Health
Rectal bleeding increases the odds of colorectal cancer diagnosis by 8.5 times
Adults under 50 years of age undergoing colonoscopy were found to be dramatically more likely to develop colorectal cancer when treatment was performed due to rectal bleeding. Researchers found that rectal bleeding increases the odds of colorectal cancer diagnosis by 8.5 times, highlighting the need to take symptoms seriously, even if there is no family history in a population that does not meet the screening age criteria.
The study will be presented at the American Surgeons (ACS) Clinical Conference 2025, held in Chicago from October 4-7.
The retrospective study analyzed 443 patients under the age of 50 who underwent colonoscopy at the University of Louisville Health System between 2021 and 2023.
Many of the early-onset colorectal cancers I see have no family history. This study gives support to the question of who performs or does not justify colonoscopy. Colonoscopy should be seriously considered if there are people under the age of screening with rectal bleeding. ”
Sandra Cavalkas, Maryland, FACS, Senior Author, Colorectal Surgeon, University of Louisville, University of Kentucky School of Medicine
Important findings
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Symptom-driven care: The majority (88%) of patients who were later diagnosed with early onset colorectal cancer had colonoscopy due to symptoms such as bleeding, compared to over half of the non-cancer patients (55%).
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Limited roles in genetics: Only 13% of early-onset colorectal cancer cases had markers associated with genetic syndromes, including genetic changes that occur in some colorectal cancers. The family history of colorectal cancer was a factor, but was only associated with a double increase in odds.
The purpose of this study is to help clinicians decide which young symptomatic patients benefit from undergoing a diagnostic colonoscopy.
“If they're 35 years old and have rectal pain, they probably don't need a colonoscopy,” explained Dr. Kavalkas. “However, if they receive a bleeding complaint, they are 8.5 times more likely to develop colorectal cancer.”
The findings address a significant gap in care for young adults who are not eligible for routine screening but are experiencing the fastest developmental rate of colon cancer. This study provides data to support compensation for diagnostic colonoscopy in young symptomatic patients.
The US Preventive Services Task Force guidelines recommend colonoscopy starting at age 45 for most people with no family history of the disease.
The research team is currently working on a larger analysis with the aim of creating a risk score calculator.
Co-authors are BA Allie Jin. Dr. Jeremy Gaskins; Ramsey Amoudi, BS; Marcus Bennett, BA; Kailyn Deitz, BS; Caroline Hourigan, BS; Natalie Dupre, SCD.
sauce:
Journal Reference:
cunning, S. , et al. (2025) Risk factors and indicators for early-onset colorectal cancer: Retrospective analysis, Science Forum, American University of Surgeons (ACS) Clinical Conference 2025.
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