The recommended starting age for colorectal cancer screening in the US is 45. Azucena “Suzy” Reyes was 32 when a tumor grew large enough to completely obstruct her transverse colon, and for the three months that took to find — August to October 2015 — the medical system’s answer was antibiotics. Writing in Business Insider, Julia Pugachevsky recounts four emergency-room visits that produced diagnoses of intestinal inflammation before a fifth, hours after her first gastroenterology appointment, turned up the tumor on an ultrasound. Reyes, now 43 and living in Alvin, Texas, had emergency surgery the next morning. The pathology report came back a week later: stage 3B colon cancer.
The symptoms had been accumulating while she ran 4 miles at her community college, studied to be a certified nurse assistant, ran a construction company with her husband and raised four children. Persistent bloating — “I looked like I was pregnant,” she said — then exhaustion she blamed on being busy, fevers, intense nausea and stomach pain severe enough that “I really thought it was an ovary that had burst because it was that painful.”
Treated for inflammation, put on a waitlist
The first ER diagnosis was colitis and enteritis — inflammation of the large and small intestines — plus a microperforation, and she was sent home with antibiotics. When the pain persisted she was admitted, fitted with a PICC line to administer medication, and kept for three weeks. Her request for a GI appointment went onto a waitlist until early October. When the PICC line came out, the nausea returned; two further ER visits produced no new answers. By the time she sat in front of the gastroenterologist she was vomiting too often to keep still. Within hours she and her husband were at the ER for the fifth time, the ultrasound found the obstruction, and the tumor came out the following morning.
The surgeon’s first read was reassurance: she was very young, he told her, and colon cancer was less common in Hispanic populations and in people under 60. That reasoning is a population average applied to one patient’s colon, and her colon had not read it. The tumor had grown through the muscular wall and into her lymph nodes. “I was scared, but then relieved at the same time,” Reyes said. “For three months, I was suffering, and I didn’t know why.”
The curve the surgeon was reading from
The risk picture behind that reassurance is roughly two decades out of date. The American Cancer Society reports that about 3 of 4 colorectal cancers found in people under 50 are already at regional or distant stage when detected — 27% of them distant — largely because no screening program reaches that age group. One in 5 diagnoses in 2019 was in a patient under 55, about double the 1995 share, with advanced-stage incidence climbing about 3% a year in the under-50s, according to Yale Medicine. Where screening does apply, the effect is measurable: early-stage diagnoses among 45- to 49-year-olds rose from 11.7 to 17.5 per 100,000 between 2021 and 2022, a 50% one-year jump the ACS attributes to screening uptake. Reyes, at 32, sat outside that net entirely; so did everyone her age with the same symptoms and a doctor willing to call them colitis.
Twelve rounds, then a decade
The first chemo estimate — two or three rounds — fed a plan to hide the illness from the children, then aged 4 to 16, under cover of a month-long couple’s trip. The oncologist revised the plan to 12 rounds, about six months, and secrecy became impossible. Side effects included nausea, fatigue and weight gain: “I was literally swollen,” she said. “It’s like they pumped air into me.” She deliberately never searched her prognosis online, crediting that for her “peace of mind” through treatment.
As of October 2026 Reyes has been cancer-free for over a decade, on annual colonoscopies, blood work and CT scans; the neuropathy never left (“it just feels like needles poking them” in her feet, arms and fingers). The diagnosis screened one more person: her brother, 42 at the time and three years below the screening threshold, resisted her push for a colonoscopy, got one, and learned he had colon cancer too. After surgery he has been clear for four years. Nothing else in the system would have caught his tumor either.
Reyes now works with the Colorectal Cancer Alliance’s Never Too Young Taskforce and focuses on Spanish-speaking communities. Her own post-diagnosis search for guidance found no one: “nobody ever reached out to me and said, ‘Hey, I’m an advocate for colon cancer. I’m here,’” she said. “I wish I would’ve had that.” The reaction she gets now: “There are so many people that come out to us, me and my husband, and they’re like, ‘Thank y’all for doing this,’”
The open number sits below 45. Guidelines have moved once already, on the strength of the rising under-50 curve; whether they move again will be decided by incidence in 20- and 30-somethings — the cohort that currently gets three months of antibiotics and a waitlist.