Risks found in data from young and middle-age adults with colorectal cancer diagnosis, showing importance of targeted screening
RENTON, Wash., Dec. 12, 2025 — Providence has released an extensive study on early onset colorectal cancer, developing a comprehensive risk model to determine younger patients at risk for colorectal cancer.
The model can help identify symptomatic and asymptomatic patients under age 45 who may benefit from earlier screening, even if they lack traditional high-risk backgrounds, including family history and genetic syndromes.
The study, published recently in Cancer Prevention Research, a journal of the American Association for Cancer Research, reviewed deidentified data from Providence patients of all demographics, ages 20 to 49, with a colorectal cancer diagnosis over a six-year period, with and without genetic risk factors, against patients who are similar in age and sex and did not have a colorectal cancer diagnosis. It showed that patients with colorectal cancer were more likely to have had a history of alcohol consumption and comorbidities like diabetes, kidney disease, liver disease, and cardiovascular disease, when compared to their peers.
In addition, the study showed:
· Use of non-steroid anti-inflammatory medications, metformin and multivitamins were seen more often among patients with a colorectal cancer diagnosis.
· People with a history of diarrhea, constipation, iron deficiency and weight loss had more instances of colorectal cancer.
· People with insurance — whether through employment, Medicare, Medicaid or self-pay — had fewer diagnoses of colorectal cancer.
“Our study featured one of the largest samples of early onset colorectal cancer cases that’s ever been reviewed,” said Staci Wendt, Ph.D., research director at Providence’s Health Research Accelerator. “As opposed to previous studies that compared just demographics or just clinical characteristics, we studied all of these factors in one combined model, allowing us to explore these factors in relation to each other.”
Providence’s Health Research Accelerator partnered with the Providence Saint John’s Cancer Institute in Santa Monica, Calif. on the study, which was funded in part by the Hearst Foundation and Stand Up To Cancer.
Anton Bilchik, M.D., executive director at Saint John’s Cancer Institute and Providence Saint John’s Digestive Health Institute, said this study shows the need for providers to consider colorectal cancer among this age group, which is not part of the recommended screening guidelines.
The findings underscore that symptoms like abdominal pain, rectal bleeding, iron deficiency anemia, and even constipation should never be dismissed in patients under 50. These are common complaints, but when they occur together, they can signal a serious risk. Providers are encouraged to act quickly — combining symptom recognition with medical and sociodemographic factors — to avoid dangerous delays in diagnosis.
“Recommended screening for colorectal cancer starts at age 45, so we’re not catching people in the early onset age range through screening, but rather when they present with symptoms,” said Dr. Bilchik. “Colorectal cancer is preventable and treatable when it’s caught early with screening, but for most patients, the cancer has progressed and likely metastasized by the time they present with symptoms.”
While colonoscopies are considered the gold standard for screening, other at-home screening options are available that providers might suggest to their younger patients with symptoms, said Dr. Bilchik.
