Young people with colon cancer are often misdiagnosed. 2 women share the symptoms their doctors missed.
Rates of colon cancer in people under 50 have grown in recent decades.
One study found that 82% of young colon cancer patients were misdiagnosed initially.
Two women who had colon cancer in their 30s were told they had hemorrhoids or a parasite.
Brooks Bell and Sarah Beran connected online in July 2023 over something unfortunate they had in common: they were both treated for colon cancer in their 30s after doctors misdiagnosed them. Now, they're working together to prevent others from having the same experience.
Before Beran was told in 2020 at age 34 that she had colon cancer, she chalked her fatigue up to being a working mom with two young kids. And she presumed the blood that had started appearing in her stools was caused by hemorrhoids.
"It was just a crazy time with the kids. They were so young. I was so tired all the time anyway, and I was just so busy," Beran, a stylist in LA, told Business Insider.
The most common colon cancer symptoms in people under 50 are abdominal pain, changes to bowel movements such as going more or less frequently, constipation, bloating, and diarrhea, according to a 2024 study published in JAMA Network Open. But other symptoms include blood in feces, unexplained weight loss, anemia, and vomiting for no obvious reason.
Many of these symptoms overlap with common digestive problems such as irritable bowel syndrome, which means doctors tread a tightrope when it comes to diagnosing younger, generally healthy patients. In a 2017 survey of 1,535 colon cancer survivors under 50 conducted by the Colorectal Cancer Alliance, 82% said they were initially misdiagnosed.
A 2020 survey by the charity Bowel Cancer UK of 1,073 colorectal cancer patients diagnosed under 50, and 222 people who responded on a patient's behalf, found 42% were told by doctors they were too young to develop the condition. Half of the participants didn't know they could get the disease at their age, and two thirds were initially diagnosed with conditions such as IBS, hemorrhoids, or anaemia.
It's a challenge to make sure a symptom is attributed to the correct condition without scaring people while also not overlooking the early signs of colorectal cancer, Joshua Demb, an assistant professor at the University of California, San Diego, who studies early-onset colon cancer, previously told BI.
A year into having IBS-like symptoms and needing to use the bathroom a lot more than usual, Beran's doctors sent her to a gastroenterologist who said she might have a parasite, but said it was likely nothing to worry about given her age, active lifestyle, and healthy diet.
An at-home stool test for colon cancer detected no abnormalities. What are known as fecal immunochemical tests, or FIT, are about 80% accurate, according to the University of Colorado Cancer Center.
When the bleeding got worse, Beran pushed for a colonoscopy and was diagnosed with stage 3 cancer. She said that doctors found a mass on her rectum and "over 100" polyps — small growths that are often harmless but can turn into cancer — on her colon.
"It was quite shocking to hear the word 'cancer,'" she said. "Because I was so healthy, it just wasn't something that I thought would happen to me." Growing up, Beran played sports and, before her diagnosis, she exercised almost every day. She ate plenty of fruits and vegetables, too.
Over two years, Beran was treated with 12 rounds of chemotherapy, and surgery to remove the cancerous tissues. She was given a temporary ileostomy connecting her small intestine to her abdomen to collect feces while her colon healed.
In early 2022, doctors told her the cancer had spread to her lungs, which was treated with more surgery, as well as radiation therapy.
She has been "cancer-free" for almost three years, she said.
"I feel so silly looking back on it, but who's not tired, you know what I mean?" Beran said.
While Beran was struggling with her symptoms in LA in 2019, Bell was seeking her own answers 2,500 miles away in North Carolina, after finding blood in her stool at age 38.
The former CEO's doctor told her over the phone that she likely had hemorrhoids. When the bleeding didn't stop after a few weeks, Bell's doctor examined her in person and couldn't find hemorrhoids, but said they were probably higher up in her rectum.
Sensing something wasn't right, Bell called a GI doctor without a referral, meaning it wasn't covered by her insurance. A colonoscopy revealed that she had stage 3 colon cancer, and was followed by three months of chemotherapy and surgery to remove 10 inches of her colon.
In 2024, Bell hit the five-year cancer-free mark, where the likelihood that a cancer patient will have a recurrence drops. The cancer hasn't returned, but the worry never went away.
"The treatment sucks, but the anxiety is so intense and is so persistent," she said, "you can't get away from it. It is barely tolerable."
Bell is glad she trusted her instinct, despite being told several times the blood in her stool was nothing to worry about.
"There were clues all along. You just needed to have someone who is willing to actually ask about your stool and really think about it, not shy away," she said.
Overall, thanks to screening and lifestyle changes, fewer people are developing colon cancer, according to the American Cancer Society. It estimates that in 2025, 107,320 new cases of colon cancer will be diagnosed.
But Bell and Beran are among a growing number of younger people to develop the disease. One in five colon cancer cases in 2019 were in people under 54, up from one in 10 in 1995, according to ACS data published in 2023.
The cause is unclear, but scientists have pointed to changes in the gut microbiome, antibiotic use, and environmental exposures as possible explanations.
Beran reached out to Bell online after she saw her Lead From Behind campaign, which featured Ryan Reynolds and Rob McElhenney getting colonoscopies on camera.
In July 2023, they met on Zoom and decided to combine their respective skill sets to create Worldclass, a clothing line intended to reframe colonoscopies as cool.
They sell tote bags with the irreverent slogan "colonoscopy enthusiast" printed on, and streetwear-style tracksuits stitched with the the word "ass."
In the US, people are advised to get their first colon cancer screening at 45, partly because age is a risk factor for developing polyps.
However, if someone younger has more than one symptom of colon cancer, they should consider getting a colonoscopy, Dr. James Cleary, a gastrointestinal oncologist at Dana-Farber Cancer Institute in Boston, previously told BI.
During a colonoscopy, patients are either sedated or under general anesthetic while a thin tube with a camera on the end is put in the rectum and colon to check for polyps. They must fast and take a laxative in the days before the procedure. If polyps are found, they can often be removed then and there, meaning the procedure can help prevent colon cancer.
"They're actually more like a fast, cleanse, then a nap. It's actually almost like a spa appointment," Bell said of a colonoscopy. "We could be reframing it in positive ways, where it's just a self-care wellness kind of experience."
She added: "People do not know that it's this empowering, hopeful thing that can actually protect you from this major threat."
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