Blood in the stool is sometimes treated as hemorrhoids. Miao Rulin, deputy chief physician at the Gastrointestinal Tumor Center of Peking University Cancer Hospital, says delays of more than half a year are not uncommon among younger outpatients, and colonoscopy may then show mid- to late-stage colorectal cancer.<\/p>\n
The Hereditary Tumor Professional Committee of the Chinese Anti-Cancer Association recently released the Chinese Expert Consensus on the Diagnosis, Treatment and Full-Course Management of Early-Onset Colorectal Cancer (2026 Edition). It states that colorectal cancer is increasingly affecting younger people, and that some miss the chance to intervene after symptoms are mistaken for hemorrhoids or enteritis.<\/p>\n
Colorectal cancer diagnosed before age 50 is called early-onset colorectal cancer. From 1990 to 2021, the age-standardized incidence among people aged 15\u201349 in China rose by an average of 1.66% a year. Incidence among those aged 15\u201329 has also been rising. Compared with older patients, early-onset disease is described as more aggressive, and many people are already at a mid- or late stage at diagnosis. If disease is found at the same stage through timely screening, the consensus summary says prognosis in younger patients is not worse than in older patients.<\/p>\n
The consensus highlights four groups.<\/p>\n
Hereditary high-risk groups.<\/strong> These include people with Lynch syndrome or familial adenomatous polyposis and their relatives. Pathogenic germline variants carry a high lifetime risk of colorectal cancer, so colonoscopy timing depends on genotype. Carriers of MLH1 or MSH2 variants are advised to start colonoscopy at age 20\u201325, or 2\u20135 years before the earliest case in the family, and to repeat it every 1\u20132 years. Carriers of MSH6 or PMS2 variants may wait until age 30\u201335. Familial adenomatous polyposis is an autosomal dominant disorder caused by pathogenic APC variants; a child of an affected person has a 50% chance of inheriting it. High-risk people\u2014a diagnosed first-degree relative, 10\u201320 adenomas, or extraintestinal manifestations\u2014should begin surveillance at age 10\u201311.<\/p>\n Adults aged 40\u201349.<\/strong> This is a priority group for colonoscopy. Screening from age 40 is advised for people with sporadic high-risk factors; people at average risk may also start earlier after being fully informed. Any one of the following indicates higher risk: a first-degree relative with colorectal cancer, a personal history of colorectal cancer or adenoma, long-term inflammatory bowel disease, or a positive fecal occult blood test. A cumulative score of 4 or more also marks sporadic high risk: age 50\u201359 scores 1 and age 60 or older scores 2; male sex scores 1; smoking history scores 1; body mass index of 23 or higher scores 1 (BMI equals weight in kilograms divided by height in meters squared); and a first-degree relative diagnosed with colorectal cancer before age 60 scores 1 for one relative and 4 for two.<\/p>\n People under 40 with risk factors.<\/strong> Without a hereditary syndrome and without high-risk symptoms, but with obesity, prolonged sitting, an unhealthy diet, or a first-degree relative with a history of malignancy, fecal immunochemical testing or multi-target stool DNA testing may be used for non-invasive initial screening. People without risk factors do not need routine systematic screening.<\/p>\n People with warning signs.<\/strong> Lack of high-risk factors does not mean absolute safety. Typical warning signs are repeated progressive rectal bleeding, unexplained iron-deficiency anemia, a change in bowel habits lasting more than four weeks, and abdominal pain that is worsening or occurs at night. Research cited in the report indicates that repeated rectal bleeding or unexplained iron-deficiency anemia can raise the risk of early-onset colorectal cancer more than tenfold, especially in men and in people aged 40\u201349. If these symptoms recur or worsen, or occur with weight loss or a family history, colonoscopy should be sought. Being young is not a reason to skip checks for organic disease.<\/p>\n Colorectal cancer reflects both heredity and environment. Family history cannot be changed; lifestyle can. The reported advice is to eat more vegetables, fruit and whole grains and less red and processed meat; do at least 150 minutes of moderate-intensity activity a week; control weight and avoid prolonged sitting; not smoke; limit alcohol; and keep regular routines. These habits can lower risk but do not replace screening. The consensus presents risk-stratified regular screening as the way to interrupt disease early.<\/p>\n Original article: https:\/\/www.lifetimes.cn\/article\/4TypCswqxsC<\/p>\n","protected":false},"excerpt":{"rendered":" Blood in the stool is sometimes treated as hemorrhoids. 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