Overall cancer deaths among Americans younger than 50 have fallen by a striking 44% since 1990, but a worrying trend is emerging: colorectal cancer is bucking the decline, and is now the leading cause of cancer death in this age group. It’s a shift that demands attention, and a deeper look at why this is happening.
Colorectal Cancer on the Rise in Younger Adults
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A new study reveals a significant decrease in overall cancer mortality for those under 50, yet colorectal cancer is a notable exception.
- Overall cancer mortality in the U.S. for those under 50 decreased by 44% between 1990 and 2023.
- Declines were seen in mortality rates for breast, lung, brain cancers, and leukemia.
- Colorectal cancer mortality increased by 1.1% per year since 2005, becoming the leading cause of cancer death in those under 50 in 2023.
- Three out of four people under 50 are diagnosed with advanced colorectal cancer, highlighting the need for increased awareness and screening.
The analysis, published as a research letter in the Journal of the American Medical Association, examined cancer death trends from 1990 through 2023, utilizing data from the National Center for Health Statistics and the Surveillance, Epidemiology, and End Results (SEER) program at the National Cancer Institute.
What explains the decline in cancer deaths for younger adults? Increased access to prevention and screening services is making a real difference in the fight against cancer, with mortality rates falling for four of the five leading causes of cancer death in this age group.
Progress Across Multiple Cancer Types
From 1990 to 2023, a total of 1,267,520 people in the United States died from cancer before reaching age 50. The overall death rate decreased by 44% during this period. Specifically, between 2014 and 2023, brain cancer mortality declined by an average of 0.3% annually, breast cancer by 1.4%, leukemia by 2.3%, and lung cancer by a substantial 5.7%. Lung cancer and leukemia, once the leading causes of cancer death, have fallen to fourth and fifth place, respectively.
“The steady rise in colorectal deaths [in those] under 50 is even more alarming compared to the dramatic declines for lung and breast [cancers] even as breast cancer incidence is climbing,” said lead report author Rebecca Siegel, MPH.
Breast cancer remains the second-leading cause of cancer death overall and the most common in women. Cervical cancer consistently ranked third among cancer deaths in women throughout the study period, despite a continuous decline. The patterns in men mirrored the overall trends, with non-Hodgkin lymphoma and pancreatic cancer replacing breast cancer as the fourth and fifth leading causes of death, respectively.
A “Tsunami” of Colorectal Cancer
The increase in colorectal cancer mortality is particularly concerning, as it’s happening at a time when overall cancer deaths are falling. Researchers emphasize the need for more research to understand the drivers of this trend, particularly in generations born since 1950. People aged 45 to 49 now account for 50% of all colorectal cancer diagnoses in those under 50, suggesting that increased screening uptake could have a significant impact.
“We weren’t expecting colorectal cancer to rise to this level so quickly, but now it is clear that this can no longer be called an old person’s disease,” said senior author Ahmedin Jemal, DVM, PhD. “We must double down on research to pinpoint what is driving this tsunami of cancer in generations born since 1950.”
Lisa A. Lacasse emphasized the importance of maintaining and expanding access to cancer prevention and screening services. “This research underscores the urgent need to protect and expand access to care, especially at a time when increasing health-care premiums and cuts to prevention and screening programs threaten to reverse our progress and undo the gains we have achieved.”
DISCLOSURE: For full disclosures of the study authors, visit jamanetwork.com.
