When Bexar County Precinct 1 Commissioner Rebeca Clay-Flores received a colon cancer diagnosis in late 2024, it came as a shock.
The disease did not run in her family, and, like many people, she did not consider herself at high risk. After treatment and recovery, Clay-Flores shared her story in hopes of helping others recognize the warning signs and understand the importance of early screening.
“Colon cancer is on the rise in younger people,” Clay-Flores said. “It’s the second leading cause of deaths amongst cancers and is now the leading cause of cancer deaths in people under 50.”
At the same time, she emphasized that colorectal cancer is also one of the most preventable forms of cancer when caught early.
“Getting a preventative colonoscopy at 45 can save your life,” she said.
Her message comes as physicians across the country report a steady rise in colorectal cancer diagnoses among younger adults -- a trend that has prompted updated screening guidelines and increased public awareness campaigns.
Rising risk among younger adults
Colorectal cancer was once considered primarily a disease that affected older adults. But in recent years, doctors have seen more cases appearing in people under 50, including individuals with no family history of the disease.
The increase has been significant enough that in 2021, the recommended age to begin routine colorectal cancer screening was lowered from 50 to 45.
The exact reasons behind the rise are still being studied, but physicians point to a combination of lifestyle and environmental factors.
“We’re eating a lot more processed food and red meat,” said Dr. Sandeep Patel, chief of gastroenterology at University Health. “Also, our sleep hygiene has changed.”
Dr. Patel said other contributors may include rising obesity rates, higher stress levels and increased alcohol use -- factors that have also grown more common in recent decades.
Symptoms can be easy to overlook
One of the challenges with colon cancer is that symptoms can be subtle or mistaken for less serious conditions.
Colon cancer often develops without noticeable symptoms in its earliest stages, which makes routine screening especially important.
When symptoms do appear, they may include:
- Blood in the stool.
- Changes in bowel habits that last more than a few days.
- Persistent diarrhea or constipation.
- Persistent weakness or fatigue.
- Abdominal cramping or pain.
- Stools that appear thinner than usual.
- Unexplained weight loss.
Because these symptoms can be vague, many people delay evaluation or attribute them to other digestive issues.
“If a person is 45 or older and has not been screened or has symptoms or a family history of colon cancer, they should contact their primary care provider to begin this important and potentially lifesaving screening,” Patel said.
Screening can stop cancer before it starts
Doctors say screening is one of the most powerful tools in preventing colon cancer deaths.
Unlike many other cancers, colorectal cancer often develops slowly from precancerous polyps -- abnormal growths in the colon that can be removed before they become cancerous.
At University Health, gastroenterologists use advanced screening and endoscopic techniques to identify and remove these polyps early, which reduce a patient’s long-term cancer risk.
There are several screening options available today. Colonoscopy remains the most comprehensive test because it allows physicians to both detect cancer and remove precancerous polyps during the same procedure.
“It’s safe, it’s easy and there’s nothing to be nervous about,” Patel said.
Less invasive options may also be available, including stool-based tests like fecal immunochemical tests (FIT) or stool DNA tests. These screenings can detect abnormalities that signal the need for a follow-up colonoscopy.
Understanding the risk factors
While colon cancer can occur in anyone, certain factors can increase a person’s risk.
These include:
- Being 45 or older.
- Having a personal or family history of colon cancer or polyps.
- Inflammatory bowel diseases like Crohn’s disease or ulcerative colitis.
- Lifestyle factors like obesity, smoking, heavy alcohol use, physical inactivity and diets high in red or processed meats.
Doctors say lifestyle changes can play an important role in lowering risk.
Eating a diet rich in fruits, vegetables and whole grains, maintaining a healthy weight, staying physically active and limiting alcohol and tobacco use are all steps that may help reduce the likelihood of developing the disease.
Early detection saves lives
For Clay-Flores, sharing her story is about helping others take action sooner rather than later.
Throughout March, University Health and Clay-Flores’ office will host events, health clinics and other activities to highlight risk factors, symptoms and screening options.
Colon cancer might be rising among younger adults, but experts say the disease remains highly treatable when detected early.
Routine screening can identify cancer in its earliest stages or prevent it entirely by removing precancerous polyps.
For many physicians and patients alike, the message is simple: Pay attention to symptoms and get screened at the recommended age -- it can make a life-saving difference.
To learn more, visit University Health’s website here.