I’m A Colorectal Cancer Doctor. Here Are 5 Things I’d Never Do.

Colorectal cancer is the third-most common type of cancer around the world. In the earlier stages, it can be tough to catch. The symptoms, like diarrhea, abdominal pain and anemia, can easily be overlooked or mistaken for another, more benign issue.

There’s also been a spike in colorectal cancer diagnoses among younger people. The reason for this, though unclear, is likely multifactorial, with genes, environmental exposures and lifestyle all contributing. What we do know is that when colon cancer is caught early, it can be effectively treated.

Fortunately, there’s a lot you can do to keep your bowel health in check. We asked Dr. Ursina Teitelbaum, a medical oncologist and section chief for gastrointestinal cancers at Penn Medicine’s Abramson Cancer Center, about the most common mistakes worth avoiding for the sake of your bowels. Here’s what Teitelbaum said she personally avoids, and what you should, too:

Family history is one of the strongest risk factors for colorectal cancer. Up to 1 in 3 people who get diagnosed with colorectal cancer have family members who also had it. There are a few reasons why cancer runs in families: genetics, shared environmental factors, and some combination of the two, according to the American Cancer Society.

Because the health of your relatives directly influences your individual risk of colon cancer, it’s crucial to know your family history. Teitelbaum recommended asking your parents, siblings or other relatives if any family members, including grandparents, cousins, or aunts and uncles, were ever diagnosed with colorectal cancer.

If you find out a first-degree relative had colon cancer, for example, you’ll be advised to start screening earlier. “Your colon health depends on your genes,” Teitelbaum said.

Cases of colorectal cancer have been rapidly increasing among young adults. Though the disease, which affects fewer than 1% of adults, is still rare, the spike in incidence has made early screening and diagnosis all the more important.

Because of this alarming trend, the U.S. Preventive Services Task Force issued new colon cancer screening guidance in 2021 to try to catch more cases. Now, all adults are advised to starting screening by a colonoscopy or stool-based test starting at age 45.

Regular colonoscopies are especially important for people with inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease, since these conditions can increase your risk of colorectal cancer. But even otherwise healthy people who have no family history can get colorectal cancer.

“No matter how healthy your lifestyle is, when you hit a certain age, you need to get screened,” Teitelbaum said. Getting screened is the best way to catch colon cancer early and treat it.

Doctors across the country have noticed that many younger adults don’t think their abnormal symptoms could be cancer, Teitelbaum said. And because they’re so young, health care providers may not immediately suspect issues either. This can lead to delayed diagnoses and poorer outcomes, research shows. The takeaway? You have to pay attention to your body, Teitelbaum stressed.

Look out for any changes in bowel habits ― if you have always pooped on schedule but now frequently feel constipated, or notice blood in your stool and have abdominal pain, it’s worth talking to a doctor. Diarrhea, fatigue or unexplained anemia also warrants a medical checkup.

It’s important to advocate for yourself. If you feel like your doctor isn’t taking your symptoms serious, go get a second opinion. “If you’re really worried, you need to persist,” Teitelbaum said.

Though the causes of colon cancer are poorly understood, over half of colorectal cancers are linked to modifiable lifestyle factors. Smoking tobacco, drinking alcohol and having a sedentary lifestyle are thought to go hand in hand with a heightened risk of colon cancer, according to the Centers for Disease Control and Prevention.

Your diet also plays a big role. Red meats and overly processed foods, such as soda, candy and cookies, have been linked to a higher risk of colon cancer, whereas vegetables, fruits and whole grains have been associated with a lower risk.

“There’s no perfect predictor for colon cancer, but globally, a healthy lifestyle may help” in avoiding it, Teitelbaum said.

Finally, Teitelbaum recommended getting comfortable with talking about poop. The more we open up about the topic, the better we can break down the stigma around discussing it.

Sometimes, an irregular bowel movement — like stools that are pencil-thin or bloody — is the only clue that something’s amiss. It can be hard to know if your experience is abnormal without telling others what you’re going through.

It can feel embarrassing to talk about poop, but we have to do it, according to Teitelbaum. “Poop is such a status of your health, and talking about it could save your life,” she said.