Colorectal Cancer in Young Adults

More young people are being diagnosed with colorectal cancer every day. This trend is unsettling, unnerving, and unacceptable — and it’s why Fight CRC is on the front lines. We partner with researchers worldwide and rally communities for awareness, advocacy, and support.

Colorectal cancer is no longer just a disease of older adults. Data shows a sharp rise in early-age onset colorectal cancer (EAO CRC):

• Rates are increasing in every racial and ethnic group in the U.S.
• One in five new cases now occurs in patients in their early 50s or younger.
• Among adults under 50, colorectal cancer is the number one cause of cancer death in men and number two in women.
• By 2030, colorectal cancer is projected to be the leading cause of cancer deaths for ages 20–49 (JAMA, 2021).
• In the U.S., cases diagnosed under age 55 nearly doubled from 11% in 1995 to 20% in 2019.
• Rectal cancer is largely driving this trend, with women experiencing the largest relative increases.

Geographic and demographic differences are also striking:

• Black patients with early-onset CRC receive less timely, guideline-based care compared to white patients (Journal of Clinical Oncology).
• Hispanic/Latino men were among the fastest growing demographics between 1992 and 2005 (Cells).
• Incidence is highest in the South and Appalachia (Gastroenterology).

The causes are not fully understood. While 20–30% of patients have a family history and 3–5% carry an inherited genetic syndrome, most young patients have no known risk factors.

Researchers are investigating:

• Environmental exposures
• Lifestyle influences
• Genetic and molecular tumor differences
• Birth cohort effects

Fight CRC’s Path to a Cure initiative and our Early-Age Onset Think Tank are dedicated to uncovering answers and fueling solutions.

The symptoms of colorectal cancer are the same across age groups, but young patients are more likely to be misdiagnosed or dismissed. A Komodo Health study with Fight CRC found young patients often report:

• Abdominal pain
• Muscle weakness
• Anemia
• Bright red blood in stool

Other warning signs include unexplained fatigue, weight changes, and persistent changes in bowel habits.

If you notice these symptoms:

• See a doctor right away — don’t delay.
• If you can’t get an appointment but are bleeding or in pain, go to the ER.
• Be persistent in seeking answers. Often, a colonoscopy is necessary.

“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.” Source: American Cancer Society

Many young adults experience misdiagnosis or feel gaslit when reporting symptoms. Trust yourself. If something feels wrong, continue pushing for answers until the root cause is found.

Financial barriers are real — but resources exist:

• 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.

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.

Become an Advocate

• Educate medical professionals: Bring awareness of rising cases in people under 50. Share our EAO CRC brochure.
• Know your family history: Document cases of colon polyps, colorectal cancer, or related conditions. Share this with your doctor.
• Spread awareness: Post colorectal cancer screening information and statistics on social media.
• Share your story: Patient and caregiver stories drive awareness and policy change.

Share Your Story

Save the Booties: Early Onset Colorectal Cancer Webinar

Colorectal cancer diagnoses have been on the rise—especially among young people. In this webinar, Fight CRC explored the latest research on early-onset cancer, our efforts to address this growing problem, and the unique challenges young adults face after a CRC diagnosis.