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Colon Cancer in Younger Adults Is on the Rise: Here’s What to Know

Medically reviewed by Morgan Spicer, Medical Communications Manager on February 16, 2024. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Last year, a report released by the American Cancer Society revealed a surprising finding: compared to a decade ago, today almost twice the number of young adults under 55 are receiving colorectal cancer (CRC) diagnoses. [1] What’s more, the report revealed that every year, more young adults are dying from colorectal cancer.

Although cancer deaths in general have been on the decline in the United States, colorectal cancer is now among the leading forms of cancer deaths among younger adults: while it was the fourth-leading cause of cancer death for both women and men under fifty in 1995, colorectal cancer today is the second- and first-leading cause in women and men, respectively, in this age group. [2] And for adults ages 50-64, new colorectal cancer diagnoses have increased compared to 1995. Meanwhile, colorectal cancer rates in older adults have been dropping, thanks to an increase in routine colonoscopies and reductions in smoking. [3]

Due to this emerging trend of increasing colon cancer rates in younger adults, the U.S. Preventive Services Task Force (USPSTF) made a downward adjustment to its screening recommendations in 2021. [4] USPSTF colorectal cancer screening guidelines now advise screenings to begin at age 45, instead of starting at age 50. [5]

Why Is Colon Cancer on the Rise in Young Adults?

These trends have spurred researchers to find answers to the big question: what explains the rise of colon cancer in younger adults? Though no conclusive answer exists yet, the available evidence points to a combination of environmental, dietary, and lifestyle factors contributing to the increasing incidence of colon cancer in younger adults. [6]

Some studies, for example, have found that high BMI/obesity is linked with early-onset colorectal cancer; the same is true for tobacco smoking. [6] It’s also possible that the significant increase in processed foods in people’s diets is partly to blame for the rise of colorectal cancer among adults under 50. Processed foods commonly have food additives like carboxymethylcellulose and polysorbate 80; experimental evidence has shown that these food additives may be associated with colorectal tumor development. [6] However, more research is needed for a clearer picture that accounts for the upward trend of colorectal cancer among adults under 50.

Non-modifiable risk factors—or risk factors that can’t be controlled or altered—for early-onset colorectal cancer include male sex, a family history of colorectal cancer, race (Black or Asian), or having inflammatory bowel disease (IBD). [7]

Signs of Early-Onset Colorectal Cancer to Look Out For

Research that came out in 2023 discovered the four most common warning signs of colorectal cancer in people under age 50. [8] Becoming familiar with these warning signs can help younger adults have important conversations with their healthcare provider and encourage potentially life-saving colorectal cancer screening.

Here are the four key warning signs [8]:

  • Abdominal pain
  • Rectal bleeding
  • Diarrhea
  • Iron deficiency anemia

Notably, experiencing three or more of these warning signs is associated with a 6 times increased likelihood of colorectal cancer compared to not having any of these signs. [8] It is also important to note that these signs and symptoms must occur with constant or near-daily frequency for several months to be associated with colorectal cancer. Isolated instances of abdominal pain or GI upset should not be considered as symptoms of CRC.

If you notice any of these warning signs, be sure to talk with your healthcare provider as soon as possible. Based on their assessment, they may recommend a colon cancer screening and/or other next steps to take.

Everlywell FIT Colon Cancer Screening Test CTA graphic

Routine Colon Cancer Screening Helps Keep You Safe

Early detection and treatment of colorectal cancer helps reduce the risk of death from the cancer. [9] “I have heard firsthand patients’ hesitation around colon cancer screenings. It's not the most glamorous topic. But the potential consequences of ignoring it are far worse. At-home screening tests are quick, painless, and incredibly effective. Remember, early detection is key, and your health is worth the extra step,” says Dr. Gabe Gaviola.

For adults under the age of 50, regular screening for colorectal cancer should begin at age 45, according to the USPSTF. [5] Recommended screening frequency depends on the type of colorectal cancer screening test used. For high-sensitivity gFOBT or fecal immunochemical tests (FIT tests), the USPSTF recommends annual screening. CT colonography or flexible sigmoidoscopy may be done every 5 years, with a colonoscopy done every 10 years. [5]

Dr. Gabe Gaviola notes that “The impact of colon cancer can be devastating. But here's the good news: early detection is our secret weapon. Taking a simple screening like at-home screening test, which you can do in the convenience of your own home, could save your life. Don't let fear or embarrassment stop you from doing this simple test. Remember, early detection is key, and your health is worth the extra step.”

As always, speak with your healthcare provider about colorectal cancer risk and what screening interval and type of screening may be advised in your case.

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References

  1. Colorectal Cancer Facts & Figures 2023-2025. American Cancer Society. Medical Citation URL. Accessed February 14, 2024.
  2. Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin. 2024;74(1):12-49. doi:10.3322/caac.21820
  3. Why Is Colorectal Cancer Rising Rapidly among Young Adults? National Cancer Institute. Medical Citation URL. Published November 5, 2020. Accessed February 14, 2024.
  4. Colon cancer is on the rise in younger adults: What you should look for. UC Davis Health. Medical Citation URL. Published March 6, 2023. Accessed February 14, 2024.
  5. Colorectal Cancer: Screening. U.S. Preventive Services Task Force. Medical Citation URL. Published May 18, 2021. Accessed February 14, 2024.
  6. Puzzono M, Mannucci A, Grannò S, et al. The Role of Diet and Lifestyle in Early-Onset Colorectal Cancer: A Systematic Review. Cancers (Basel). 2021;13(23):5933. Published 2021 Nov 25. doi:10.3390/cancers13235933
  7. Gausman V, Dornblaser D, Anand S, et al. Risk Factors Associated With Early-Onset Colorectal Cancer. Clin Gastroenterol Hepatol. 2020;18(12):2752-2759.e2. doi:10.1016/j.cgh.2019.10.009
  8. Fritz CDL, Otegbeye EE, Zong X, et al. Red-flag signs and symptoms for earlier diagnosis of early-onset colorectal cancer. J Natl Cancer Inst. 2023;115(8):909-916. doi:10.1093/jnci/djad068
  9. Kanth P, Inadomi JM. Screening and prevention of colorectal cancer. BMJ. 2021;374:n1855. Published 2021 Sep 15. doi:10.1136/bmj.n1855
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