Colorectal Cancer Now Leading Cause of Cancer Death in Younger Adults
- Colorectal cancer is now the leading cause of cancer-related death among adults under 50 in the United States, a concerning shift from its position as the fifth leading...
- While overall cancer death rates in individuals younger than 50 have fallen by 44% since 1990, colorectal cancer (CRC) mortality has increased by 1.1% annually since 2005.
- The rising incidence of CRC in younger adults is prompting investigation into the underlying causes.
Colorectal cancer is now the leading cause of cancer-related death among adults under 50 in the United States, a concerning shift from its position as the fifth leading cause in 1990. This change, identified in research , published in JAMA, highlights a troubling trend as mortality rates for most other common cancers in this age group have declined.
While overall cancer death rates in individuals younger than 50 have fallen by 44% since 1990, colorectal cancer (CRC) mortality has increased by 1.1% annually since 2005. This makes it an “outlier,” according to Rebecca Siegel, senior scientific director of surveillance research at the American Cancer Society.
The rising incidence of CRC in younger adults is prompting investigation into the underlying causes. Experts suggest a combination of factors are at play, including delayed screening, lifestyle factors and potentially, changes in the disease itself.
The Role of Delayed Screening
One significant contributor to the increase in CRC deaths is a lack of timely screening. Current guidelines recommend that individuals at average risk begin regular screening at age 45. However, many individuals are not adhering to these recommendations. Jordan Karlitz, MD, senior medical officer of screening at Exact Sciences and a clinical educator at the University of Colorado School of Medicine, emphasizes that delayed screening leads to delayed diagnoses and treatment initiation at more advanced stages of the disease.
individuals with a family history of colorectal cancer or other risk factors may require screening at an earlier age than 45, a fact that is often unknown to those at increased risk.
Lifestyle and Risk Factors
Beyond screening, modifiable lifestyle factors play a role in CRC risk. A Western-style diet, characterized by high consumption of red and processed meats, and a sedentary lifestyle are associated with increased risk.
Recognizing the Symptoms
Early detection is crucial for improving outcomes in colorectal cancer. Key warning signs include rectal bleeding, abdominal pain, and changes in bowel habits. However, these symptoms are often dismissed or attributed to less serious conditions, particularly in younger individuals, leading to delays in seeking medical attention. Dr. Karlitz stresses the importance of taking these symptoms seriously and promptly seeking evaluation by a healthcare professional.
“We need to be vigilant about risk factors,” Dr. Karlitz stated. “We need to take symptoms seriously and get workups done quickly.”
Understanding the Shift in Cancer Mortality
The research letter also highlighted a contrasting trend: mortality rates for the four other leading causes of cancer-related death in those under 50—lung cancer, leukemia, breast cancer, and brain cancer—have all declined. Lung cancer deaths, in particular, fell from the leading cause in 1990 to fourth place in 2023, decreasing by nearly 6% annually from to . Leukemia deaths also saw a significant decline, dropping from third to fifth place over the same period, with an annual decrease of nearly 2.5%.
What So for the Future
The unexpected acceleration of colorectal cancer to the top spot—seven years earlier than previously projected—underscores the urgency of addressing this growing public health concern. The research analyzed data from nearly 1.3 million people younger than 50 who died of cancer between and , providing a comprehensive overview of cancer mortality trends in this age group.
While the reasons for the increase in CRC among young adults are still being investigated, the findings emphasize the need for increased awareness, improved screening rates, and a focus on modifiable risk factors. Early detection remains the most effective strategy for improving outcomes and reducing the burden of this increasingly prevalent cancer.
Reference
McCormick B. CRC becomes leading cause of cancer-related death in younger adults, highlighting prevention gaps. AJMC®. . Accessed . https://www.ajmc.com/view/crc-becomes-leading-cause-of-cancer-related-death-in-younger-adults-highlighting-prevention-gaps