Colorectal Cancer: Rising trends in Adults Under 50 – And What You Should Know

Colorectal cancer is the third most common cancer globally and the second leading cause of cancer-related death In 2022, over 1.9 million new cases and 904,00 deaths were estimated worldwide. In the United State, approximately 153,020 new cases and 52,550 deaths were projected for 2023 American Cancer Society.  

A concerning trend is the rising incidence in younger adults. Since 2021, rates have increased by 2% annually in people younger than 50 years and 20% of colorectal cancers in 2019 occurred in individuals aged 54 or younger from 11% American Cancer Society. 

What is Colorectal Cancer? 

Colorectal cancer includes cancers of the colon and rectum. Most cases begin as small growths called polyps inside the colon. Over time, some polyps can develop into cancer. In its early stages, colorectal cancer often causes no noticeable symptoms, which is why routine screening is so important. Detecting and removing precancerous polyps can prevent cancer before it starts.  

Why Are Younger Adults Getting Colorectal Cancer? 

The rising incidence of colorectal cancer in younger adults is primarily driven by modifiable lifestyles and environmental factors, particularly obesity, Western dietary patterns and sedentary behavior, though the exact mechanism remains incompletely understood. While genetics play a role in some cases, most early onset colorectal cancer is sporadic, suggesting that exposures occurring early in life are major contributors (JAMA 2025). Smoking and alcohol are established risk factors. Proposed mechanism linking these risk factors to early onset colorectal cancer likely involves chronic inflammation, insulin resistance and gut microbiome disruption.  

Prognosis  

The 5-year relative survival rate for colorectal cancer has improved from 50 % in the mid-1970s to 64-65% currently, reflecting early detection through screening and advances in treatment  

Stage-specific 5-year survival rate 

• Stage I: >90%
• Stage II: 82-84%
• Stage III 59-71%
• Stage IV 12-16% 

Symptoms of Colorectal Cancer in Younger Adults 

The most concerning symptoms for colorectal cancer include.   

• Rectal bleeding or blood in your stool
• Abdominal pain or cramping that does not go away
• Altered bowel habits
• Unexplained iron deficiency anemia
• Unintentional weight loss  

In adults under 50, symptoms are sometimes overlooked or attributed to stress, diet, or hemorrhoids. According to NCCN guidelines, all patients regardless of age who present with these symptoms should undergo prompt evaluation (National Comprehensive Cancer Network. Updated 2025-06-24. ) 

Screening 

 Colonoscopy is the Gold Standard for Screening for Colorectal Cancer  

Current guidelines recommend starting colorectal cancer screening at age 45 for average risk individuals American Cancer Society. Screening should continue through age 75, with individual decisions for ages 76-85 based on life expectancy and prior screening history ( National Comprehensive Cancer Network) 

For individuals with increased risk based on family history, screening recommendations differ. Those with one first degree relative with colorectal cancer diagnosed before age 60 should begin colonoscopy at age 40 or 10 years before the youngest affected relative’s diagnosis, whichever comes first, and repeat every 5 years.  

At Holy Cross Health in Fort Lauderdale, our Gastroenterology (GI) and colorectal specialists provide comprehensive colorectal cancer screening and treatment. Colonoscopy remains the gold standard screening method because it allows physicians to detect and remove polyps during the same procedure, reducing cancer risk before it develops.  

If cancer is detected, our multidisciplinary team works closely with oncology specialists to create a personalized treatment plan using advanced, minimally invasive techniques whenever possible. Our team partners with each patient to determine the right timing for screening based on individual health, risk factors, and family history.  

Take the Next Step 

If you are 45 or older or experiencing concerning symptoms, do not wait. 
Early detection saves lives. 

Schedule a colorectal cancer screening or connect with a Holy Cross Medical Group colorectal surgeon or GI specialist today.