Azucena Reyes dropped her youngest son off for his first day of pre-K in August 2015 while pushing through months of intense nausea. The next day, severe stomach pain sent her to the hospital.
"I thought my ovary burst, but it was actually a tumor," she told Healthline.
For the next three months, doctors removed the tumor but insisted it could not be cancerous. Reyes was only 32 years old and Hispanic, they told her, and that combination did not fit the profile for colon cancer.
"They told me, 'You have a very, very slight chance, or no chance at all, of having cancer. You're only 32. It happens to people who are African American and older in their 60s,'" Reyes said.
Two months later, in October 2015, the tumor returned. Reyes was diagnosed with stage 3B colon cancer. When she asked her doctors to explain why it happened to her, she did not get a clear answer.
"When I asked doctors why I got it when I was so young and not the right race, they told me they didn't have an answer," she said.
Reyes now believes her experience pointed to a much broader gap in awareness about early-onset colorectal cancer, a gap that has only grown more visible in the years since her diagnosis.
"At the time I was diagnosed, I don't think doctors were as educated as they are now," said Reyes. "But now it's rising. It's rising high in Hispanics."
She is right that the numbers have shifted. According to Healthline, colorectal cancer is now rising fastest among Hispanic and Latino adults younger than 50.
In 2018, the American Cancer Society revised its screening age recommendation, lowering it from 50 to 45 for people at average risk. But for younger patients who fall outside that window, the path to diagnosis often runs only through symptoms.
Richard Wender, MD, Medical Advisor at the Colorectal Cancer Alliance, explained the current approach to testing in younger patients.
"So most testing in people under 45 is in response to symptoms," he said. "We are increasingly realizing that people of any age can develop colorectal cancer, so warning symptoms require diagnostic testing regardless of a person's age."
Wender listed the symptoms that should prompt a visit to a doctor, no matter how old a patient is. Those include blood in the stool or rectal bleeding, a persistent change in bowel habits such as new diarrhea, new constipation, thin stools, or trouble emptying completely, persistent abdominal pain, cramping, or bloating, unexplained anemia, and unintentional weight loss combined with feeling weak and tired.
He also identified groups of people under 45 who should pursue screening even without symptoms. Those include anyone who carries a known genetic mutation such as Lynch syndrome or Familial Adenomatous Polyposis, people with a strong family history of colorectal polyps or cancer particularly when it appears at a young age, and anyone who has had inflammatory bowel disease such as Crohn's disease or ulcerative colitis.
Insurance coverage remains a barrier for younger patients who do not meet those criteria. Coverage for screening in people under 45 without symptoms or a documented high-risk condition is not guaranteed, which means cost can prevent some patients from pursuing testing even when they have concerns.
Reyes has continued to speak publicly about her experience. Her case illustrates what can happen when a patient's age and background are treated as reasons to dismiss symptoms rather than evaluate them.
Doctors and researchers are now working to change that approach, but the shift is still ongoing, and younger patients with symptoms continue to face the challenge of being taken seriously before a diagnosis is confirmed.