Colorectal cancer deaths among adults under 50 are rising sharply, with rectal cancer increasing faster than colon cancer and mortality concentrated in those without a college degree, according to new research presented by the American Cancer Society and academic medical centers.
Deaths from rectal cancer in people ages 20 to 44 have increased up to three times faster than overall colorectal cancer deaths since 1999, based on CDC data analyzed by researchers at SUNY Upstate Medical University. Hispanic adults in this age group experienced the steepest rise in rectal cancer mortality of any demographic.
If current trends continue, rectal cancer deaths will surpass colon cancer deaths in people under 50 by 2035, warned Mythili Menon Pathiyil, lead author of the unpublished study and a gastroenterology fellow. Colon cancer remains the leading cause of cancer death in this age group.
The American Cancer Society projects 158,850 new colorectal cancer cases and 55,230 deaths in the U.S. In 2026, with nearly a third of fatalities occurring in people under 65.
A separate analysis of over 101,000 colorectal cancer deaths in adults aged 25 to 49 from 1994 to 2023 found the increase occurred almost entirely among those without a four-year college degree. For this group, mortality rose from 4.0 to 5.2 per 100,000, while rates for college graduates remained stable at approximately 2.7 per 100,000.
For more on this story, see Colorectal cancer deaths rise sharply among less-educated Americans under 50.
Researchers emphasized that a degree itself does not confer biological protection but serves as a marker for socioeconomic factors linked to higher risk, including obesity, physical inactivity, smoking, and poor diet — conditions more prevalent among those with lower education and income.
Colorectal cancer is now the leading cause of cancer death for men under 50 and the second leading cause for women in the same age group. Since 2005, mortality in Americans under 50 has risen by 1.1% annually, making it the deadliest cancer in that demographic.
Standard treatments for rectal cancer — surgery, radiation, and chemotherapy to the pelvic region — can impair bladder, bowel, and sexual function, adding to the disease’s burden on younger patients.
Scientists do not yet realize why tumors are increasing in younger adults or whether they are more aggressive, but they stress the need to understand tumor biology to reverse trends and improve treatment.
This follows our earlier report, 2026 ESMO Guidelines for Metastatic Colorectal Cancer: A Precision Oncology Approach.
The U.S. Preventive Services Task Force lowered the recommended screening age for colorectal cancer from 50 to 45 in 2021, reflecting growing concern over early-onset disease.
What symptoms should younger adults watch for?
Warning signs include blood in stool, rectal bleeding, persistent changes in bowel habits such as diarrhea or constipation, narrowing of stool, unintended weight loss, and abdominal cramps or pain lasting more than a few days.
Why are college graduates seeing stable death rates while others face rising risk?
Education level acts as a proxy for socioeconomic conditions; those without degrees often face barriers to healthcare, healthy food, exercise opportunities, and preventive care, which may delay diagnosis and limit access to timely treatment.
Keep reading
