A new international analysis of nearly 25 million patients younger than 50 across 81 studies has provided crucial insights into the most common presenting signs and symptoms of early-onset bowel cancer. Published in JAMA Network Open, the study found that blood in the stool (hematochezia), abdominal pain, altered bowel habits, and unexplained weight loss were the most prevalent indicators of early-onset bowel cancer.
The study revealed that nearly half of the individuals (45%) presented with blood in the stool, 40% with abdominal pain, and more than one-quarter (27%) with altered bowel habits, which included constipation, diarrhea, or alternating bowel habits. Significantly, blood in the stool and abdominal pain were associated with a 5 to 54-fold and 1.3 to 6-fold increased likelihood of early-onset bowel cancer, respectively.
The research also indicated that the risk of diagnosis with bowel cancer before age 40 has more than doubled since 2000 in Australia, reinforcing the critical importance of recognizing symptoms and seeking timely medical intervention. A/Prof Graham Newstead AM, the Medical Director of Bowel Cancer Australia, emphasized the necessity for heightened awareness of red flag signs and symptoms and prompt access to diagnostic procedures such as colonoscopy to rule out early-onset bowel cancer.
In addition, the analysis highlighted the alarming prevalence of diagnosis delays, with the average time from symptom onset to bowel cancer diagnosis ranging from 1.8 to 13.7 months. Notably, delays in diagnosis were up to 40% longer for younger individuals compared to older individuals, potentially contributing to a greater proportion of late-stage diagnoses and increasing mortality rates.
The findings from this study underscore the crucial role of healthcare professionals, particularly general practitioners, in recognizing and addressing potential red flag signs and symptoms in younger individuals. The authors recommended the implementation of a 30-to-60-day follow-up visit for young patients to confirm the accuracy of the initial diagnosis or to refer for further diagnostic evaluations such as colonoscopy.
Furthermore, the study’s results align with previous Australian research, emphasizing the substantial delays in diagnosis for younger individuals. This highlights the need for improved awareness, timely intervention, and collaborative efforts between healthcare providers and younger patients to expedite the diagnostic process and potentially improve outcomes for individuals with early-onset bowel cancer.
