It is frequently reported that colorectal cancer rates are increasing among young adults in the United States.

In fact, according to the American Cancer Society, colorectal cancer cases in people 55 and younger have increased from 11% in 1995 to 20% in 2019, and since the late 1990s, colorectal cancer has transitioned from cancer to Fourth cause of death rises Among people under 50, cancer is the first cause of death in men and the second cause of death in women.

But when it comes to colorectal cancer testing, the Centers for Disease Control and Prevention says only adults between the ages of 45 and 75 should get screened. This can be done a few different ways, but the U.S. Food and Drug Administration calls colonoscopy “the gold standard for screening.”

Given the rising rates of colorectal cancer in young adults, it’s safe to say that many people shouldn’t wait until age 45 to have their first colonoscopy. Experts say certain symptoms, personal health history and family health history are reason enough to get screened before then. At this point you may want to consider:

You have blood in your stool.

Blood in the stool doesn’t always indicate cancer, but it can be a sign, according to the American Cancer Society.

Even if it’s just blood on the toilet paper and you think it might be secondary to hemorrhoids, you should get it checked out. Whether it’s bright red or dark brown blood or it’s causing black, tarry stools, you should tell your doctor.

You have persistent bowel changes.

Any change in bowel habits and appearance—whether you have more or fewer bowel movements than usual, or your stools are different in shape or consistency—can be a red flag. Persistent constipation is another warning sign.

According to the American Cancer Society, it’s especially worth bringing up with your doctor if intestinal changes persist for more than a few days. At the very least, you should have a physical exam, and your doctor may recommend a colonoscopy.

You are experiencing sudden abdominal pain or weight loss.

Unexplained abdominal pain may also be cause for concern. Symptoms can range from cramping to general malaise to body aches.

It’s important to know that discomfort can vary based on a person’s perception and pain tolerance.

If you’ve lost weight without trying, that’s also a sign that you should see your doctor and ask about a colonoscopy.

You have a family history of colon cancer.

People who have a parent, sibling or child with a history of colorectal cancer should get screened by age 45. If you have a first-degree relative with colorectal cancer, your risk is about twice as high, according to a meta-analysis of multiple studies.

If that first-degree relative gets colon cancer at age 50 or younger, your risk is three times higher. If you have a first-degree relative with colorectal cancer, it is recommended that you have your first colonoscopy at age 40, or 10 years earlier than the age your family member was diagnosed, whichever comes first. For example, if your mother was diagnosed with colon cancer at age 44, you should have your first colonoscopy at age 34. If your parents or siblings have large polyps, you should also get screened at age 40.

During a colonoscopy, if the doctor sees polyps and thinks they are precancerous (the vast majority are), the doctor will remove the polyps during the colonoscopy. By doing this, you can reduce your risk of colorectal cancer.

Polyps are not typically a topic of frequent discussion among family members, so it’s important to be open about your medical condition with your loved ones and inform them of any procedures or findings.

You have iron deficiency anemia, inflammatory bowel disease or a history of certain cancers.

While iron deficiency anemia is extremely common in young women, it can be a red flag in some (but not all) cases. Menstruation can be a cause of iron deficiency anemia, but if your OB-GYN thinks there’s reason to be concerned, or you’re nervous, contact your doctor and ask about a colonoscopy. Iron deficiency in men is always a concern and a colonoscopy should be discussed with a doctor.

If you have inflammatory bowel disease, you may also need to have a colonoscopy before age 45.

Any inflammation involving the colon puts you at risk for a precancerous condition called dysplasia or colon cancer. There are other medical conditions. For example, if someone has had radiation therapy to the pelvic or abdominal area for other reasons, this may also increase your risk of colon cancer.

You are also at high risk for colorectal cancer if you have a personal history of colorectal cancer. Additionally, if you carry an alteration in one of these cancer genes, you should also start colorectal cancer surveillance as early as possible.

Colorectal cancer screening is important for everyone. Don’t be afraid to advocate for yourself and your health.

People who are at higher risk due to family history or symptoms should get a colonoscopy. But if you’re 45 or older, don’t have any risk factors, and are avoiding screening because of concerns about colonoscopy or preparation issues, you do have other screening options, including stool tests and CT scans.

If you are of screening age, the most important thing is to get screened. The biggest problem right now is that we’re only screening about 70% of the high-risk population, which means 30% of people are not being screened. We have shown that through proactive screening we can reduce colorectal cancer mortality by at least 50%.

As mentioned above, colorectal cancer rates are rising in young adults. Just because the guidelines say you can wait until age 45 to get colorectal cancer screening, that doesn’t mean you should.

To put the numbers into perspective, people born in the 1990s have twice the risk of colon cancer and four times the risk of rectal cancer as people born in the 1950s.

Therefore, it is important to take family history, personal health history, and symptoms seriously. If you have any concerns, no matter how minor they may seem, don’t be afraid to ask your doctor about a colonoscopy.

However, while waiting for your appointment, it is important not to panic. The symptoms highlighted above do not necessarily mean you have colon cancer, but they may be a sign that something is going on that warrants a colonoscopy, one of which may be colon cancer being the cause of the symptom changes.

Taking control of your health is never a bad idea. At the very least, it can help you manage any bothersome symptoms. In some cases, it may save your life.

Colorectal cancer is preventable, so take advantage of the testing available to catch it early and remove polyps before they have a chance to turn into cancer.