In 2020, Matt Vitale, at right, then a sergeant first class, with Erik Brodin, then a staff sergeant, at Fort Leonard Wood, an Army training installation in Missouri. Vitale had completed aggressive treatment for an advanced stage of colon cancer. (Matt Vitale)

WASHINGTON — Matt Vitale had just completed air assault school with the Missouri National Guard in 2017 and was weeks away from mobilizing to the Middle East, when he noticed blood in his stool.

Vitale, who at the time was a 37-year-old sergeant first class, was in top physical shape and assumed he injured himself in training. But the bleeding did not stop; it grew worse.

He took a photo of the problem and showed it to his supervisor, who referred him to a doctor. A colonoscopy was ordered that same week. When Vitale followed up for the results, he was days away from deployment.

“I walked into the doctor’s office with the thought I needed to wrap this up. My bags were packed. But he sat me down and said, ‘I have some bad news. You have Stage 3 colon cancer,’ ” said Vitale, who asked if he could put off treatment until he returned.

“The doctor said, ‘If you don’t start treatment now, you could possibly die,’ ” Vitale said. “I was in shock. Everything changed for me in that moment.”

About 150,000 cases of colon cancer are diagnosed each year. While rates are declining in people over age 50, they are on the rise in younger adults, a trend called early onset colorectal cancer. Adults in their 20s and 30s are more often diagnosed at advanced stages of colon cancer than older adults, according to the National Institutes of Health.

Younger adults may overlook signs of colorectal cancer, according to Dr. Eric Wargotz, a pathologist and clinical professor emeritus at George Washington University School of Medicine and Health Sciences. Colon cancer is a type of colorectal cancer. Younger people, who otherwise feel healthy, may dismiss symptoms such as bleeding and abdominal pain until they are severe.

Most colon cancers start with benign growths that can be removed, preventing cancer from developing. When caught early, the cure rate is over 90%. The prognosis for Vitale was different.

Stage 3 colon cancer means the cancer has grown through the colon wall and spread to one or more lymph nodes. It often is managed with aggressive treatment — which is what Vitale required.

Military members and veterans can be at a disadvantage in getting checkups and screenings that can spot pre-cancerous growths and provide earlier diagnoses for colon cancer, Wargotz said.

“The challenge is greater for service members and veterans, who may experience gaps in care due to deployments, relocations or transitions between military and VA systems,” said Wargotz, who previously served at the VA Medical Center and the Armed Forces Institute of Pathology, in Washington, D.C.

Matt Vitale, a first sergeant, serves with the National Guard Homeland Response Force in Missouri. Vitale was diagnosed with an advanced stage of colon cancer in 2017, as he prepared to deploy to the Middle East. Vitale said he almost skipped seeing a doctor, after dismissing his own symptoms. (Matt Vitale)

Vitale admitted he was about to skip seeing a doctor altogether if not for pressure from his sister. “She said, ‘Hey, dummy, get this checked out. This isn’t right.’ ”

Vitale started treatment the day after his diagnosis, which included radiation, chemotherapy and surgery over the course of several months.

He took medical leave for the more intensive phases of treatment but returned to active duty. “I have a passion for serving. This is my career,” said Vitale, a 47-year-old first sergeant who has served for 27 years.

Vitale’s deployments have included missions to Korea, Iraq, Guatemala and Honduras. During a 12-month deployment to Iraq from 2002 to 2003, his unit was exposed to pollution from burn pits.

Vitale entered his name and health information in the burn pit registry managed by the Department of Veterans Affairs after his cancer diagnosis. The registry tracks health issues connected to airborne hazards.

From 2018 to 2020, Vitale worked in a military police brigade in Missouri. He later transferred to the National Guard Homeland Response Force in Missouri, where he serves today.

Vitale is cancer-free and on a personal mission to urge friends, family and colleagues not to ignore signs of medical problems or put off seeing a doctor. “The last thing I thought I had was cancer,” Vitale said.

Routine colon cancer screenings are recommended for people ages 45 and older, so younger individuals are not included in standard screening programs.

But persistent symptoms such as blood in the stool should not be dismissed on age alone, said Dr. Sam Asgarian, vice president of clinical development for screening at Guardant Health.

A new generation of colon cancer tests that are less invasive make it easier to detect colon cancer in individuals who are not exhibiting symptoms and at average risk of the disease. The tests involve collecting a stool sample at home and getting bloodwork at a doctor’s office or lab.

Asgarian said the Shield blood test, for example, “is an important innovation that makes colorectal cancer screening easier and more convenient.” Shield is an FDA-approved test for detecting cancer DNA in bloodwork. Positive results require a follow-up colonoscopy.

“There’s no reason to be a hard charger about your health,” Vitale said. “Every solider is important.”