Colorectal Cancer Rising in Young Adults | 2026 ACS Report

Colorectal cancer (CRC) rates are shifting in the United States, with a concerning rise in diagnoses among younger adults even as overall incidence declines, according to the American Cancer Society’s (ACS) latest statistics report for 2026. The findings, published last week in CA: A Cancer Journal for Clinicians and accompanied by the 2026 Cancer Facts & Figures report, highlight a complex trend requiring further investigation and potentially revised screening strategies.

A Tale of Two Trends

For decades, CRC incidence has generally been falling, largely due to increased screening rates and improvements in treatment. However, this overall decline masks a significant and troubling increase in cases among individuals under 55. The ACS report indicates that while rates continue to drop in older adults, younger people are experiencing a rise in this once-less-common cancer. This divergence is prompting researchers to explore potential contributing factors, including dietary changes, lifestyle factors, and alterations in the gut microbiome.

The 2026 statistics represent the 75th year the ACS has compiled comprehensive cancer data, offering a long-term perspective on evolving trends. Notably, the report also reveals a positive development: the five-year relative survival rate for all cancers combined has reached 70% for those diagnosed between 2015 and 2021. Specifically, survival rates for distant-stage rectal cancer have improved from 8% to 18% since the mid-1990s, a testament to advances in early detection and treatment. You can read the full press release here.

Understanding Colorectal Cancer

Colorectal cancer begins as a growth on the inner lining of the colon or rectum. These growths, called polyps, can be benign or pre-cancerous. Over time, pre-cancerous polyps can develop into cancer. Symptoms can include changes in bowel habits, rectal bleeding, abdominal discomfort, and unexplained weight loss. However, many individuals with early-stage CRC experience no symptoms, underscoring the importance of regular screening.

Screening tests, such as colonoscopies and fecal immunochemical tests (FIT), can detect polyps before they become cancerous, or identify cancer at an early, more treatable stage. Current guidelines generally recommend beginning regular screening at age 45, but the rising incidence in younger adults is fueling debate about whether this age should be lowered. More information about colorectal cancer facts and figures can be found on the American Cancer Society website.

Disparities in Incidence and Mortality

The ACS report also highlights significant disparities in CRC incidence and mortality across different populations. Alaskan Natives, for example, are two to three times more likely to be diagnosed with and/or die from CRC compared to any other ethnic group in the US. This disparity underscores the need for targeted interventions and culturally sensitive outreach programs to improve access to screening and treatment for underserved communities.

The Role of Early Detection and Screening

The improvement in survival rates for distant-stage rectal cancer demonstrates the power of early detection. When cancer is diagnosed at a localized stage, the five-year survival rate is significantly higher than when it is diagnosed at a distant stage. However, screening rates remain suboptimal, particularly among certain populations. The ACS National Colorectal Cancer Roundtable (ACS NCCRT) is actively working to increase screening rates through various initiatives, including the development of resources for primary care practices. You can find updates to the ACS NCCRT Steps Guide here.

What Does This Mean for Individuals?

The rising incidence of CRC in younger adults is a cause for concern, but it’s vital to remember that CRC remains preventable and treatable, especially when detected early. Individuals should be aware of the symptoms of CRC and discuss their risk factors with their healthcare provider. While current screening guidelines recommend starting at age 45, individuals with a family history of CRC or other risk factors may benefit from earlier or more frequent screening. It is crucial to have an open conversation with a qualified clinician to determine the most appropriate screening schedule.

Understanding Relative vs. Absolute Risk

It’s important to understand the difference between relative and absolute risk when interpreting cancer statistics. While a relative risk increase may sound alarming, it’s crucial to consider the absolute risk – the actual probability of developing the disease. For example, a 50% increase in relative risk for a rare cancer may translate to a small absolute risk increase.

Looking Ahead: Public Health Surveillance and Guidance Updates

The ACS report will likely prompt further review of current screening guidelines and public health strategies. The Centers for Disease Control and Prevention (CDC) and other public health agencies continuously monitor cancer trends and update recommendations based on the latest evidence. Ongoing surveillance is essential to track the evolving epidemiology of CRC and identify emerging risk factors. The ACS NCCRT will continue to play a vital role in disseminating information and promoting best practices for CRC prevention and control.

The next steps involve continued research to understand the underlying causes of the rising incidence in younger adults, as well as efforts to improve screening rates and address disparities in access to care. The ACS and other organizations are committed to saving more lives from colorectal cancer through ongoing research, education, and advocacy.