Understanding Why Colorectal Cancer Rates are Surging in Adults Under 50

In the 1990s, colorectal cancer was the fourth-leading cause of cancer deaths in men and women under 50. But the latest data from the American Cancer Society (ACS) has found a striking shift: Colorectal cancer is now the top cause of cancer death in men under 50, and second to only breast cancer for women under 50.

March is Colorectal Cancer Awareness and this year the concerning trend among younger adults is getting much of the attention, partly because the factors behind their surging rates of diagnoses are unclear.

Overall, the rate of people being diagnosed with colorectal cancer each year has dropped overall since the mid-1980s. That’s primarily due to more people getting screened and modifying lifestyle-related risk factors, including weight management, healthier eating and regular physical activity.

From 2011 to 2019, colorectal cancer incidence rates dropped by about 1 percent each year. But this downward trend is mostly in older adults. In people younger than 55 years of age, rates have been increasing by 1 percent to 2 percent a year since the mid-1990s, states the ACS. 

More Research Needed on Genetic Factors

Clinical studies on colorectal cancer have not discerned all the genetic factors behind early-onset diagnoses.

Colorectal cancer includes cancers of the colon or the rectum. depending on where they start. Colon cancer and rectal cancer are often grouped together because they have many features in common. The three primary factors that makes a person at higher risk of developing colorectal cancer are: A strong family history of colorectal cancer or certain types of polyps; A personal history of colorectal cancer or certain types of polyps; A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease).

Modifiable or Treatable Risk Factors

There are several modifiable risk factors, starting with obesity.

U.S. guidelines recommend that people 45 to 75 years of age be screened for colorectal cancer to reduce their risk of dying from this disease. Those who are at above-average risk should consult a physician and be screened at an even earlier age.

Up to one-third of people diagnosed with colorectal cancer before 50 have a family history or genetic predisposition, and should begin screening before age 45 years. 

Vital Importance of Family History

All patients, particularly those younger adults possible at higher risk, should have frank discussions with family members about any history of cancer.

And there is the matter of not knowing, ignoring or putting off colorectal cancer screenings. Another striking trend reported by the American Cancer Society: Nearly 80 percent of adults between the ages of 45 and 50 have not been screened.