Colon cancer is now the deadliest cancer among young men and the second deadliest among young women.
SEATTLE — Natalie Phelps was 38 when she gave birth to her second child and was blindsided by a life-altering diagnosis: colorectal cancer.
The news was a devastating blow.
“To go home and look at your baby and think, ‘I just gave birth to this baby and I might not get to see this baby grow up,'” Phelps recalled. “It was crushing emotionally, but there was also a lot of disbelief and feelings of unfairness”.
Phelps thought her symptoms — weight loss, abdominal pain and unusual bowel movements — were because of her pregnancy, not a sign of cancer. She had no family history of colon cancer, so she never imagined it would be something so serious.
Her primary care physician didn’t initially consider cancer either. The doctor referred her to a therapist, suspecting that postpartum depression could be at the root of her symptoms. Phelps was simply too young for colon cancer, or so they thought.
But a growing number of people under 50, like Phelps, are now being diagnosed with the disease, often years before they’re due for their first recommended screening.
According to a 2023 report released by the American Cancer Society, colorectal cancer cases among adults younger than 55 increased from 11% in 1995 to 20% in 2019.
It’s now the deadliest cancer among young men and the second deadliest among young women.
Dr. Rachel Issaka, gastroenterologist and researcher at Fred Hutch Cancer Center, has dedicated her career to studying the rise in early-onset colorectal cancer and its disparities.
“I think there is this misconception that colon cancer is an older person’s disease, Dr. Issaka said. “In some settings, there’s even a misconception that it’s only an older man’s disease. And that’s not true at all.”
That’s why screening guidelines changed in 2021.
The recommended age to begin screening used to be age 50. People are now advised to begin screenings at age 45, with those having a family history of the disease potentially starting even earlier. Colonoscopy is considered the gold standard for detection, as it can identify polyps before they turn into cancer. Additionally, a stool test and a new blood test, approved by the FDA last year, are now available options for early detection.
“This blood test is looking for circulating tumor DNA, and what that means is that cancers in the body can release specific signals that suggest that those are cancer cells compared to normal cells,” Dr. Issaka said.
Colon cancer is often called a “silent” disease. By the time symptoms appear, the cancer may already be in an advanced stage. However, when caught early, the five-year survival rate for colon cancer can be as high as 90%.
By the time Phelps was diagnosed, her cancer was at stage four. Today, she is committed to raising awareness about the importance of screenings and the lack of funding for colorectal cancer research.
On March 30, the Seattle Mariners are hosting Strike Out Against Colorectal Cancer Day. For every ticket sold, $8 will benefit the Colorectal Cancer Alliance’s 2025 Seattle Walk to End Colon Cancer — an event Phelps helps co-organize. She’ll be at the Mariners game helping to spark a conversation about a topic many people avoid.
“We’ll be having a game where you toss poo in a toilet, and then you get to keep a little ice pack shaped like poop,” Phelps said. “Then you get this little QR code that is a quiz. You can take it home in private, and it’ll ask you all the embarrassing questions about your poo. But at least with that, I’m hoping people will do that and start thinking and paying attention to their body and advocating if they are having symptoms or concerns with their primary doctor.”
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