Colorectal cancer is now the leading cause of cancer deaths for Americans under 50, a grim milestone revealed in new research. It’s a shocking shift, and one that’s leaving doctors scrambling to understand why this disease, once considered an “older person’s” ailment, is striking younger adults with increasing frequency.
The JAMA study, published Thursday, found a disturbing 1.1% annual rise in deaths from colon and rectal cancers in those under 50 since 2005.
- Colorectal cancer is now the #1 cancer killer for those under 50 in the U.S.
- Deaths in this age group have risen 1.1% annually since 2005.
- The disease is increasingly diagnosed at later, more difficult-to-treat stages.
- Experts are urgently calling for increased screening and research.
What’s driving this surge in colorectal cancer among younger adults? While the exact reasons remain elusive, experts agree that something is fundamentally changing, and the stakes are incredibly high.
Jenna Scott, now 39, knows this all too well. She remembers the abdominal pain during her pregnancy with her son. Doctors initially dismissed it as a normal part of being pregnant. But the pain persisted, and more than a year after giving birth to a healthy baby boy, Scott received a devastating diagnosis: stage 4 colon cancer. “We did a colonoscopy and when I woke up, there was my husband, my doctor and four nurses in the room. The GI doctor said he didn’t need to send anything off to pathology to know that I had cancer,” Scott recalled in an email. The cancer had already spread to her liver.
“I’ve always been super fit and healthy. I’ve been an athlete all my life. I didn’t even grow up eating red meat. In an instant, my life changed completely and unexpectedly,” she said. “I was in a state of disbelief because that word ‘cancer’ didn’t live in my world. Cancer means death.” Scott, now an advocate for the Colorectal Cancer Alliance, continues to undergo chemotherapy and targeted therapy to keep the disease at bay, hoping one day to become a grandmother.
The new research, analyzing data from the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics from 1990 through 2023, paints a stark picture. While overall cancer deaths in those under 50 fell by 44% during that period, colorectal cancer deaths bucked the trend. It rose from being the fifth most common cause of cancer death in this age group in the early 1990s to the top cause in 2023.
“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 Dr. Ahmedin Jemal, senior vice president of surveillance, prevention and health services research at the American Cancer Society and senior author of the study, in a news release. “We must double down on research to pinpoint what is driving this tsunami of cancer in generations born since 1950.”
Colon cancer screening and symptoms
The research underscores the importance of screening, which is currently recommended to start at age 45 for people at average risk. However, Jemal noted that only 37% of adults ages 45 to 49 are up-to-date on their screenings.
“Colorectal cancer screening can not only detect cancer at the early stage, but also it removes the polyps before it becomes cancer,” Jemal explained. “So, it’s one of the two screening types that we have that not only detects cancer at early stage but also prevents it, the other being cervical cancer screening.”
But screening isn’t the whole story, according to Dr. Y. Nancy You, professor at the University of Texas MD Anderson Cancer Center and director of its Young-onset Colorectal Cancer Program. “There is an unmeasurable group of young adults who have symptoms that may be consistent with colorectal cancer, but either sit on the symptoms because they are busy or are scared, or eventually access their health care system but encounter a provider who thinks it’s just a hemorrhoid and doesn’t trigger further investigations,” she said.
Common symptoms of colorectal cancer include:
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Blood in the stool or rectal bleeding
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Unexplained changes in bowel habits — such as diarrhea, constipation or narrowing of the stool — for more than a few days
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Persistent abdominal pain or cramping
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Weakness or fatigue
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Unintended weight loss
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Lingering sensation of fullness, needing to have a bowel movement even after going
Delays in diagnosis often mean the cancer is discovered at a later, more advanced stage. As of 2023, more than 60% of colorectal cancer patients under 50 are diagnosed at stage 3 or 4, according to data from the National Cancer Institute. “In this younger group, when we do see later stage of diagnosis, that is highly associated with lower survival,” said Christine Molmenti, an associate professor and cancer epidemiologist at Northwell Health in New York.
“I think it is very heartbreaking,” Molmenti added. “What we see a lot of times is that these patients are healthy. They’re fit. Sometimes they’re athletes…and often times young people ignore symptoms, or their symptoms are dismissed. So, I think there needs to be awareness.”
Nearly 60 new colorectal cancer cases are diagnosed in people under 50 each day in the United States, according to the Colorectal Cancer Alliance—that’s a diagnosis roughly every 25 minutes.
