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Colorectal Cancer Is Now Leading Cause Of Cancer Deaths In People Under 50

Colorectal cancer is now the top cause of cancer-related deaths in the United States, according to a new report. Thomas Northcut/Getty Images

Colorectal cancer is now the leading cause of death due to cancer for Americans under 50, rising annually, while deaths from other major cancers have declined over the past decade.
Three out of four young patients are diagnosed at advanced stages, when the five-year survival rate drops from 89% to 16%.
People at above-average risk should begin screening before age 45.
Stigma around discussing bowel habits and doctors dismissing symptoms in younger patients contribute to late diagnoses.

Colorectal cancer has become the leading cause of death due to cancer for people under 50 in the United States. In the early 1990s, the disease ranked fifth.

A new report from the American Cancer Society (ACS) examined cancer deaths in younger adults over three decades and found that while overall cancer mortality dropped 44% for this age group, colorectal cancer deaths moved in the opposite direction. It appears to be the only major cancer doing so.

The five deadliest cancers for people under 50 are:

From 2014 to 2023, the report found deaths from four of those cancers declined.

Colorectal cancer, any cancer that develops in the colon or rectum, stands alone with mortality rising 1.1% each year since 2005. That steady increase pushed it past lung cancer in 2023 to become the number one cause of death due to cancer.

Why is colon cancer rising in young people?

Researchers don’t have a definitive answer on what’s behind young people developing colorectal cancer, but the evidence right now points to lifestyle and environmental factors.

Arif Kamal, MD, chief patient officer for the American Cancer Society, said Americans don’t eat enough fruits, vegetables, and whole grains, while consuming too much red meat, particularly smoked or highly processed varieties.

He noted how obesity increases colorectal cancer risk, and obesity rates are steadily climbing.

Another factor, he told Healthline, is that the colon is uniquely vulnerable because “everything you put into your body, your colon will see.”

Despite these clues, the full picture remains unclear.

Anjee Davis, CEO of advocacy organization Fight Colorectal Cancer, told Healthline that answers wouldn’t be as elusive if cancer were more of a national priority.

“We have to figure out why this keeps rising in young people because in our community, we hear it as young as 11 years old, 17 years old, 20 years old,” she said. “It really breaks my heart.”

Early detection for colorectal cancer is crucial

The report shows that three out of four patients under 50 receive their diagnosis after the disease has already reached an advanced stage.

“Mortality has everything to do with when you find the cancer in its growth trajectory,” Kamal said.

Early detection dramatically improves survival odds. The Centers for Disease Control and Prevention (CDC) reports that about 89% of people diagnosed at the earliest stage live at least five years. For those diagnosed at the most advanced stage, that figure drops to 16%.

A 2024 study found that four to six months typically passed between symptoms appearing and patients receiving a diagnosis.

The most common warning signs included:

abdominal pain
blood in stool
changes in bowel habits (i.e., persistent diarrhea or constipation)

Other red flags were unexplained weight loss, persistent fatigue, and feeling like a bowel movement isn’t quite finished.

High risk groups: Who should get screened early?

While most people should start screening at age 45, family history, genetic conditions, and certain symptoms push that timeline for many.

Of those at average risk because of their age, under 30% of 45- to 49-year-olds are up to date on their screenings, according to the CDC and the ACS. That’s far below the more than 70% of older adults who keep up with screenings.

Two demographic groups are at an increased risk. Native Americans and Alaska Natives lead the world in incidences of colorectal cancer, prompting some communities to encourage screenings to begin at 40.

Black men die from colon cancer disproportionately, with ACS data showing a more than 40% higher risk of dying than whites, making early screening critical for this group.

Family history and genetics

Family history requires careful attention. Kamal noted that there is nuance in determining if someone is at an increased risk based on their family history and genetics.

Anyone with a parent or sibling who had colon cancer carries an increased risk and should typically start screening 10 years before that family member’s diagnosis age.

For example, someone whose mother was diagnosed at 45 should start screening at 35.

The risk extends beyond direct links to colon cancer. Family histories of stomach, pancreatic, or breast cancer also elevate colorectal cancer risk, Kamal said. “There are certain cancers that run kind of with each other, and in different people show up in different ways.”

Genetic conditions like BRCA2 mutations and inflammatory bowel diseases like Crohn’s disease or ulcerative colitis also put people in higher-risk categories, he said.

Kamal recommended compiling family medical information and bringing it to a doctor’s appointment. “Write all that down. Go talk to your doctor,” he said.

Colon cancer stigma may deter early detection

Multiple forms of stigma may keep people from getting screened, which experts say helps explain why so many cases reach advanced stages before diagnosis.

Lynn Durham, EdD, president and CEO of Georgia CORE and a cancer survivor, sees the reluctance to discuss bathroom habits causing real harm. Her organization recently completed a statewide awareness campaign about recognizing warning signs early.

“People don’t want to talk about their poop. They don’t want to talk about anything indelicate like that,” Durham told Healthline. “If you have dramatic changes in your stool, there’s something going on, and you need to see your doctor right away.”

Davis advocates for treating bowel health like any other health topic, starting with family conversations.

“When you have a little baby, you’re talking about their poop all the time,” she said. “When’s the last time they pooped? When’s the last time you changed their diaper?”

Those conversations typically end as children age, but Davis thinks people need to maintain that openness throughout life by asking straightforward questions:

How regular are you?
Is there a change in your bowel habits?
Have you talked to your doctor about poop, rectal bleeding, gas, diarrhea, or constipation?

“We can socialize that this is just a part of gut health… we just have to make it normalized.”

Stigma also affects medical providers. Kamal said many doctors still associate cancer primarily with older adults, creating a blind spot when younger patients report symptoms.

Providers rarely ignore a breast lump in a 35-year-old, he noted, but routinely dismiss belly pain and blood in stool as ordinary digestive issues.

Doctors and individuals alike often dismiss colon cancer symptoms because they mimic common, minor ailments. Kamal said that’s part of what drives the mortality rate.

Davis said those with symptoms or a higher risk shouldn’t accept dismissive explanations.

“If a doctor says, ‘I think you’re fine. You should just, you know, eat fiber, do fruit shakes’ … Find another healthcare provider,” Davis said.

“I really feel like our young onset patients need to be heard, and sometimes they are too scared to say, ‘you know, I need to go find somebody else that will listen to me,’” she said.

Colorectal cancer prevention, lifestyle changes

While research on cancer prevention continues to evolve, doctors know certain lifestyle changes can make a difference.

Limiting red and processed meats and eating more vegetables, fruits, and whole grains may help lower your risk of developing colorectal cancer.

Maintaining a healthy weight, exercising regularly, reducing alcohol consumption, and quitting tobacco use can also help.

“It’s this idea that there are lifestyle changes you can make starting today that’ll affect your risk of colon cancer 10 years from now,” Kamal said.

For Durham and Davis, the urgency is personal. Durham survived cancer three times. Davis has spent years advocating for patients who were diagnosed too late.

“The fact that this is a preventable cancer makes it tragic,” Davis said. “We have it in our power to figure out why. I know we do.”

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