Health
Red flags for colorectal cancer that warrant screenings before 45 years of age
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Colorectal cancer (CRC) is now the leading cause of cancer death in adults under 50 and the second leading cause of cancer death in the U.S., highlighting the importance of routine screenings.
Adults 65 and younger comprise nearly half (45%) of all new cases — a significant increase from 27% in 1995, according to a report from the American Cancer Society.
“Once considered a disease that primarily affected people over 50, we are now seeing increasing diagnoses in patients in their 20s, 30s and 40s — making it even more important not to dismiss symptoms based on age alone,” Dr. Timothy Cannon, director of the Molecular Tumor Board and co-director of the Gastrointestinal Cancer Program at Inova in Virginia, told Fox News Digital.
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Official health agencies recommend that CRC screenings start at age 45 and continue through age 75 for adults at “average risk.”
Stool-based tests can be used to detect blood or DNA changes, potential indicators of cancer. Depending on the type of stool test, it can be performed every one to three years.
Colorectal cancer is now the leading cause of cancer death in adults under 50 and the second leading cause of cancer death in the U.S. (iStock)
A colonoscopy is a medical procedure that allows a doctor to examine the inside of the patient’s colon and rectum using a thin, flexible tube with a camera on the end. For average-risk adults, a colonoscopy is typically done every 10 years.
“Colonoscopy remains the gold standard because it not only detects cancer early, but can also prevent it by identifying and removing precancerous polyps,” Cannon said.
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Dr. Michael Martin, a California physician, emphasized that colonoscopy is generally preferred for younger patients who are clearly at higher risk.
“Stool-based tests are appropriate screening options for average-risk adults, but they are not the best choice for people with significant family history, inflammatory bowel disease, hereditary syndromes or alarm symptoms,” he told Fox News Digital. “If symptoms are present, the goal is not screening but diagnosis, and colonoscopy is usually the more appropriate test.”
3 reasons to get screened before 45
Doctors may suggest earlier screenings for people who fall into the following higher-risk groups.
Strong family history
“A family history can make screening earlier and more frequent,” Martin told Fox News Digital.
The American College of Gastroenterology recommends early screening if one first-degree relative is diagnosed with colorectal cancer or an advanced polyp before age 60, or if two first-degree relatives are diagnosed at any age.
A colonoscopy is a medical procedure that allows a doctor to examine the inside of the patient’s colon and rectum using a thin, flexible tube with a camera on the end. (iStock)
“They should generally start colonoscopy at age 40 or 10 years before the youngest affected relative’s diagnosis, whichever comes first,” Martin said. “In that setting, repeat the colonoscopy every five years is then generally recommended.”
Critical symptoms
Cannon listed the following red flags that warrant earlier screenings.
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- Rectal bleeding with bright-red blood
- Dark or black stools
- Blood in the stool
- Persistent changes in bowel habits, such as new constipation or diarrhea
- Unexplained iron-deficiency anemia
- Ongoing abdominal pain or cramping
- Unexplained weight loss
- Persistent sensation that the bowel is not emptying fully
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“While many of these symptoms can be caused by less serious conditions, they should never be ignored,” he said.
Ongoing abdominal pain or cramping is one warning sign that could warrant earlier screenings. (iStock)
Rectal bleeding in particular should always be taken seriously, even in younger patients, Cannon said.
“Too often, symptoms are attributed to hemorrhoids, diet, stress or athletic activity without further evaluation,” he noted. “Any persistent or unexplained bleeding warrants a conversation with a physician, and in some cases, a colonoscopy.”
“If something feels new, persistent, or concerning, don’t wait. Early evaluation can save your life.”
Certain genetic conditions
Some common hereditary syndromes increase the risk of colorectal cancer and may warrant earlier screenings.
For example, people with Lynch syndrome — an inherited DNA mutation that greatly increases lifetime risk — should get a colonoscopy every one to two years starting at about 20–25 years old or two to five years before the youngest diagnosed family case, according to the National Cancer Institute.
Familial Adenomatous Polyposis (FAP), another genetic variant, carries the risk of thousands of polyps and a nearly 100% lifetime risk of CRC, noted the American Cancer Society. Those with FAP are advised to start annual screenings at as early as 10 to 12 years old.
