Assess the patient for relevant symptoms (e.g., rectal bleeding) or for signs such as unexplained iron deficiency anemia* and review history of pertinent diagnostic testing. Your clinical expertise and shared decision making are key to developing an appropriate plan for each patient.

The incidence of colorectal cancer in younger patients.34, 42–47

  • Recent studies indicated that incidence of colorectal cancer is increasing among adults under age 50, often presenting with rectal bleeding and /or abdominal pain.
  • Rectal bleeding in patients under age 40 should not be attributed to hemorrhoids without an adequate work up, including history, rectal exam, perianal exam and sigmoidoscopy. Colonoscopy may be considered.


*Colonoscopy is only part of the workup for patients with iron-deficiency anemia.

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