When diagnosed with colon cancer, younger patients are often at a more advanced stage of disease. You may have already read that the American Cancer Society recommends we all get our first colon cancer screening at 45, five years earlier than the long-time recommendation. This is in part because with the success of screening tests catching patients in the very early stages of disease. The flip side is that a higher percentage of patients now are younger folks with more advanced disease. Well, it turns out that the incidence of colon cancer misdiagnosis in patients under 45 is alarmingly high.
Colon cancer screening guidelines almost create a catch-22 for symptomatic adults under 45. The purpose of cancer screening is to identify cancer while it is pre-cancerous or even early stage and very treatable. The procedure is “screening” because the patients often have no symptoms. It’s a purely preventative measure. This is because with diseases like colon cancer, symptoms often do not start presenting until it is a later stage, and therefore far more difficult to treat.
So, a patient will present with symptoms, but colon cancer will be low on the physician’s differential largely because of the patient’s age. Researchers have found that this is the case even in patients with a family history of colon cancer. The symptoms for colon cancer may include constipation, bleeding, blood in stool, abdominal pain or bloating, or fatigue. And when physicians do not ask their patient about the full extent of their symptoms, especially blood in stool or rectal bleeding, the diagnosis will be missed.
The results of missed diagnoses are striking. Researchers with the American Association for Cancer Research found that nearly three quarters of patients younger than 50 were stage III or IV when the cancer was discovered, and more than 2/3 if the subjects had been to at least two physicians before being diagnosed.
Given that colon cancer is known to be quite treatable when caught at an early stage, these statistics reflects devastating diagnoses.