Several other syndromes and genetic variations — including Peutz–Jeghers Syndrome, Juvenile Polyposis Syndrome and MUTYH-Associated Polyposis (MAP) — can also warrant earlier screenings.
Inflammatory bowel disease
Those with inflammatory bowel disease (IBD), including ulcerative colitis and Crohn’s disease, face a higher lifetime risk of developing colorectal cancer, according to the Centers for Disease Control and Prevention.
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This is largely due to chronic inflammation that causes cellular changes. In this case, the patient may be advised to start colonoscopy screenings before age 45.
If someone falls into a category that warrants an early screening before 45, and then the screening is normal, the length of time until the next one will depend on the specific risk factors, according to Martin.
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“If it was performed because of a strong family history, repeating it every five years is common,” he advised. “If the person turns out not to have colon cancer (or an advanced polyp) and is closer to average risk than to high risk, the interval may be longer.”
In many cases, early screenings will be covered by insurance, Martin said, but coverage rules can differ depending on whether the exam is classified as screening or diagnostic.
Those with inflammatory bowel disease, including ulcerative colitis and Crohn’s disease, face a higher lifetime risk of developing colorectal cancer. (iStock)
“Under federal law, recommended screening tests for average-risk patients are generally covered without cost-sharing, but a colonoscopy done because of symptoms is often considered diagnostic, as mentioned above,” he noted. “This can have an impact on deductibles or co-pays. The exact out-of-pocket cost varies by insurer and plan.”
The encouraging news is that colorectal cancer is often preventable, Cannon emphasized.
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“Most cancers develop slowly from precancerous polyps over many years,” he said. “Screening allows physicians to detect and remove these polyps before they turn into cancer.”
“The key message: If something feels new, persistent, or concerning, don’t wait. Early evaluation can save your life.”
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Health and government officials are warning of a potential deadly substance in the illegal drug supply.
The Centers for Disease Control and Prevention (CDC) and the White House Office of National Drug Control Policy (ONDCP) issued a health advisory on Thursday about reports of medetomidine being detected in fentanyl.
Also known as “rhino tranq,” “mede” or “dex,” medetomidine is a veterinary sedative that causes severe, prolonged sedation. Classified as an alpha-2 agonist, it acts on the nervous system similar to other veterinary sedatives, like xylazine, and can cause life-threatening withdrawal symptoms.
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The advisory is based on surveillance data, including forensic drug testing, wastewater analysis, clinical case reports and overdose investigations.
In 2023, there were 247 incidences of medetomidine detected in drug samples, which rose to 2,616 in 2024 and 8,233 in 2025 – a more than 3,000% increase. Forensic drug reports showed that about 98% of medetomidine-positive samples also contained fentanyl.
Health and government officials are warning of a potential deadly substance in the illegal drug suppl (iStock)
The drug has been detected in at least 18 states and Washington, D.C., with a concentration in the Northeast and Midwest regions of the U.S., per the CDC alert.
Dr. Adam Scioli, chief medical officer of Caron Treatment Centers in Pennsylvania, said the alert highlights a “concerning and rapidly evolving development” in the illicit opioid supply.
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“Its co‑occurrence with fentanyl significantly complicates overdose presentation and withdrawal management, further increasing both clinical acuity and unpredictability,” he told Fox News Digital.
“Medetomidine is not routinely detected on standard toxicology screens, increasing the risk of under‑recognition without a high index of clinical suspicion.”
The drug has been detected in at least 18 states and Washington, DC, with a concentration in the Northeast and Midwest regions of the U.S. (iStock)
Naloxone (Narcan), known for its overdose reversal effects, does not counteract medetomidine, the advisory warned.
“While naloxone remains essential for reversing opioid‑induced respiratory depression, it does not address the sedative effects of medetomidine,” Scioli confirmed.
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The initial effects of the drug include deep sedation or decreased consciousness, bradycardia (slow heart rate), hypotension (low blood pressure) and respiratory depression, especially when combined with fentanyl and other opioids.
Withdrawal symptoms typically begin about a few hours after taking medetomidine. They can be severe and rapid, peaking at about 18-36 hours, according to experts.
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Initial withdrawal symptoms include rising blood pressure, tachycardia, agitation and nausea/vomiting, gradually leading to severe hypertension, altered mental status, and possible cardiac or neurologic complications, per the alert.
