March was colon cancer awareness month. But the reality is that this often silent killer can strike any time and doctors are discovering it affects more and more younger adults. To learn more about colorectal cancer and how to spot it early – and have a good chance to stop its progression – we spoke with Tufts Medical Center’s Chief of Colon and Rectal Surgery, Dr. Lilian Chen, MD.

Sampan: What are some typical early warning signs that a person could be at risk for colorectal cancer?
Dr. Chen: Many early warning signs include changes in bowel habits such as persistent constipation or diarrhea and the presence of blood in the stool. Other symptoms can include unexplained weight loss, fatigue, and persistent abdominal discomfort or cramps. However, early-stage colorectal cancer is often asymptomatic, which is why regular screening is so important.

Sampan: Are there any significant demographic risk factors for the disease?
Dr. Chen: Age is the most important risk factor, with colorectal cancer being more common in people aged 45 and older. A family history of colorectal cancer or polyps can also increase your risk. Lifestyle factors, such as a diet low in fiber and high in red or processed meats, as well as smoking and obesity, can further contribute to risk.

Sampan: New tests have emerged that don’t require a colonoscopy; how good are they at detecting risk for the cancer?
Dr. Chen: Yes, non-invasive tests like fecal immunochemical tests (FIT) and multitarget stool DNA tests (sDNA-FIT) have become popular options for screening. These are stool-based tests that are effective at detecting hidden blood or DNA markers associated with polyps and early cancers. However, a positive result from these tests still needs confirmation with a follow-up colonoscopy for a diagnosis, and many of these tests need to be done once a year.

Sampan: What is the typical prognosis when catching tumors or suspicious polyps early?
Dr. Chen: When tumors or polyps are detected early, the prognosis is generally very favorable. Precancerous polyps can be removed during a colonoscopy, and early-stage colorectal cancer is highly treatable with excellent outcomes. Early detection and prompt treatment significantly improve survival rates, underscoring the importance of regular screening.

Sampan: What should someone do if they experience any symptoms or have concerns?
Dr. Chen: If you notice any changes in your bowel habits, blood in your stool, unexplained weight loss, or persistent abdominal pain, it’s important to contact your healthcare provider promptly. Even if you don’t have symptoms, regular screening is key because early-stage colorectal cancer often does not cause noticeable symptoms. Our clinic is here to help—please don’t hesitate to reach out for a consultation or to schedule a screening.
Sampan: At what age do you recommend people first start getting screened for the disease?
Dr. Chen: We recommend that average-risk adults begin screening at age 45. Early screening is essential because it can detect precancerous polyps or early-stage cancer when treatment is most effective.

For our local Chinatown community, our gastroenterology clinic offers bilingual services to ensure clear communication and comfort. To schedule a visit, please call our clinic at (617) 636-5883 or visit our website at https://tinyurl.com/2wp8zk44 for more information. Our staff can contact a translator, if needed, once you call.
If you have experienced bleeding in your stool or other symptoms, you can also make an appointment to see me in the Colorectal Surgery Clinic at 617-636-6190; I speak Cantonese and Mandarin.