Colorectal cancer is on the rise in young adults. Today, 1 in 5 diagnoses occurs in someone under the age of 55 — and it has become a leading cause of cancer-related death in young people. In this interview, Dr. Kruzel addresses common questions about colorectal cancer, why early detection is key, and suggests lifestyle changes you can make that may help lower your risk.
Q: What is Colorectal Cancer (CRC)?
A: Colorectal cancer is a type of cancer that starts in the colon or rectum. It usually begins as a small, non-cancerous growth called a polyp. Over time, these polyps can turn into cancerous tumors.
Colorectal cancer is the third most commonly diagnosed cancer in the US, with an estimated 150,000+ men and women diagnosed in 2025. Because it often starts quietly, regular screening is the most powerful tool we have to catch these polyps before they become a problem.
Q: Why is colorectal cancer considered one of the most preventable forms of cancer (with timely screening)?
A: It all comes down to timing. Because colorectal cancer usually grows very slowly, we have a window of opportunity to find and remove polyps before they ever turn into cancer. The USPSTF recommends screening all adults ages 45-75 for colorectal cancer. When you follow standard screening guidelines, this disease is not just highly treatable, but it is often entirely preventable or curable.
Q: What are the different screening options available for colorectal cancer, from at-home tests to colonoscopies, and what are the pros and cons of each? How can a test help in diagnosing colorectal cancer?
A: There are several options for patients to get screened.
Colonoscopy is the gold standard; it is the most thorough method because it allows a doctor to find, biopsy, and/or remove polyps during the same procedure.
Stool-based tests are great options for people who want a non-invasive start. Quest offers a Colorectal Screening (FIT) Test Home Collection Kit at questhealth.com; this test is a convenient and private way to check for hidden blood in the stool, which can be an early sign of polyps or cancer. Another perk about the FIT (Fecal Immunochemical Test) is no special “prep” (like special drinks or fasting) is required, and the collection is simple—you simply collect a sample of water in the toilet after a bowel movement.
Blood-based tests are newer to the market and offer another emerging way to look for cancer markers.
As always, you should speak to a healthcare professional to determine which testing option is best for you. Because colorectal cancer does have a known hereditary component, understanding your family history can influence how frequently and when you should start screening for CRC.
Q: Colorectal cancer is rising at an alarming rate in US adults under the age of 50 – by nearly 3% per year – even as incidence has declined slightly in the overall population. Why do you think CRC is affecting young people more?
A: It is a complex puzzle. While we don’t have one single answer, we do know that CRC is a multifactorial disease, meaning that there are many factors that can impact who develops CRC and when. Genetics, diet, and lifestyle all play significant roles. And, the rise of processed foods and the obesity crisis are likely other major factors.
The bottom line? Don’t assume you’re too young for CRC. If you notice a change in your bowel habits, talk to your doctor, regardless of your age. And, make it a priority to get screened if you fall within the recommended age range or if you know you are at higher risk of developing CRC.
Q: Aside from age, what are other risk factors that increase a person's chances of developing colorectal cancer?
A: Beyond getting older, your risk for CRC increases based on:
1. Family history: Genetics play a big role.
2. Hereditary syndromes: Certain genetic conditions (eg. Lynch syndrome, Cowden syndrome, and Peutz-Jeghers syndrome)
3. IBD: Inflammatory Bowel Disease (like Crohn’s or Ulcerative Colitis)
4. Lifestyle & Diet: Habits like smoking or a diet low in fiber
Q: When colon cancer is found in early stages, the 5-year survival rate is about 90%. While some people with early-stage colon cancer can have little to no symptoms, what are potential warning signs that shouldn't be ignored?
A: Early-stage cancer often has no symptoms, which is why screening is so important. However, you should see a doctor if you notice:
- Bright red blood in your stool
- Changes in your bowel habits (frequency, shape, or consistency) lasting more than a week
- Unintentional weight loss
- Unexplained fatigue or anemia
- Persistent abdominal pain
Q: Beyond regular screenings, what are the most impactful lifestyle choices someone can make to reduce their risk of developing colorectal cancer?
A: The “basics” of health can go a long way with regard to colorectal cancer. To lower your risk:
- Manage your weight and stay active
- Eat plenty of fiber (commonly found in fruits and vegetables)
- Limit alcohol and avoid highly processed foods
- Stick to the schedule. If you are age 45 or older, get screened. Whether it’s a yearly home collection screening (like the FIT kit) or a colonoscopy (as directed by your doctor), screening is the key to prevention.
CRC is uniquely preventable because the precursor states (polyps) are identifiable and removable. The optimal strategy involves being consistent with screening, diet, and lifestyle. You know your body better than anyone else, and if something feels “off,” don’t just wait for it to go away. Being your own advocate and seeking a professional opinion will be your best defense.
No doctor visit is required to buy your own lab test at questhealth.com. PWNHealth and its affiliates review your purchase to ensure it is medically appropriate before submitting the test order for processing. PWNHealth also reviews your test results and will contact you directly if they require prompt attention. Included in each purchase is the ability to discuss your test results with an independent healthcare provider; however, you are also encouraged to speak with your primary healthcare provider.