Modern Treatment Is Changing the Outlook for Rectal Cancer, and Screening Matters.

Noticing blood in the toilet after a bowel movement can be concerning. While it could be something as common as hemorrhoids or a temporary issue with your diet, this is a scenario in which it’s better to get the facts than to be left wondering.

Rectal bleeding can be a sign of rectal cancer—a disease that’s highly treatable. In fact, rectal cancer is one of the only cancers that is virtually preventable through screening, which is why it’s so important.

For 2026, the American Cancer Society projects more than 100,000 new cases of colon cancer and about 50,000 cases of rectal cancer will be diagnosed in the U.S. Rectal cancer has historically been viewed as a condition that impacts older people, but that is changing. Colorectal cancers are the fourth-leading cause of cancer-related death in women, and the third in men. 

While proactive screening has successfully lowered death rates among older adults, there has been a concerning increase in deaths among those under age 55 since the mid-2000s. Because more younger people are being diagnosed, screening guidelines are evolving, too. The recommended age to begin screening was lowered from 50 to 45 in recent years. 

Screening can make a real difference when it comes to spotting potential cancers early, when treatment has the best chance of success. That’s why it’s important to understand your risk and get screened when it’s time. 

Our colorectal experts diagnose and treat many patients each year. Studies have shown that patients have better outcomes – including higher survival rates and a lower risk of colostomy – when they seek care from teams like ours at a high-volume center.  

What is rectal cancer?

It’s common to use the terms “colon cancer” and “rectal cancer” interchangeably but these cancers are not the same. The rectum is the 6- to 7-inch organ that connects the colon to the anus. Rectal cancers occur when cells in the rectum—the final section of the intestinal tract—grow out of control.

The rectum is in the “crowded real estate” area in the pelvis, near the bladder, reproductive organs, nerves, and major blood vessels. Our teams use very precise treatments to remove the cancer and protect each patient’s long-term function and quality of life.

Related: Read: "Cancer Rates Rise Among Younger People: How Screening Can Help."

Symptoms that could indicate rectal cancer.

Many rectal cancers don’t have symptoms until they are advanced, which is why early detection through screening makes such a big difference. 

One of the main challenges in diagnosing rectal cancer early is the hemorrhoid trap. Too often, patients and some providers notice bleeding, assume it’s caused by hemorrhoids and delay further testing. While hemorrhoids can result in bleeding, especially during a bowel movement, it’s important to thoroughly investigate and rule out a more serious condition such as cancer. 

If you notice rectal bleeding or any of the following symptoms, speak with your doctor or a colorectal cancer specialist:

• Abdominal discomfort: Ongoing gas, bloating, or cramps

• Changes in bowel habits: Including diarrhea, constipation, or narrow stool (poop)

• Persistent urgency: The feeling that you need to have a bowel movement, even after you’ve just had one

• Unexplained weight loss: This can be a sign of more advanced disease

Some factors that can increase your risk of developing rectal cancer include:

• Age: Women and men over age 45 have a higher risk than younger people

• Family history: If you have family members with colorectal cancer, you are at higher risk

• High-fat diet: Studies show that if you eat a diet high in fatty calories, such as those in red meat, you may have higher risk. Your risk could be higher if your diet is low in fruits and vegetables, too. 

• Lack of exercise: You may have a higher risk of developing cancer if you aren’t active.

• Medical history: Some conditions, such as ulcerative colitis, Chron’s disease, Type 2 diabetes, and other types of cancer can raise your risk. If your doctor found polyps during a colonoscopy your risk is also higher.

• Ethnicity: People with African American, or Eastern European Jewish backgrounds are at increased risk

• Tobacco and alcohol use: Smoking and drinking alcohol in excess can increase risk.

Related: Read: "What You Need to Know About Alcohol and Cancer Risk."

Rectal cancer screening: The opportunity for  prevention.

Most rectal cancers begin as small growths called polyps. During a colonoscopy, polyps can be identified and removed before they have a chance to turn into cancer.

Non-invasive screening tests are available on the market. These tests enable you to mail in a stool sample from home, but they have limitations. More reliable screening options for rectal cancer include:

• Colonoscopy: The gold-standard screening for colorectal cancers. We examine the entire colon and rectum with a camera on a thin, flexible tube to spot and remove pre-cancerous polyps. 

• Sigmoidoscopy: An examination of the rectum and lower colon using a thin scope to identify abnormalities.

• Digital rectal exam: The doctor checks for lumps and growths in the lower rectum with a gloved, lubricated finger.

An important note on family history: If you have a parent or sibling (a first-degree relative) who had colorectal cancer, you should begin screening 10 years earlier than the age at which they were diagnosed to give us the best chance of spotting and removing polyps before they can become cancer.

When rectal cancer is diagnosed, advanced treatments offer the best quality of life for many patients. Our teams of experts are dedicated to collaborating on the best care for patients. We combine our expertise so each patient gets a personalized roadmap to health.

Modern rectal cancer treatment.

Rectal cancer surgery once meant large incisions and lifelong changes in bowel function. Today, using laparoscopic and robotic-assisted techniques, surgeons can now operate with extreme precision through much smaller incisions. These state-of-the-art techniques mean less pain, shorter hospital stays (sometimes as few as 2-4 days), and a faster return to regular life. Advanced surgical techniques also mean fewer patients than ever have permanent colostomies.

In about 30%-40% of cases, modern chemotherapy and radiation are so effective that rectal tumors disappear completely. This is known as “complete response.” In these cases, we can often avoid surgery altogether with a “wait and watch” protocol. 

The importance of team-based care.

If you are diagnosed with rectal cancer, you can get the best treatment from a team-based approach to care. I’m proud to have worked with my colleagues to help establish the National Accreditation Program for Rectal Cancer (NAPRC) in the U.S., which prioritizes this multidisciplinary team approach.

At MedStar Health’s NAPRC-accredited centers this approach includes:

• Tumor board: Every patient’s case, from their imaging to their laboratory results, is presented to a team of experts who discuss the most effective treatment strategy for every individual.

• Collaborative decisions: Surgeons, oncologists, and radiologists work together to personalize your treatment so you can achieve your health goals.

• One-stop shopping: With all these experts collaborating under one roof, there’s no need to drive across town to schedule appointments at different offices. We coordinate your care so you can focus on healing.

Working together, our experts are focused on helping our patients achieve the best quality of life after rectal cancer treatment.

Our collaboration with Georgetown Lombardi Comprehensive Cancer Center enables our patients to have access to the latest clinical trials and cutting-edge research. Research participants have access to the latest advances before the public. Our clinician researchers are constantly studying new ways to make surgery more effective and improve care for our patients. 

Related: Read "MedStar Washington Hospital Center Earns National Rectal Cancer Accreditation—Twice in a Row."

Take heed, get screened.

Rectal cancer doesn’t have to be a devastating diagnosis, and the earlier you get screened, the better your chances. With a multidisciplinary team of experts on your side, rectal cancer is a highly treatable disease. If you’re 45 or older or experiencing symptoms, don’t wait. Talk with your doctor about rectal cancer screening.