A routine blood test turned out to be a lifesaver for a Miami man who had no obvious symptoms, and his case highlights a worrying rise in colorectal cancer among younger adults. Microscopic blood loss on a standard screen prompted a colonoscopy that found early-stage disease, leading to successful surgery and an ongoing recommendation for regular monitoring. Doctors involved are urging people to pay attention to subtle signs like anemia and to keep up with basic blood work and screenings.
Ian Ferguson, 37, had a regular physical and asked for standard blood work because “it had been a while.” The lab flagged microscopic blood loss, and his physician first suggested iron pills and repeat testing. “When I went back, it wasn’t the change they were looking for,” he said.
A follow-up colonoscopy detected a growth, and the lesion was removed at Mount Sinai Medical Center before it advanced. “They found a growth,” he said. “Thankfully, they caught it early. I was able to get surgery done and get it pulled out.” Because it was caught early, he avoided chemotherapy and radiation and now requires only annual colonoscopies.
Ferguson is candid about the small signs he ignored while juggling work and a move, admitting he mistook fatigue for hard workouts or poor sleep. “I just thought maybe I hit the gym a little harder that day, or maybe I wasn’t getting enough protein, or just didn’t get enough sleep,” he said. He also warned others that “There’s always an excuse, always a reason to not be seen by a professional.”
Grateful for the intervention, he reflected on the importance of listening to medical advice and acting quickly when tests suggest a problem. “I’m glad that I was able to take the medical professional’s words seriously and move forward, because they were able to find something deadly and take it out.” He now recommends routine blood work for everyone, regardless of age, because it’s simple and potentially life-saving.
Dr. Kiranmayi Palla Muddasani, a colorectal surgeon at Mount Sinai, says she is seeing a steady increase in younger colorectal cancer patients. “When I started my practice, I would see maybe one every six months, one or two cases a year. And now I see literally one to two cases a month,” she said. That uptick has shifted how clinicians think about screening and follow-up for younger adults.
Muddasani suspects environmental factors play a role, but admits the exact drivers remain unclear. “There is no rhyme or reason to it,” she said, adding that she has treated triathletes and vegans who were diagnosed. Many younger patients present first with persistent anemia, which often triggers the colonoscopies that catch early disease.
The doctor recommends a baseline routine complete blood count and basic metabolic panel yearly or every other year for many patients, noting that early-stage colorectal cancer is often silent. “Most people who have symptoms usually have advanced disease or metastatic disease,” she said. That makes proactive testing and vigilance especially important when iron levels or red blood cell counts are abnormal.
Symptoms can vary depending on tumor location in the colon, and that affects how early problems are noticed. “Patients with right-sided cancers can get to a very advanced stage while having no symptoms,” the doctor said. Left-sided tumors tend to produce more obvious signs like changes in bowel habits, visible blood, cramping, or obstructive symptoms.
While some risk factors such as age and family history can’t be changed, lifestyle choices can alter risk, the surgeon emphasizes. “A high-fiber diet is protective,” she said. “Exercise is also protective, as is decreasing your BMI to a healthy level.” She also warned that “Having processed meat increases the risk of colon cancer by two to three times, which is a big deal,” and urged practical steps: “We can’t control everything, but we can control diet, fiber, exercise, avoiding processed meat, just to start with some basics.”
Physicians say patients’ instincts matter and should prompt evaluation even when nothing specific stands out. “Sometimes I have patients showing up in my office and they can’t pinpoint anything specific, but they’re like, ‘I don’t feel well. I don’t feel normal.’ And that’s enough to start an investigation.”
