WILLIAMSTOWN, N.J. — Rick Rivers, a father of three in Williamstown, N.J., is marking 13 years cancer-free after being diagnosed with colorectal cancer at age 31. Rivers has urged other young adults to get screened, convincing several people, including other parents and friends at his judo dojo, to undergo testing.

Rivers did not know his grandfather had died of colorectal cancer until he himself was diagnosed. In the years since, he has undergone many major surgeries. "There's a shame factor to talk about certain areas of your body and them not functioning the way that they're supposed to," Rivers said.

Colorectal cancer incidence has been increasing and is now the type of cancer most likely to kill people under age 50. The disease occurs more often and is more lethal among Black people. Tumors take years to grow, and colonoscopies and fecal tests such as FIT and Cologuard can reliably detect cancers early enough that they are relatively easy to treat.

Dr. Neil Parikh, a gastroenterologist at Hartford Hospital, said early detection can stop the disease before it develops. "This is a cancer that if you find a polyp — a little pimple on the inside — and you remove it, you can prevent it." he said.

Parikh also cited reluctance to discuss bowel function as a barrier to screening. "We need to talk more about poop," he said. "If you mentioned farting to my 8-year-old, they love it — but yet then we can't fart in public for the next 40 years of our life."

Insurance limitations or lack of awareness can prevent people from getting screened, and coverage for colonoscopy and other colorectal cancer screenings is not standard until age 45 under federal U.S. Preventive Services Task Force guidelines. High-risk patients under age 45 can request that doctors order a diagnostic colorectal cancer exam.

Clinically, people in their 30s and 40s are less likely to discuss warning signs such as bloody stools or changes in bowel regularity. According to the Colorectal Cancer Alliance's survey, symptoms in younger patients often go ignored, delaying diagnosis and treatment. Three out of four colorectal cancer diagnoses in young people are late-stage, according to Michael Sapienza. Patient advocates want more people to talk to their doctors about colorectal cancer risk factors and bowel movements.