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Colorectal cancer has now become the leading cause of cancer-related death in people under 50, even as deaths from other cancers continue to fall.
Overall, colorectal cancer is currently the second most common cause of cancer deaths, with a rate that has been dropping by 1.5 percent per year for the past several decades in patients over 55 years old. The main reason for the decrease in cases is the increase in screening in older adults, which has detected cancers earlier when they are easier to treat and treatment options for more advanced cancers have improved.
Unfortunately, the death rates in people under 55 have been increasing by about 1 percent per year over the past 20 years. This shift is changing how clinicians think about awareness for younger adults who may not realize they’re vulnerable to a disease once considered a concern of older age.
Understanding colorectal cancer
Colorectal cancer begins in the colon or rectum, often developing from small growths called polyps that form on the inner lining of the bowel. While many polyps are benign, some can slowly change over time and become cancerous.
“When colorectal cancer is found early, it is highly treatable and, in many cases, preventable,” said Dr. Peter Senatore, colorectal surgeon and Director of Rectal Cancer at Inspira Health. “The challenge is that early-stage colorectal cancer usually causes no noticeable symptoms, which can delay diagnosis.”
As the disease progresses, symptoms may appear and can include persistent changes in bowel habits, blood in the stool, abdominal pain, unexplained weight loss or ongoing fatigue. Because these symptoms can overlap with more common digestive issues, younger adults may not think about the potential for cancer and therefore delay seeking care.
Why are colorectal cancer deaths rising in younger adults?
While colorectal cancer diagnoses among younger adults have been increasing for years, rising mortality adds a new layer of concern. One contributing factor is that younger adults are more likely to be diagnosed at later stages of the disease, when treatment is more complex and outcomes are less favorable.
Delayed diagnosis often occurs because colorectal cancer is not immediately suspected in people under 50 when symptoms appear.
Lifestyle and environmental factors may also play a role. “Diets high in ultraprocessed foods, low physical activity levels, obesity, smoking and alcohol use have all been linked to increased colorectal cancer risk,” said Dr. Senatore. “Young adults have been exposed to these factors during their entire life, unlike prior generations of adults. Emerging research also suggests that changes in the gut microbiome and chronic inflammation may also contribute to early-onset disease.”
Screening saves lives at any age
Routine colon cancer screening remains the most effective tool for preventing the disease or detecting it early. For adults at average risk, professional guidelines recommend starting screening at age 45. Screening options include colonoscopy and stool-based tests, depending on patient preferences and the presence of symptoms.
People with a family history of colorectal cancer, inflammatory bowel disease or certain hereditary conditions may need screening earlier or more often. Importantly, symptoms should never be ignored, regardless of age.
Younger adults should not wait until they reach screening age to talk to a doctor. New or persistent digestive symptoms should always be evaluated.
What younger adults should watch for
Because a colorectal cancer diagnosis is more unexpected in younger populations, awareness is critical. Symptoms such as rectal bleeding, unexplained anemia, ongoing abdominal pain or lasting changes in bowel habits warrant medical attention.
Early detection not only improves survival but can also reduce the intensity of treatment and the risk of long-term side effects.
“The rise in colorectal cancer deaths among adults under 50 highlights the need for earlier conversations, increased awareness and proactive care,” said Dr. Senatore. “While overall cancer mortality trends are encouraging, this exception underscores the importance of screening, symptom recognition and healthy lifestyle choices at every stage of life.”
Colorectal cancer is not just a disease of older adults, and recognizing that reality can save lives.
