CHICAGO: Rates of colorectal cancer have been rising consistently in younger adults — a trend that concerns surgeons and other medical professionals at the forefront of treating the disease.
“We’ve been noticing an alarming rise in colorectal cancer in adults under the age of 50. In fact, people born in the 1990s are two times more likely than people born in the 1950s to develop colorectal cancer,” said James T. McCormick, DO, FACS, FASCRS, a colorectal surgeon and American College of Surgeons Commission on Cancer (CoC) State Chair of the Pennsylvania chapter. “And that’s remarkably striking. We’re not quite sure why that’s happening or how to screen for it at such a young age. That’s the conundrum.”
For Colorectal Cancer Awareness Month this March, experts with the American College of Surgeons are available for interviews to share insights about the rise of colorectal cancer in younger adults and what steps people of all ages can take to reduce their risk of dying from the disease.
How much is colorectal cancer increasing in younger adults?
Researchers have noted a 15% increase in colon cancer diagnoses in people aged 18-50 since 2004, according to hospital-based data from the National Cancer Database (NCDB). By comparison, there was only a 3% increase in colon cancer diagnoses in adults aged 45-55 during the same period.
The NCDB, a clinical oncology database jointly operated by the CoC and the American Cancer Society, captures approximately 74% of all newly diagnosed cancers in the U.S.
Colorectal cancer is also killing more young adults. According to the American Cancer Society, colorectal cancer is now the leading cause of cancer deaths in men younger than 50 and the second leading cause of cancer deaths in women of the same age group.
Why is colorectal cancer increasing among young people?
The exact causes behind the increase of colorectal cancer in younger people are not fully understood. However, most experts believe that the rise results from multiple factors, including environmental changes, potential exposure to toxins, genetic factors that may increase a person’s risk of developing the disease earlier in life, and lifestyle factors such as high consumption of ultra-processed foods. Research into all these areas is ongoing.
“We really don’t know one single cause, but it’s likely multifactorial, and risk factors may depend on where the patient lives, what they eat, their lifestyle habits, and other hereditary factors,” said Nitin Mishra, MBBS, MPH, FACS, CoC State Chair of the Arizona chapter, and an associate professor of surgery at Mayo Clinic in Phoenix, Arizona.
What can people do to prevent colorectal cancer?
Despite the unknown, there are several steps everyone can take to reduce their risk of developing the disease and/or dying from colorectal cancer.
First and foremost, ACS experts recommend that people of all ages remain vigilant and report any changes in bowel habits, including bleeding and persistent changes such as constipation or diarrhea, to their primary care physician. Be persistent, and don’t be afraid to ask questions.
“I think a lot of prevention starts with awareness,” said Paula Denoya, MD, FACS, FASCRS, CoC State Chair of the Eastern Long Island-NY chapter and a colorectal surgeon at the Stony Brook Cancer Center. “We’ve all seen patients who had rectal bleeding that was dismissed as hemorrhoids or IBS symptoms for a while before they were found to have colorectal cancer. Knowing your family history is also critically important.”
Starting at age 45, all people should be screened for colorectal cancer annually. Screening may need to start earlier for people with a family history of the disease or for people considered high-risk for the disease due to other health factors.
The gold standard of colorectal cancer screening is with a colonoscopy, which can help physicians detect colorectal cancer at its earliest stage, when it’s more treatable, and even prevent colorectal cancer through the detection and removal of precancerous growths called polyps. Screening with colonoscopy may be one factor of many that has resulted in nearly 16,000 fewer colon cancer diagnoses among older adults per year, according to hospital-based data from the NCDB. Still, approximately 1 in 4 adults of screening age are not up to date with colorectal cancer screening recommendations, according to national data estimates.
Finally, exercising regularly to maintain a healthy body weight and eating a balanced diet high in lean meat, fiber, whole grains, vegetables, and fruits may also help reduce risk.
“Staying active even has other health benefits besides reducing the risk of colorectal cancer,” said Howard Kaufman, MD, FACS, CoC State Chair of the Southern California chapter and regional medical director of Huntington Cancer Center, an affiliate of Cedars-Sinai Cancer, in Pasadena, California. “For colorectal cancer, my main takeaway message is to get screened if you’re at the appropriate age or have other risk factors, and to see your doctor if you have any unusual bowel symptoms. If your symptoms persist and there’s not a plan to evaluate those symptoms from your doctor, then seek additional care. Don’t ignore symptoms.”
Available for Media Interviews
- Paula Denoya, MD, FACS, FASCRS, CoC State Chair of the Eastern Long Island-NY chapter, a colorectal surgeon at the Stony Brook Cancer Center, program director for the colorectal surgery residency program, and an associate professor of surgery at the Renaissance School of Medicine at Stony Brook University in Stony Brook, New York
- Howard Kaufman, MD, FACS, CoC State Chair of the Southern California chapter and regional medical director of Huntington Cancer Center, an affiliate of Cedars-Sinai Cancer, in Pasadena, California
- James T. McCormick, DO, FACS, FASCRS, CoC State Chair of the Pennsylvania chapter, professor of surgery at Drexel College of Medicine, and chief of colorectal surgery at Allegheny Health Network in Pittsburgh, Pennsylvania
- Nitin Mishra, MBBS, MPH, FACS, CoC State Chair of the Arizona chapter, and associate professor of surgery at Mayo Clinic in Phoenix, Arizona
Journalists may contact pressinquiry@facs.org to schedule an interview with ACS experts about colorectal cancer.
Additional resources
References
- Cotler J, Chan K, Zhu X. Colorectal cancer statistics, National Cancer Database, 2024.
- American Cancer Society. Cancer Facts & Figures 2024. Atlanta: American Cancer Society; 2024.
- Siegel RL, Fedewa SA, Anderson WF, et al. Colorectal Cancer Incidence Patterns in the United States, 1974–2013, JNCI: Journal of the National Cancer Institute, Volume 109, Issue 8, August 2017, djw322, https://doi.org/10.1093/jnci/djw322
- “Key Statistics for Colorectal Cancer.” American Cancer Society, January 29, 2024, https://www.cancer.org/cancer/types/colon-rectal-cancer/about/key-statistics.html
- “Health and Economic Benefits of Colorectal Cancer Interventions.” Centers for Disease Control and Prevention, December 21, 2022, https://www.cdc.gov/pcd/issues/2023/23_0071.htm
