(HealthDay News) — Researchers have identified 4 red-flag signs and symptoms associated with an elevated risk of early-onset colorectal cancer (CRC). They reported their findings in the Journal of the National Cancer Institute.

The researchers evaluated 5075 early-onset CRC cases among US commercial insurance beneficiaries with 2 or more years of continuous enrollment (2006 to 2015) to identify red-flag signs and symptoms of early-onset CRC between 3 months to 2 years before the index date. These 5075 cases were matched to 22,378 control individuals.

The researchers found that 4 red-flag signs and symptoms — abdominal pain, rectal bleeding, diarrhea, and iron deficiency anemia — were associated with an increased risk of early-onset CRC. The odds ratio (OR) was 1.34 for abdominal pain, 1.43 for diarrhea, 2.07 for iron deficiency anemia, and 5.13 for rectal bleeding.

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The risk of early-onset CRC increased with increasing signs and symptoms. The OR was 1.94 for 1 symptom, 3.59 for 2 symptoms, and 6.52 for 3 or more symptoms. Even stronger associations were seen for younger ages and rectal cancer.

Roughly 1 in 5 CRC cases (19.3%) had their first sign/symptom occur between 3 months and 2 years before diagnosis (median diagnostic interval, 8.7 months), whereas 49.3% had the first sign/symptom within 3 months of diagnosis (median diagnostic interval, 0.53 months).

“Although validations are warranted, these findings indicate the potential utility of leveraging red-flag signs and symptoms to improve the early detection of early-onset CRC,” the researchers wrote.

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