Colorectal cancer often hides behind symptoms people dismiss as temporary digestive issues, but experts warn that persistent bowel changes and any blood in the stool deserve immediate medical attention. A Texas woman's recent diagnosis after months of brushing off warning signs highlights a troubling pattern: patients, especially younger ones, frequently miss the early signs of a disease that has become the leading cancer-related cause of death for people under 50.

How Did a Woman with Cancer Knowledge Miss Her Own Symptoms?

Candace Tucker, 41, worked at an oncology practice in Texas and had watched family members battle cancer, including her grandfather's prostate cancer, her grandmother's breast cancer, and her aunt's pancreatic cancer. Despite this exposure to cancer care, when she noticed strange bowel movements and small amounts of blood in her stool in September 2025, she attributed the changes to her recent dietary shift toward more fiber. She was busy with work and raising her 7-year-old grandson, so she didn't prioritize the symptoms.

After a few months of mild discomfort and occasional bleeding, Tucker finally underwent a colonoscopy. The procedure revealed what she feared: Stage II rectal cancer. "I was terrified. I couldn't believe it," Tucker said. "Your mind goes to the worst possible scenario. I was crying." She quickly began aggressive chemotherapy and is now working with her oncology team to determine whether she'll need surgery and radiation.

What Warning Signs Are People Actually Missing?

Dr. Bradley Scott Colton, Tucker's gastrointestinal oncologist, emphasized that he sees patients miss colorectal cancer symptoms "far too often." The key is understanding which symptoms warrant concern and which are temporary.

"If you have bad food and you get some food poisoning and you get diarrhea or some weird bowels for a week, that's OK. You don't have to worry about that. If those symptoms aren't temporary, after a week or a couple weeks, see a GI doctor," said Dr. Bradley Scott Colton.

Dr. Bradley Scott Colton, Gastrointestinal Oncologist at Texas Oncology

Warning signs that should prompt a medical visit include:

• Rectal bleeding: Any blood in the stool is abnormal and should be evaluated, even if it's just a small amount.
• Persistent bowel changes: Lasting alterations in bowel habits that continue beyond a week or two, including diarrhea, constipation, or changes in stool consistency.
• Lower abdominal pain: Unexplained discomfort in the lower belly region that doesn't resolve quickly.
• Unexplained weight loss: Losing weight without intentional dieting or lifestyle changes.
• Changes in stool color: Noticeable shifts in the appearance of stool that persist over time.

"Rectal bleeding is not normal. Is it always cancer? No. But is it normal? Also no," said Dr. Megan Turley.

Dr. Megan Turley, Colon and Rectal Surgeon at Texas Oncology

Why Is Colorectal Cancer Surging in Younger Adults?

Colorectal cancer diagnoses and deaths are increasing year-over-year in people aged 20 to 49, making it the leading cancer-related cause of death for people under 50. While experts haven't pinpointed a single cause, they suspect multiple factors may be contributing to this troubling trend, including diet and lifestyle changes, family history, and obesity. The lack of a clear explanation makes prevention and early detection even more critical.

How Can Smokers Reduce Their Colorectal Cancer Risk?

Research reveals that smoking is a significant risk factor for colorectal polyps, which can develop into cancer. In a large screening study, 25% of current smokers had polyps, compared with 19% of ex-smokers and 17% of nonsmokers. This difference is substantial enough that some experts recommend earlier screening for smokers.

Notably, quitting smoking for more than 10 years appeared to eliminate the excess risk, bringing ex-smokers' polyp rates down to levels similar to those who never smoked. Other factors that did not appear to reduce polyp risk included body mass index (BMI), weekly exercise, daily use of nonsteroidal anti-inflammatory drugs (NSAIDs), and consumption of fruits and vegetables.

"Smokers should be considered as high risk, similar to individuals with a family history of colon cancer, and smokers may need to be screened at an earlier age," said Dr. Rajeev Attam.

Dr. Rajeev Attam, Senior Fellow in Gastroenterology at Stony Brook University School of Medicine

What's Keeping High-Risk Patients From Getting Screened?

Even among patients who should be prioritized for screening, adherence remains low. Childhood cancer survivors who received abdominal or pelvic radiation face elevated risk for colorectal cancer as a secondary malignancy, yet only about 37% of eligible survivors complete recommended screening. A recent randomized trial tested whether a digital mobile health intervention could improve these rates.

The ASPIRES trial enrolled 300 childhood cancer survivors and found that a remote patient activation intervention, delivered through text messages, video content, and resource links, tripled the odds of screening completion. Among participants who received the digital intervention, 32% completed colorectal cancer screening within 12 months, compared with just 14% in the control group. Interestingly, adding primary care provider activation on top of the patient intervention did not meaningfully improve results, suggesting that tailored digital engagement alone can be highly effective.

The intervention worked best for certain groups. Survivors with a high school education or less showed the strongest response to the intervention, with 4.4 times higher odds of screening completion compared with control. Among survivors without chronic conditions, the intervention produced 3.6 times higher odds of completion.

Why Is There Stigma Around Colorectal Cancer?

Tucker noted that colorectal cancer carries a stigma that other cancers don't. It wasn't until after her diagnosis that her aunt revealed multiple relatives had experienced colorectal cancer, a family history that had never been openly discussed. "Maybe I would have been more cautious of any of the symptoms I had if I knew," Tucker said. "It's almost like it's the 'dirty' cancer. And I don't think anybody should be ashamed of having cancer".

Tucker

Reducing this stigma is important because it may encourage people to seek screening and report symptoms earlier. Recent high-profile cases, including the deaths of actor James Van Der Beek and Catherine O'Hara, have brought increased attention to the disease and its warning signs, potentially helping to normalize conversations about colorectal health.

Steps to Take If You're at Risk for Colorectal Cancer

• Know your risk factors: Current smoking, family history of colorectal cancer, prior abdominal or pelvic radiation, and age over 50 all increase your risk. If you have any of these factors, discuss screening timelines with your doctor.
• Don't dismiss persistent symptoms: If bowel changes, rectal bleeding, abdominal pain, or unexplained weight loss last longer than a week or two, schedule a visit with your primary care doctor or a gastroenterologist rather than waiting.
• Ask about screening options: Standard screening typically begins at age 50 for average-risk individuals, but those with risk factors may benefit from earlier screening. Options include colonoscopy every 10 years, multitarget stool DNA testing every 3 years, or flexible sigmoidoscopy.
• Consider smoking cessation: If you smoke, quitting reduces your polyp risk significantly. Gastroenterologists can be part of your support team in this effort.
• Use digital tools if available: If you're a childhood cancer survivor or have other barriers to screening, ask your healthcare provider about mobile health interventions or reminder systems that can help you stay on track.

Tucker's experience underscores an important message: colorectal cancer doesn't discriminate based on age, knowledge, or proximity to medical care. Early detection through screening and prompt evaluation of symptoms can make a significant difference in outcomes. As Tucker looks toward completing her treatment, she hopes her story will encourage others to take their digestive health seriously and remove the shame from discussing colorectal cancer openly.