Severe cases require intensive care in a hospital. “Management may require ICU‑level monitoring and care,” said Scioli.
Naloxone (Narcan), known for its overdose reversal effects, does not counteract medetomidine, the advisory warned. (Reuters/Andrew Kelly)
In a May 2024 example cited by the CDC, medetomidine in the illegal opioid supply was linked to a cluster of overdoses in Chicago, potentially exceeding 175. At least 16 people were hospitalized and one died.
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There were some limitations to the surveillance, the agency acknowledged. Surveillance systems rely on small samples that may not be representative of all areas.
There is also the chance that the numbers could be overestimated due to contamination or repeated use of drug paraphernalia. Conversely, numbers could actually be higher than recorded, as medetomidine is rapidly metabolized in the body and is not typically tested in clinical settings.
An expert noted that the alert highlights the need for “careful assessment beyond standard opioid toxicity models,” as well as close coordination with toxicology, emergency medicine and public health partners. (iStock)
The surveillance was conducted by the CDC with support from federal public health programs and collaboration with other agencies.
Scioli noted that the alert highlights the need for “careful assessment beyond standard opioid toxicity models,” as well as close coordination with toxicology, emergency medicine and public health partners.
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“The drug supply is evolving in ways that strain traditional opioid‑focused frameworks and demand greater clinical vigilance,” he said.
“From a treatment perspective, this is another clear example of why addiction care must be adaptive, medically sophisticated, and grounded in whole‑person, long‑term recovery — not solely acute stabilization,” he added.
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A panel of judges has ruled that it is impossible to determine which of two identical twins fathered a woman’s baby.
The child (referred to as “P”), who was conceived in 2017, is now 8 years old, according to court documents.
The U.K. woman, who was only identified as “the mother,” reportedly engaged in sexual relations with the identical twins just four days apart.
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She remained in a relationship with one twin, who was named on the birth certificate and initially acted as the legal father, the filing stated. When the relationship ended, it triggered a legal dispute.
The mother and the twin who is not listed on the birth certificate brought the case, seeking to overturn an earlier ruling and have him legally recognized as the child’s father, the document detailed.
The child (referred to as “P”), who was conceived in 2017, is now 8 years old, according to court documents. (Child not pictured) (iStock)
The Court of Appeals ruled that legal paternity rights are only granted to a genetic father. While DNA testing shows a 50/50 chance for each twin to be the father, there is no definitive answer.
“Currently, the truth of P’s paternity is that their father is one or other of these two identical twins, but it is not possible to say which,” stated Lord Justice Moylan in the Court of Appeal ruling.
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Moylan added that the child’s paternity “is binary and not a single man,” highlighting the legal uncertainty created by the case.
Since neither twin can prove he is the biological father, neither can be given legal parental responsibility, the court declared.
The case is significant because it reveals a limit of DNA evidence, which is the foundation of many legal cases.
Monozygotic (identical) twins share virtually identical genetic profiles, including the markers used in standard paternity tests. (iStock)
“Identical twins share the same genetic DNA code. While, over time, there are subtle changes to patterns around the DNA that would allow matching in some circumstances for adults’ cells, these markers are significantly degraded at the time of fertilization — making it not practical with current technology to assign paternity to identical twin brothers,” Paul Brezina, physician and fertility expert at Fertility Associates of Memphis, an Ivy Fertility Center, told Fox News Digital.
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In addition to medical questions, this situation could have an emotional impact on the parents and child, noted Brezina, who was not involved in the case.
“Support for the patient and the child through counseling and their medical professionals is vital moving forward,” he advised.
Since neither twin can prove he is the biological father, neither can be given legal parental responsibility, the court declared. (iStock)
Identical twins have long presented a challenge in DNA testing, previous medical research has shown.
Monozygotic (identical) twins share virtually identical genetic profiles, including the markers used in standard paternity tests, meaning they “cannot be differentiated using standard DNA testing,” according to a study published in Forensic Science International: Genetics.
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There are more advanced methods, such as whole genome sequencing, that can detect some rare genetic mutations among twins, but researchers say these techniques are complex, expensive and not commonly used in legal cases.
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A study published in PLOS Genetics confirms that distinguishing between identical twins’ DNA requires highly specialized analysis that goes beyond standard forensic testing.
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