Familial Colorectal Cancer: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 2, 2026.
What kind of doctor treats Familial Colorectal Cancer?
A gastroenterologist usually manages screening and diagnosis for people with a family history. If cancer is found, treatment often involves a surgeon and an oncologist. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is familial colorectal cancer?
Familial colorectal cancer is cancer of the colon or rectum that runs in families more often than chance would explain. It happens when a shared gene change or shared habits raise the risk for several family members. Doctors usually find it through earlier and more frequent screening tests.
Colorectal cancer usually begins as a polyp, a small growth in the colon or rectum that can turn into cancer over years. Doctors use the word familial when cancer appears in close relatives. Unlike hereditary syndromes such as Lynch syndrome, familial colorectal cancer likely comes from a mix of shared genes and lifestyle factors.
Symptoms
Early colorectal cancer often causes no symptoms, which is why screening matters. When symptoms appear, they can include a lasting change in bowel habits, blood in the stool, and unexplained weight loss. Only testing can tell what is causing them.
Causes and who gets it
Having one first degree relative with the disease roughly doubles lifetime risk, and the risk climbs higher if several relatives were affected or diagnoses came at a young age. Shared habits like smoking, obesity, and heavy alcohol use may also play a role.
How doctors diagnose it
The main test is a colonoscopy, which views the whole colon and can remove polyps during the same procedure. People with a family history usually start around age 40, or 10 years before the youngest relative's diagnosis, whichever comes first.
Treatment
Treatment depends on how far the cancer has grown. Surgery to remove the tumor is the most common first step; some people also need chemotherapy or radiation.
When to see a doctor
See a doctor if you notice blood in your stool, a lasting change in bowel habits, or constant belly pain. Tell the doctor about any relative who had colorectal cancer, since that can change when and how often you should be screened.
How a direct primary care or concierge doctor fits in
A direct primary care doctor is paid a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can take your family history, order tests, and refer you to specialists.
Common questions
Does having a relative with colon cancer mean I will get it?
No. A family history raises risk, but it does not mean cancer is certain. Regular screening that removes polyps early can greatly lower the chance of ever developing the disease.
At what age should I start screening if colon cancer runs in my family?
Most guidelines suggest starting around age 40, or 10 years before the age at which your youngest affected relative was diagnosed. Ask a doctor which applies to your family. The right schedule depends on the details of your history.
Are at home stool tests as good as a colonoscopy?
Stool tests can find many cancers, but they miss some, and they must be repeated more often. A colonoscopy looks at the whole colon and can remove polyps on the spot. People with a strong family history are usually advised to have colonoscopy.
Can lifestyle changes lower my risk?
Yes, healthy habits help. Eating more fiber, exercising, keeping a healthy weight, not smoking, and limiting alcohol all lower risk. Screening is still needed even with good habits.
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Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
