How to recognize the silent symptoms of colorectal cancer
Colorectal cancer is one of the most common cancers and is, unfortunately, the leading cause of cancer deaths in the U.S. in adults younger than 50 years old. It is more important than ever to raise awareness and take steps to prevent and detect colon cancer early. Understanding the symptoms and regular screenings can make all the difference.
What are the signs of colon cancer?
Colorectal cancer may not show symptoms until the cancer is more advanced. We call these silent symptoms of colorectal cancer. Early screening to detect precancerous polyps or early-stage cancer is essential in stopping colorectal cancer.
"Patients with colorectal cancer often don't have symptoms early on, or sometimes even at all," says Philip Y. Pearson, MD, colorectal surgeon at Bryn Mawr Hospital and Paoli Hospital, both part of Main Line Health. "By the time symptoms do appear, the cancer may have grown or spread to other organs, which can make treating it much more difficult."
The silent symptoms of colorectal cancer symptoms can be subtle and easy to overlook, which is why knowing what to watch for is so important. Pay attention to signs like:
- A change in bowel habits that lasts for more than a few days, including diarrhea, constipation and change in stool caliber (width or thickness)
- Bright red or very dark red blood in your stool
- Constant fatigue
- Ongoing cramping, abdominal pain or bloating
- Unintended weight loss
These symptoms may be caused by colorectal cancer but could also be symptoms of other gastrointestinal (GI) conditions like hemorrhoids, irritable bowel syndrome (IBS) or inflammatory bowel disease (Crohn's disease). Regardless, don't dismiss them. Talk to your doctor immediately if you notice one or more of these symptoms.
"People with symptoms need to be evaluated, but the only way to truly lower your risk of developing colorectal cancer is to undergo regular screening exams," says Dr. Pearson. "Because precancerous polyps and early cancer often don't show symptoms, regular screening exams for early detection and treatment are key."
How can you lower your risk of colon cancer?
"The good news is that colorectal cancer is one of the most preventable cancers," explains Rasiq Zackria, DO, interventional gastroenterologist at Main Line HealthCare Gastroenterology. According to Dr. Zackria, you can take steps to lower your risk by making healthy lifestyle choices, such as:
- Staying physically active
- Eating a healthy, balanced diet that includes plenty of fruits, vegetables and whole grains
- Limiting alcohol consumption
- Avoiding smoking
- Maintaining a healthy weight
While these habits can't guarantee prevention, they can play a significant role in reducing your risk and promoting overall health.
How is colorectal cancer detected?
Fortunately, although colorectal cancer has few unique warning signs, it is a treatable disease if detected early. A colonoscopy is the best way to detect cancer and precancerous polyps.
Polyps are growths within your colon that typically are benign (not harmful). During a colonoscopy, your doctor can review your polyps and remove them before they turn into cancer.
When should I get a colonoscopy?
The age when you should start your first colonoscopy depends on how at-risk you are:
- Most people should begin having regular colonoscopy screenings at 45 years old.
- If you have a family history of colorectal cancer, certain genetic conditions or other risk factors, your screenings should start earlier.
- If you have any symptoms like changes in bowel habits, blood in your stool or ongoing abdominal pain, talk to your doctor about getting screened earlier.
"Colonoscopies are the most effective way to prevent colorectal cancer,"" says Dr. Zackria. "Detecting and removing precancerous polyps during a colonoscopy can stop cancer before it starts."
Additional screening options
In average risk patients, stool-based testing is another option for colorectal cancer screenings. Your doctor can help determine your risk based on your personal health history and family history as well as help identify the most appropriate test for you.
What does the latest research say?
Recent research has good news that overall cancer deaths have decreased, particularly among people under 50 years old. However, a study published in JAMA on January 22, 2026, found that colorectal cancer is now the leading cause of cancer deaths in the U.S. for people under 50 years old. This alarming trend highlights the importance of early detection and lifestyle changes to combat this preventable disease.
Don't wait to prevent this cancer
If you're due for a colon cancer screening, experiencing symptoms or just feel that something in your body isn't right, don't wait to schedule an appointment with your doctor. As Dr. Zackria, reminds us, "colorectal cancer is highly treatable if caught early and taking action now could make all the difference in your health and future."
Make your health a priority. Talk to your doctor today about scheduling your next screening or addressing any symptoms you may be experiencing.
Next steps:
Learn more about Philip Y. Pearson, MD
Learn more about Rasiq Zackria, DO
Learn more about gastroenterology care at Main Line Health
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