Normally, we prefer our bowels to keep it low-key. But experts say that silence is exactly what allows colorectal cancer to fly under the radar and turn deadly.
“Some patients reach stage 4 without noticeable symptoms,” Dr. Parul Shukla, regional chief of colorectal surgery for Northwell Westchester, told The Post. “By the time symptoms appear — such as blood in the stool — the cancer is usually quite advanced.”
Shukla’s warning comes amid a recent surge in colorectal cancer cases among patients 45 and younger, particularly women — a trend that’s baffling doctors who once saw the disease as primarily affecting older adults.
Colorectal cancer is often called a “silent killer,” partly because the early-stage symptoms can be mistaken for other conditions, according to Dr. Poppy Addison, colorectal surgeon at Northwell Staten Island University Hospital.
“Symptoms can include a change to your normal bowel habits, including diarrhea or constipation, or a change in the stool size or color, particularly if the stool becomes bloody or dark,” Addison said. “Other symptoms can be vaguer, including weight loss you didn’t intend, abdominal pain or fatigue.”
When patients do experience these early signs, Shukla says many dismiss them as indigestion, hemorrhoids, or diet-related issues. As a result, doctors may delay further testing, missing the chance for early intervention.
“Women may misattribute anemia to heavy periods,” he added. “In some cases, undiagnosed colorectal cancer is the actual cause, leading to a dangerous missed diagnosis.”
Doctors also say they’re seeing many patients who just don’t want to talk about their tummy troubles.
embarrassed” to talk about symptoms that could be a sign of early colon cancer. sirichai – stock.adobe.com
“I’m seeing patients in their mid-20s with aggressive cancer,” Dr. Mark Soliman, a colorectal surgeon, said in a recent video on SurgeOn, an app that acts like a social media platform for surgeons to share skills and advice with each other.
“As a surgeon, it is heartbreaking to witness because it is 100% preventable,” he said. “But people are too embarrassed to talk to their doctor about their bowel movements or the color of their stool.”
If you experience any of these symptoms, Addison recommends speaking with your doctor right away, as colorectal cancer is considered highly treatable when caught early.
In fact, more than 90% of people treated for early-stage colorectal cancer are alive five years after diagnosis, according to the National Cancer Institute.
That number drops to 15% or less once the disease has spread to distant organs beyond the colon or rectum.
Today, “many cases are only caught when the tumor has grown significantly, underscoring the importance of proactive testing,” Shukla said.
In 2025, the American Cancer Society estimates 107,320 new cases of colon cancer and 46,950 new cases of rectal cancer will be diagnosed in the United States. They also expect 52,900 people to die from the diseases.
Colorectal cancer screening guidelines were previously set to begin at age 50, but the recommendations were recently lowered to 45 for average-risk adults due to the rise in cases among younger people.
From 2000 to 2016, colorectal cancer cases among adults aged 40-49 jumped by almost 15%, according to the US Preventive Services Task Force.
Even more alarming, these cancers are being diagnosed at more advanced stages in younger adults, making colorectal cancer the leading cause of cancer death in US men under 50, and the second leading cause in women the same age.
While the exact cause of these trends is still unknown, some experts point to the Western diet, lack of exercise and environmental pollutants as likely factors.
“The clear message should be that for average risk patients, screening should start at 45,” Addison said.
Colorectal cancer screening can be done with a stool-based test, blood test or a visual exam of the colon or rectum, such as a colonoscopy.
People in good health should continue regular screenings through age 75. For those aged 76-85, the decision to be screened depends on personal preferences, life expectancy, overall health and prior screening history.
Screening generally isn’t recommended after age 85, as the risks of a colonoscopy — including perforation, bleeding, and anesthesia complications — often outweigh the potential benefits.
