Stay ahead of colorectal cancer risk

Colorectal cancer is one of the most preventable and treatable cancers—if caught early. Yet, more than 150,000 Americans are diagnosed each year, making it the second leading cause of cancer-related deaths in the United States. The good news? Regular screening can cut the risk of dying from colorectal cancer by half and reduce incidence by nearly a third.

Know the warning signs

Early symptoms may be easily attributable to conditions like inflammatory bowel disease (IBD) or minor digestive issues, such as irritable bowel syndrome (IBS), but these could be signs of something more serious, said Jason R. McKnight, MD, MS, FAAFP, clinical associate professor at the Texas A&M University Naresh K. Vashisht College of Medicine.

Possible warning signs:

• Unanticipated weight loss.
• Sudden and persistent changes in bowel movements, such as consistency or frequency.
• Ribbon-like, narrow bowel movements.
• Bowel movements with bright red blood.
• Darker-than-normal stools.
• Feeling the urge to have a bowel movement while not being able to defecate or not feeling relieved upon defecation.

While not an all-inclusive list, McKnight said watching for those possible warning signs makes a good starting point. Having the conversation with your doctor is the most important step to determine if any diagnostic testing is necessary. The screening process is safe and relatively easy, McKnight said, so he advises patients, it’s better to be safe than sorry, and when in doubt, ask a doctor. `

Catch it early

Due to better screening and changing lifestyle-related risk factors, colorectal cancer rates have seen overall declines, dropping by about 1% annually from 2013 to 2022. But for adults under 50, rates of colon cancer increased 2.9% in the same time span. In older adults, the mortality rate of colorectal cancer has been dropping about 1.5% per year over the past decade. In adults under 55, however, mortality rates have been increasing 1% per year since the mid-2000s.

In response to this growing concern, the U.S. Preventive Services Task Force (USPSTF) recently lowered the recommended age for general screening from 50 to 45. This change aims to catch colorectal cancer earlier in younger adults in order to improve survival rates.

The lifetime risk for developing colorectal cancer is about one in 24 for men and one in 26 for women, but screening reduces mortality rates by about 50%.

However, McKnight said certain pre-existing conditions such as Crohn’s Disease, Ulcerative colitis or Lynch syndrome, or family history of colorectal or other cancers may require earlier-than-normal testing since these conditions increase risk of colorectal cancer. Speaking to a doctor is critical, he said, to determine individual risk level.

Although colonoscopy may immediately come to mind as the standard screening technique for colorectal cancer, many other options exist for age-appropriate average risk screening. Some less invasive screening alternatives include the fecal immunochemical test (FIT), combination hemoglobin immunoassay and stool DNA tests like Cologuard®, and CT colonography. According to McKnight, utilizing any of these options could be lifesaving.

“The best screening test for the patient is the one that actually gets done,” he said.

However, if you are symptomatic, he said it’s important to speak with your doctor about a colonoscopy since it is the only diagnostic test.

Lower your risk with healthy habits

Lifestyle also plays a role in overall health, including cancer prevention. Non-modifiable risks like genetics notwithstanding, McKnight said certain lifestyle changes may greatly reduce the risk of developing colorectal cancer.

McKnight recommends eliminating smoking and stopping or reducing alcohol consumption as part of a lifestyle shift to minimize risk for colorectal cancer. Many cancers have been linked to smoking and tobacco use, and recent studies demonstrate an increased correlation of cancer with excessive alcohol consumption.

He also recommends maintaining a balanced diet—high in fiber, fruits and vegetables, and low in processed and refined foods, such as breads, candy, sodas and sugary cereals. He also suggests getting plenty of sleep and exercise to bolster overall health.

Start the conversation

To assess any concerning symptoms, speak to a health care professional about a screening. The Texas C-STEP program—conducted through the Texas A&M Health Family Care clinic with funding from the Cancer Prevention and Research Institute of Texas (CPRIT)—provides free and reduced cost access to cancer screenings, including free colorectal screenings, to uninsured, underserved and low-income Texans.

For more information visit the Texas C-STEP website or call 979-436-0499.

“It’s thought that about 90% of colorectal cancer is preventable with appropriate screening,” McKnight said. “You never know what’s going on until you get screened, and it has some risks, but it’s a relatively quick, safe procedure that that can absolutely be lifesaving.”

CPRIT is funded through a grant (Grant ID #PP220013).

Updated March 2026