Colorectal Cancer Rising in Under 50s: New Study Reveals Alarming Trend

Colorectal cancer – cancer of the large intestine or rectum – is now the leading cause of cancer deaths in people under 50 in the United States, according to a new study. This shift marks a significant and concerning trend, as historically, colorectal cancer has been primarily diagnosed in older adults.

The incidence of colorectal cancer and mortality rates have been steadily increasing in individuals under 50 each year since 2013 and 2004, respectively. Research published in March 2026 by the American Cancer Society (ACS) highlights that this rise in early-onset diagnoses is largely driven by cases presenting at more advanced stages. This means the cancer has already spread when it’s detected, making treatment more challenging.

A Shift in the Landscape of Colorectal Cancer

The researchers, including Rebecca Siegel, Nikita Sandeep Wagle, and Dr. Ahmedin Jemal, emphasized the seriousness of this trend. “The trend is very serious,” they stated. “Colorectal cancer is the only common cancer [in people] under 50 with rising mortality.” This contrasts sharply with the decreasing rates of new bowel cancer cases and deaths observed in adults aged 65 and over. The overall decline in older age groups is, in a sense, masking the opposing pattern emerging among younger cohorts.

The study compiled data on new colorectal cancer cases from 1998 to 2022 and mortality data from 1930 to 2023, drawing from the National Cancer Institute and the Centers for Disease Control and Prevention (CDC). This analysis revealed that the increase isn’t limited to those under 50, but extends to individuals up to age 65. This phenomenon, known as the “birth cohort effect,” suggests that shared exposures or experiences during specific birth years are contributing to the increased risk.

This birth cohort effect points to the possibility that factors present in more recent generations are driving the increase in colorectal cancer, rather than simply age itself. As Siegel explained in a statement, this suggests “a real uptick in disease because of something we’re doing or some other exposure.”

Unraveling the Causes: What’s Driving the Increase?

Pinpointing the exact causes of this rising trend remains a challenge. Traditional risk factors for colorectal cancer, such as smoking, are less prevalent in younger populations. Approximately 14% of colorectal cancer cases across all ages are attributable to smoking, but individuals under 50 are less likely to have a history of smoking.

Researchers are exploring potential links to more recent environmental exposures, including microplastics and ultraprocessed foods. Previous research has as well established associations between colorectal cancer and high antibiotic exposure and the consumption of processed meat.

The American Cancer Society estimates that there will be 158,850 new cases of bowel cancer in 2026. Of those, 47,600 will be in 50- to 64-year-olds and 24,640 will be in those under 50. Over 55,000 people of all ages are projected to die from the disease this year, with 7% of those deaths occurring in individuals under 50 and 24% in those aged 50 to 64.

The Importance of Screening and Early Detection

Given the increasing number of advanced-stage diagnoses in younger individuals, early detection is crucial. The ACS guidelines currently recommend that individuals at average risk – those without a personal or family history of the disease – begin colorectal cancer screening at age 45. Medicare covers various screening tests, including stool DNA tests and colonoscopies, starting at this age. Individuals with a higher risk may require earlier and more frequent screenings, as determined by their healthcare provider.

However, current screening rates are concerning. Only 37% of 45- to 49-year-olds are up-to-date with their colorectal cancer screening. Considering that half of deaths in people under 50 occur within this age group, increasing screening rates could prevent a significant number of deaths.

Raising awareness of potential symptoms is also vital. Symptoms such as blood in stool, abdominal pain, diarrhea, or fatigue can often be mistaken for other health issues. Prompt attention to these symptoms could lead to earlier diagnosis and more effective treatment.

Screening not only allows for the detection of cancer but also enables the earlier removal of precancerous lesions in the bowel. This preventative measure accounts for 79% of averted colorectal cancer deaths.

Looking Ahead: Ongoing Research and Public Health Initiatives

The rise in colorectal cancer among younger adults underscores the necessitate for continued research to identify the underlying causes and develop more effective prevention and treatment strategies. Public health initiatives focused on increasing screening rates and raising awareness of symptoms are also essential.

The ACS and other organizations are actively working to eliminate barriers to screening and ensure that all individuals have access to timely and appropriate care. This includes advocating for policies that expand insurance coverage for screening tests and promoting culturally tailored outreach programs to reach underserved populations.

Further investigation into the role of environmental factors, dietary habits, and lifestyle choices will be critical in understanding the complex interplay of factors contributing to this concerning trend. Ongoing surveillance and data analysis will also be essential for tracking the incidence and mortality rates of colorectal cancer and evaluating the effectiveness of prevention efforts.