Early Detection Matters: Understanding Colorectal Cancer

March is Colorectal Cancer (CRC) Awareness Month, an opportunity to shine a light on the risks associated with this increasingly common disease. Kristin Schmidt, Certified Physician Associate at Amoskeag Health, shares more insight into what we can do to prevent, catch and treat colorectal cancer.

1. Research on colorectal cancer is constantly evolving. What recent findings are most relevant for the general public?

   The most striking finding in 2026 is the "two-speed" trend in the United States. While rates continue to decline among adults 65+, they are rising in people under 65, particularly those in their 40s. Recent data shows that 75% of colorectal cancers in adults under 50 are being diagnosed at an advanced stage. However, the 5-year survival rate for local-stage disease is 95%, highlighting that "late discovery" is the primary hurdle, not the disease's treatability.
   

2. What are the common symptoms of colorectal cancer?

   Many people with CRC have no symptoms in the early stages. When they do appear, they often include:

   • Changes in bowel habits: diarrhea, constipation, or narrowing of the stool that lasts more than a few days

   • Rectal bleeding: bright red blood or very dark/tarry stools

   • Abdominal discomfort: persistent cramping, gas, or pain

   • Incomplete emptying: lack of relief and continued urge to have a bowel movement after using the bathroom

   • Unexplained weight loss and fatigue: feeling weak or losing weight without trying
     

3. What steps can people take to reduce their risk of colorectal cancer?

   
   

   The most effective "prevention" step is for getting screened CRC because it allows doctors to find and remove polyps before they ever become cancerous.

   Beyond screenings, over 50% of colorectal cancers are linked to modifiable lifestyle choices:

   • Diet: limit red meats (beef, pork, lamb) and processed meats (hot dogs, lunch meats). Focus on fiber-rich fruits, vegetables, and whole grains.

   • Weight and activity: maintain a healthy weight and aim for at least 150 minutes of moderate activity per week.

   • Limit alcohol and tobacco: avoiding smoking and limiting alcohol intake significantly lowers risk.
     

4. Who is most at risk for developing colorectal cancer?

   CRC can affect anyone but those in the following categories are at higher risk: people age 45 and older; Black Americans; and people with a personal or family history of certain genetic or colorectal conditions. Black Americans have the highest incidence and mortality rates of colorectal cancer of any racial group in the United States and should receive routine preventative screenings. Hereditary conditions like Lynch Syndrome or Familial Adenomatous Polyposis (FAP), as well as a family history of polyps, CRC or inflammatory bowel diseases (like Ulcerative Colitis or Crohn’s) indicate a need to get screened earlier.
   

5. Data shows colorectal cancer rates are rising among people ages 45–49. What might be driving this trend?

   Because the recommended screening age was lowered to 45 in 2021, more people in this group are finally getting tested, leading to increased detection and a "catch-up" in diagnosed cases. Additionally, research suggests that changes in the gut microbiome (due to ultra-processed foods, antibiotic use early in life, and sedentary lifestyles) are causing a genuine biological increase in rectal and distal colon cancers in younger generations.
   

6. What colorectal cancer screening options does Amoskeag Health offer? Are there additional services—either through Amoskeag Health or other resources—that you recommend for prevention or treatment?

   
   

   Right now there are two methods that we generally recommend to patients who are due for screening. The screening method used depends on a person’s risk factors.
   

   • Stool-Based Tests (Non-Invasive): These tests look for signs of cancer in your stool. They are more convenient as they can be done at home, but they are required more frequently.
     

     • FIT (fecal immunochemical test): looks for blood in the stool that could be an earlier indicator of cancer; repeated annually if negative
       

     • Cologuard test: looks for blood in the stool and for DNA mutations that could suggest cancer; repeated every three years if negative
       

   • Colonoscopy: This procedure is performed by a gastroenterologist at a local facility. After doing a colon cleaning preparation at home and fasting, a camera is used to examine the entire colon using a flexible tube while you are sedated, looking for any findings that could suggest risk for colon cancer. If negative, this test is repeated every ten years.
     

   There are newer screening methods involving blood samples that require more research. As we learn more about these options, we may expand our screening recommendations to include additional screening methods.
   

7. What is the most important message you want people to remember about colorectal cancer?
   

   The benefits that result from being screened early greatly outweigh the discomfort of the screening tests. While a colonoscopy is not necessarily the most pleasant experience, early detection of CRC leads to a higher probability of successful treatment outcomes.

   Last year, one of my patients elected to take one of the non-invasive stool-based screenings, which came back positive for signs of cancer. We then referred her for a colonoscopy, which detected stage 1 colon cancer. She received surgery to remove the cancer, and one year later she is doing great and living a cancer free life.

   Colorectal cancer is preventable and treatable, but without early detection through routine screenings, options for treatment become more limited.

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If you would like to discuss your options for colorectal screening, or to schedule an appointment with an Amoskeag Health provider, please call 603-626-9500.