that will help you minimize the risk of colorectal cancers:

• Eat lots of vegetables, fruits, and whole grains. Also, eat less red meat (beef, pork or lamb) and processed meats (hot dogs and luncheon meats), which can increase the risk of colorectal cancer.
• Stay physically active. People who have a sedentary lifestyle may have a greater chance of developing colorectal cancer.
• Watch your weight. Being overweight or obese increases the risk of getting and dying from colon or rectal cancer. Control your weight by eating healthier and exercising.
• Don’t smoke. Longtime smokers are more likely than nonsmokers to develop colorectal cancer. If you are ready to stop smoking, the Smilow Cancer Hospital Tobacco Treatment Program tailors treatment to your situation and tobacco use history. To learn more or to schedule a consultation, call 203-688-1378.
• Avoid alcohol. Studies show alcohol use is linked to a higher risk of colorectal cancer. The American Cancer Society recommends no more than two drinks a day for men and one drink a day for women.

Scheduling regular screenings can make a big difference in your health and wellbeing. Click here to learn more about colon and gastrointestinal cancers, and all the services the Center for Gastrointestinal Cancers at Smilow Cancer Hospital and Yale Cancer Center offers.