Young adult colorectal cancer is an unsettling, alarming trend. This phenomenon is also called early-age onset colorectal cancer (EAO CRC) or early onset colorectal cancer (EOCRC), which refers to people under age 50 facing the disease.

Not only are younger patients getting diagnosed with colon cancer or rectal cancer every year at increasing rates, but the diagnoses are coming at later stages—when the cancer is more advanced and harder to treat. Rates amongst young patients are on the rise in every racial and ethnic group in the U.S.

1 in 5 new cases now occur in patients who are in their early 50s or younger.

Why is EAO CRC happening?

The answers to “why” have largely gone unanswered.

We know that 20%-30% of all colorectal cancer patients have a family history and 3%-5% of patients have an inherited genetic syndrome. However, most young adult colorectal cancers are sporadic, meaning they’re not the result of a genetic or familial syndrome and typically, the cause is unknown.

Reasons for the sharp increases are not clear, but urgent research is underway in areas like evaluating birth cohorts (groups of people based on when they were born), environmental factors, lifestyle factors, and genetic and molecular tumor types of EAO CRC patients.

Fight CRC’s Path to A Cure and Early-age Onset Colorectal Think Tank series is moving the needle when it comes to researching the rising incidence around the world. We are convening and working with top researchers and scientists to uncover the “why” and find ways to prevent, treat, and support EAO CRC patients and their families. We are also funding researchers focusing on EAO CRC patients.

Meet the researchers we’ve funded and learn how to support the cause.

Are the signs and symptoms different between young and older colorectal cancer patients?

The signs and symptoms of colorectal cancer are the same for all patients; however, Fight CRC and Komodo Health partnered on a study and found many young colorectal cancer patients are going to the ER and reporting these types of symptoms more frequently:

• Abdominal pain
• Muscle weakness
• Anemia

Additionally, younger patients are reporting seeing bright red blood in/on poop.

Any sign or symptom, such as extreme fatigue, unexplained weight changes, or changes in bowel movements should be taken seriously and given medical attention.

What should a young adult do if they’re seeing signs or symptoms?

It’s incredibly important to see a doctor about any signs or symptoms you’re experiencing. If you cannot get in to see your primary care doctor or medical team, but you’re in pain or losing blood, go to the ER.

Be insistent about finding the root cause of your symptoms. Not always, but often, a colonoscopy will be needed.

Here’s a startling finding by the American Cancer Society: “A study of symptomatic patients found a 40% longer time to diagnosis among individuals younger than 50 years versus older individuals, including both longer duration of symptoms and work-up time, often because of misdiagnosis with more common conditions.”

Unfortunately, misdiagnosis is very common among young adults with colorectal cancer. That’s why it’s important to take quick action if anything feels off with your body and not stop until you’ve found what’s causing your symptoms.

What if I cannot afford to see a doctor?

This is an unfortunate reality for many, many patients—especially young patients. We urge you to not give up—especially if you’re seeing signs or symptoms. You need to get checked out.

Here are a few ways to find financial assistance:

• Colonoscopy Assist Program: Provides colonoscopy procedures at select facilities at an all-inclusive rate.
• Ask to speak with a hospital social worker or screening patient navigator and ask about local foundations or resources that provide assistance, and insurance options if you’re uninsured.
• Call the hospital or clinic and ask about payment plans, discounted care programs, or special programs for low or reduced cost screening.
• Some faith communities offer Care Funds that can help with medical expenses.

Why isn’t the screening age lower if young adults are getting colon and rectal cancer more and more?

Research data is what drives official recommendations on the screening age. As more data becomes available, recommendations can change. The current screening age guidelines followed by most insurance companies are set by the USPSTF, and their screening age recommendation was lowered to begin at age 45 instead of age 50 in 2021. They evaluate recommendations at least every five years.

Fight Colorectal Cancer, along with many other professional societies, offer public comments each time the screening age is being evaluated, urging decision-makers to consider the rising incidence of colorectal cancer and how to prevent more cases in young adults.

It will continue to take advocacy and research to make changes to the screening age guidelines. If you’re ready to be involved, register as an advocate. We will notify you of any actions we’re taking together regarding the screening age, along with other health policies impacting our community.

What do the statistics say?

In 2030, it is estimated that colorectal cancer will be the leading cause of cancer deaths for those ages 20-49, according to a 2021 JAMA study.

The American Cancer Society Cancer Facts & Figures 2024 report showed:

• In men under 50, colorectal cancer is the number ONE cause of cancer related deaths.
• In women under 50, it is the second most common cause of cancer related deaths (after breast cancer).

In Colorectal Cancer Statistics 2023, it was revealed:

• Rates have been increasing in adults ages 20–39 years since the mid-1980s and in those ages 40–54 years since the mid-1990s.
• Number of patients in the U.S. diagnosed under 55 years of age doubled from 11% in 1995 to 20% in 2019.
• Number of patients in the U.S. diagnosed with advanced-stage colorectal cancer increased from 52% in the mid-2000s to 60% in 2019.

Rectal cancer is largely driving this trend. Increasing rates of colorectal cancer in young adults are also being seen in many high-income countries around the world.

While the entire U.S. is seeing increases, some groups and areas are seeing even steeper inclines of young adult colorectal cancer:

• “Patients with early-onset CRC racialized as Black receive worse and less timely care than individuals racialized as White. Health insurance, a modifiable factor, was the largest contributor to racial disparities in receipt of guideline concordant care in this study.” Source: Journal of Clinical Oncology
• “Hispanic Latino men were among the fastest growing demographic of early-onset CRC, with an annual increase of 2.7% from 1992 to 2005.” Source: Cells
• “Early-onset CRC incidence is highest in southern states and Appalachia.” Source: Gastroenterology
• The largest relative increases in rectal cancer incidence have occurred in women. Source: Gastroenterology

Young adult colorectal cancer is maddening—what can I do NOW?!

We get it 100%. And we are with you.

We will continue applying pressure through research and advocacy. While these efforts take time, they are effective in creating systemic changes that ultimately affect lives like yours and ours.

In the meantime, however, you can become an advocate and make your voice heard in these ways:

• Educate medical professionals of the increasing incidence of colorectal cancer in the under 50 population—talk about it at your checkups and doctors appointments. Make them aware. Need materials? Start with our EAO CRC brochure.
• Delve into your biological family history (if you’re able). Ask if anyone has had colon polyps, cancer of the colon or rectum, or any other disorders that may increase your risk of colorectal cancer. Write it down and notify your doctor at your next appointment, as well as other family members.
• Share colorectal cancer screening information on social media.
• If you’ve been impacted by colorectal cancer, share your story, and share the stories of other patients. Stories get attention.

What if I’m a young adult and I was diagnosed with colorectal cancer?

We are so sorry you’re experiencing a diagnosis, but we are thankful you’ve found us here at Fight CRC. Many of our advocates are also EAO CRC patients and caregivers.

If you’re newly diagnosed, please check out our resources. We’re here to guide you through the fight and offer support every step of the way. Join a meetup to talk with others. Subscribe to Beyond Blue for stories of hope.

And: Be sure to check out The Colon Club, a space created for young adults fighting colorectal cancer way too young.