What's Happening with Colorectal Cancer?
Colorectal cancer, cancer that starts in the colon or rectum, is the second leading cause of cancer death in the United States. While overall rates have been dropping for decades thanks to screening, a troubling pattern has emerged: colorectal cancer is rising sharply among younger adults.
Since the mid-1990s, cases in people under 50 have been increasing by about 2% each year. In 2019, one in five colorectal cancers occurred in someone 54 years or younger, compared to just one in ten cases in 1995. Even more concerning, death rates from this cancer are now increasing in younger adults while continuing to fall in older age groups.
Why This Matters
This shift is happening for reasons scientists don't fully understand. Most younger people with colorectal cancer have no family history of the disease—about 75% of cases appear to be "sporadic," meaning they occur without an obvious genetic cause. The increase appears linked to changes in how we live and eat. People born after 1950 face higher risks than earlier generations, suggesting that exposures during childhood and young adulthood play an important role. The risk for someone born in 1990 is double that of someone born in 1950 for colon cancer, and four times higher for rectal cancer.
Without action, this trend could reverse decades of progress against colorectal cancer as these high-risk generations age.
What Increases Your Risk?
Research has identified several factors that raise your chances of developing colorectal cancer:
- Diet-related factors:
- Regular consumption of red meat (beef, pork, lamb) and processed meats (bacon, sausage, hot dogs, deli meats)
- Drinking two or more sugar-sweetened beverages daily, especially during teenage years
- Low intake of fruits, vegetables, and whole grains
- Heavy alcohol consumption
- Lifestyle factors:
- Being overweight or obese, particularly during adolescence and young adulthood
- Physical inactivity and prolonged sitting
- Smoking
How to Protect Yourself
The good news is that you can take concrete steps to lower your risk.
Get screened. Screening is one of the most powerful tools for preventing colorectal cancer because it can find and remove precancerous polyps before they turn into cancer. Current recommendations:
- Start screening at age 45 for people at average risk
- Start earlier (age 40 or 10 years before the youngest family member's diagnosis) if you have a family history of colorectal cancer or advanced polyps
- Continue screening through age 75
- Several screening options exist, including colonoscopy every 10 years and annual stool-based tests. Talk with your doctor about which option is best for you.
Make Healthy Lifestyle Choices. Evidence shows that the following habits can reduce your colorectal cancer risk:
- Maintain a healthy weight through balanced eating and regular activity
- Stay physically active with at least 150 minutes of moderate exercise weekly
- Eat more plant-based foods: fruits, vegetables, whole grains, and beans
- Limit red and processed meats: choose fish, poultry, and plant proteins instead
- Increase fiber intake from whole grains, legumes, fruits, and vegetables
- Include dairy products: milk, yogurt, and cheese (good sources of calcium)
- Avoid or limit alcohol
- Don't smoke or quit if you currently smoke
- Limit sugar-sweetened beverages
Pay Attention to Symptoms. Don't ignore warning signs, regardless of your age. See your doctor promptly if you experience:
- Rectal bleeding or blood in your stool
- Persistent changes in bowel habits
- Unexplained abdominal pain
- Unintended weight loss
Younger adults often experience delays in diagnosis because both patients and doctors may not consider colorectal cancer as a possibility. Early evaluation of symptoms is critical.
The Bottom Line
Colorectal cancer is increasingly affecting younger people, but it's also one of the most preventable cancers. Regular screening starting at age 45, combined with healthy eating and lifestyle habits, can dramatically reduce your risk. If you have a family history of colorectal cancer, talk to your doctor about starting screening earlier.
The choices you make today, including what you eat, how active you are, whether you get screened, can make a real difference in protecting yourself from this disease.
