Amid an uptick in early onset colorectal cancer (CRC), the Texas Medical Association has developed one-page educational resources for physicians and patients.
According to the American Cancer Society, CRC cases in people under 50 have increased by 2% each year since 2011. The rise in prevalence in younger adults has happened alongside the cancer’s increased mortality in the same patient population. Deaths in people under 50 in the U.S. caused by CRC have increased by 1% annually since 2005, and CRC is projected to be the leading cause of cancer deaths in people age 20 to 49 by 2030.
TMA’s “Early Onset Colorectal Cancer for Physicians” education resource lists lifestyle risk factors and CRC screening guidelines. Additionally, it includes a table that details the benefits, limitations, testing intervals, and performance and complexity levels of the various recommended CRC screening tests.
Terri Woodard, MD, who co-chairs TMA’s Committee on Cancer, which developed the CRC education resources, says it’s important for physicians to take seriously complaints of gastrointestinal symptoms from otherwise young and healthy patients.
“A lot of times … it’s easy to kind of brush those complaints off and think oh, they’re just constipated, or oh, it’s anxiety,” said the Houston oncofertility specialist and reproductive endocrinologist. But with the rise of CRC in younger adults, she says, any relevant symptoms reported by patients, regardless of age, need to be investigated further. Awareness and early detection “really change [patients’] treatment trajectory and possibly their prognosis.”
Common signs and symptoms of CRC detailed in the physician education resource include:
- Blood in the stool (bright red, black, or very dark);
- Changes in bowel habits (e.g., diarrhea, constipation);
- Changes in stool shape (e.g., narrower than usual);
- The feeling that the bowel is not completely empty;
- Abdominal cramps or pain; and
Patient reluctance to discuss gastrointestinal symptoms can hinder timely diagnosis and treatment of CRC, making open rapport with patients key, Dr. Woodard says. The patient education resource, which will also be available in Spanish, also has a table outlining screening methods and intervals, and can be shared online or via hard copies in practice waiting rooms or tucked into new patient folders.
When broaching the topic one on one, acknowledging awkwardness around the topic can help break the ice, she says.
“Prefacing things by [saying] hey, listen, I know this is something that’s uncomfortable [to talk about] … And then sometimes [patients] will kind of be like, OK, well, [the doctor] brought it up, so I can talk about it.”
There are multiple time points to elicit information from patients, Dr. Woodard says.
“Before patients even come in the office, there’s an opportunity to have them fill out paperwork, a review of symptoms. So if you see that [patients] mark constipation, diarrhea, blood in stool, make sure you read those pre-evaluations and follow up with the appropriate questioning.”
Find both CRC one-page resources on TMA’s cancer control and prevention webpage.
Jessica Ridge
Reporter, Division of Communications and Marketing
(512) 370-1395