Rectal Bleeding Identified as Key Predictor of Early-Onset Colorectal Cancer

November 2025 A recent study presented at the American College of Surgeons Clinical Congress 2025 highlights rectal bleeding as a strong predictor of early-onset colorectal cancer (EOCRC) in individuals under 50. Conducted by Jin et al., the retrospective cohort analysis included 443 patients undergoing colonoscopy between 2021 and 2023, of whom 195 (44%) were diagnosed with EOCRC.

Key Findings:

· The presence of rectal bleeding significantly increased the likelihood of EOCRC

· Other risk factors included benign colon polyps, family history of colorectal cancer, and former smoking history.

· 39% of EOCRC cases presented with rectal bleeding compared to 23% of non-cases.

· The majority of EOCRC patients (70%) had no family history, and only 13% were microsatellite-deficient.

Take home message: Dr. Sandra Kavalukas emphasized that rectal bleeding in individuals below the standard screening age warrants strong consideration for colonoscopy, even in the absence of family history. This study supports more symptom-driven approaches to earlier colorectal cancer screening.