An increasing number of people are dying of colorectal cancer at a young age, including those as young as 20. The recent death of actor James Van Der Beek, who was diagnosed with colorectal cancer in 2023 and passed away on , has brought renewed attention to this concerning trend.
Colorectal cancer, encompassing cancers of the colon and rectum, is historically considered a disease of older adults. However, diagnoses are rising significantly in individuals under 50, now representing the leading cause of cancer deaths in this age group. This shift has prompted medical professionals to urge younger adults – even college students – to be aware of potential symptoms and discuss any concerns with their doctors.
Why the Rise in Young-Onset Colorectal Cancer?
Researchers are actively investigating the reasons behind this increase, but a single definitive answer remains elusive. Several factors are believed to contribute, including lifestyle choices, changes in the gut microbiome, and potentially, genetic predispositions. While lifestyle factors like diets high in ultra-processed foods and alcohol consumption, coupled with a lack of physical activity, are correlated with increased risk, it’s important to note that these are associations, not proven causes.
A growing area of focus is the gut microbiome – the complex ecosystem of microorganisms residing in the digestive tract. Disruptions in the balance of these microbes, known as dysbiosis, can lead to inflammation and potentially increase cancer risk. Further research is needed to fully understand the interplay between the gut microbiome and the development of colorectal cancer in younger individuals.
Recognizing the Symptoms
Early detection is crucial for improving survival rates. The most common signs and symptoms of early-onset colorectal cancer include blood in the stool, abdominal pain, and changes in bowel habits. Unexplained anemia, or low red blood cell levels, can also be a warning sign. It’s important to emphasize that experiencing these symptoms doesn’t automatically indicate cancer, but they warrant a prompt discussion with a physician.
Yale Medicine doctors have reported diagnosing colorectal cancer in young patients who initially attributed their symptoms, such as rectal bleeding, to less serious conditions like hemorrhoids. In one instance, a practice saw seven patients under the age of 35 diagnosed with rectal cancer within a single week, including an 18-year-old.
Risk Factors Beyond Genetics
While genetic factors and family history play a role in some cases – approximately 20% of colorectal cancer patients under 50 have an inherited genetic mutation – they don’t account for all instances. Lifestyle factors significantly influence risk. A diet high in red and processed meats, low in fiber, and regular alcohol consumption are all associated with increased risk. Smoking, obesity, and a sedentary lifestyle also contribute.
Screening and Prevention
Current screening guidelines generally recommend starting regular colorectal cancer screenings at age 45 for individuals with average risk. However, those with a higher risk – due to family history, hereditary conditions, or inflammatory bowel disease – may need to begin screening earlier and more frequently. The American Cancer Society reported in 2023 that rates of advanced disease increased by about 3% annually in people younger than 50.
Several screening options are available, including stool-based tests that check for blood and abnormal cells, and imaging scans like colonoscopies that visualize the colon and rectum. The choice of screening test should be discussed with a healthcare provider to determine the most appropriate approach based on individual risk factors.
Survival Rates and the Importance of Early Detection
The debate continues regarding whether survival rates differ between those diagnosed with early-onset colorectal cancer and those diagnosed at an older age. However, early detection remains paramount. When colorectal cancer is found at an early stage, five-year survival rates can be as high as 80% to 90%. However, when diagnosed at an advanced stage, after the cancer has spread, survival rates drop to 10% to 15%.
Some studies suggest that young patients with metastatic colon cancer may have slightly lower survival rates compared to those aged 50 or older, highlighting the importance of prompt diagnosis and treatment in this population.
Taking Control of Your Health
Proactive communication with your healthcare team is essential. Discuss your personal risk factors, including age, family history, and any symptoms you’re experiencing, to determine the appropriate screening schedule. Adopting a healthy lifestyle – including regular physical activity, a diet rich in fruits, vegetables, and fiber, and limiting processed foods, alcohol, and tobacco – can also help reduce your risk.
Sharing your personal and family history of polyps or colorectal cancer with your doctor and loved ones can contribute to early detection and potentially save lives. Understanding your risk and taking preventative measures are key steps in protecting your health.
As noted in a 2026 study published in the Journal of the American Medical Association, while overall cancer mortality decreased by 44% in people younger than 50 between 1990 and 2023, colorectal cancer increased by 1.1% each year since 2005, rising from the fifth to the first leading cause of cancer deaths in this age group.
