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Colorectal cancer and adults under 50: A growing risk

A woman and her doctor look at a tablet.

March 2, 2026—If you're under 50, you probably don't spend much time worrying about colorectal cancer. But new research suggests it deserves your attention. Colorectal cancer has become the leading cause of cancer death among U.S. adults younger than 50, according to a recent research letter published in JAMA.

That's a dramatic shift. Back in the 1990s, it ranked fifth.

Underneath the scary headline, there's good news along with the bad news. Overall, cancer death rates for people under 50 fell by 44% between 1990 and 2023. In fact, colorectal cancer is the only major cancer in this age group that's seen deaths go up.

But death rates from colorectal cancer have risen by an average of 1.1% per year since 2005, researchers report.

That steady climb has health experts concerned. One reason why? Three out of four patients under 50 are diagnosed after the cancer has already reached an advanced stage.

Here's what you should know, and what you can do about it.

Warning signs to watch for

Because younger adults aren't typically screened for colorectal cancer, most early-onset cases are caught because of symptoms. According to the American College of Surgeons, research shows that 88% of young patients diagnosed with colorectal cancer had a colonoscopy because of symptoms and not during a routine screening. And 70% of young patients have no family history of the disease.

That makes knowing the warning signs really important. Watch for:

  • Abdominal pain.
  • Rectal bleeding or blood in the stool.
  • Changes in bowel habits, especially diarrhea.
  • Iron-deficiency anemia.
  • Fatigue.
  • Unexplained weight loss.

According to research from the National Cancer Institute, having even one of these signs is linked to twice the risk of a colorectal cancer diagnosis in younger adults. For those with three or more, the risk was six times as high.

Detecting cancer early matters. When colorectal cancer is found early and hasn't spread, the five-year survival rate is above 90%. But once it has spread to distant organs, that rate drops to about 15%.

So if you notice any of these symptoms, don't brush them off. See your healthcare provider so you can get checked out.

Screening can save lives

Learn more about what screening options are available, including colonoscopy and at-home stool tests, and ask your healthcare provider which one is right for you.

For people at average risk, colorectal cancer screening should start at age 45. If you have a family history or a genetic condition that raises your risk, talk to your doctor about starting earlier.

Sources

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