Most types of cancer have become less deadly over time among adults under 50 in the U.S., but cancers of the colon and rectum continue to take lives at an alarming rate. A new report from the American Cancer Society. Data show that colorectal cancer has officially become the number one cause of cancer-related deaths among young people.
The report analyzes annual US mortality rates from 1990 to 2023 for the top five deadliest cancers for men and women under 50 – an age group that researchers are tracking to understand early cancer risk. Encouragingly, the overall cancer mortality rate in the age group declined by 44 percent. But rates of colorectal cancer among young people have been rising steadily in recent decades, and the disease is projected to rise from the fifth leading cause of cancer deaths in 1990 to the first in 2023.
“This is an inflection point,” says William Duhut, chief scientific officer of the American Cancer Society. “This is the first time it’s the number one cause of cancer deaths among people under 50.”
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Amanda Montanez; Source: “The leading cause of cancer deaths among people under 50,” Rebecca L. By Siegel et al. Published online 22 January 2026 (data)
Deaths from all other major cancers, including breast, lung and pancreatic cancer, have declined – which Dahut largely attributes to improvements in treatments. “I think this is another important statement that our investment as a nation in science to develop better treatments is paying off in our young adults,” he says.
In contrast to these positive trends, only colorectal cancer mortality rates have worsened. The findings show that it is the leading cause of cancer deaths in men and second only to breast cancer in women – and that it has become the leading cause of cancer deaths for the overall population. Many cancers, including colorectal cancer, are commonly seen later in life in people’s 60s and 70s, says Jeff Meyerhart, M.D., a gastrointestinal oncologist and co-director of the Colon and Rectal Cancer Center at the Dana-Farber Cancer Institute.
“These are considered cancers of aging,” he says. “At least in the case of colorectal cancer, the age (of onset) was determined for a long time, until recently.”
Since the 1990s, cases of colorectal cancer among people under age 50 have increased by about 2 percent annually. And Most cases are diagnosed in the later stagesWhen they are more difficult to treat.
“About three quarters, maybe 60 to 70 percent, of people (under age 50) have more advanced disease,” says Andrea Sersek, MD, founder and co-director of the Center for Young Onset Colorectal and Gastrointestinal Cancer at Memorial Sloan Kettering Cancer Center. She says that despite advances in the treatment of colorectal cancer, survival rates in advanced stages of the disease are still low. “Unfortunately, this is what I expected to see,” Sersek says of the new data.
Late diagnosis is a potential factor leading to more severe and fatal cases. In the US, screening for colorectal cancer is usually done using the gold standard, colonoscopy. It is recommended to start at the age of 45 Most people do not have a genetic or family history of the condition. that was the age recommendation It was reduced to less than 50 a few years ago In response to increasing incidence rates in younger age groups. Young people with colorectal cancer may not seek medical attention for symptoms such as bleeding in the stool, difficult bowel movements, swelling or signs of anemia, all of which can sometimes be confused with other health problems. And doctors may not consider screening such individuals for colorectal cancer because their age puts them at lower risk, Meyerhart says.
But some researchers think there’s more going on than delayed diagnosis.
Dahut says it usually takes several years for a colorectal polyp or small growth to develop into a cancerous tumor. Scientists are trying to understand when exactly tumors begin to grow and how fast they spread if cancer is occurring at a much younger age than previously thought. Sersec says the data shows fastest rise in cases It has occurred in children aged 20 to 30 years.
“If you think about the normal process for, let’s say, a 22-year-old person, the polyps would have started, literally, when they were 10 years old,” she says. This is plausible but difficult to ascertain without examining people at a very early age. Sersek says there may also be differences in tumor progression. “We are very interested to see if there is something in this process that could be faster, that could be different,” she adds.
Scientists are investigating several possible explanations for this trend, including diet, exercise, lifestyle, genetics, and environmental factors. microplastic And antibiotics. But many researchers agree that there is no single cause. Meyerhart says limiting the reliable factors will hopefully allow more targeted screening without increasing false positives or unnecessary surgeries or colonoscopies for young people at high risk of the disease. Sersek says improving treatments so they are less toxic for patients, as well as providing emotional and social support during recovery, will be important as the number of young people facing colorectal cancer continues to rise.
“The ‘big picture’ of what’s happening is worrying. But it’s extremely important to acknowledge that surviving a young adult with colorectal cancer is life-changing. It’s incredibly difficult and can be incredibly taxing from an emotional, physical and financial standpoint,” she says. “The earlier we can diagnose, the better it is for our patients.”
And perhaps such improvements in treatment and detection will eventually bring colorectal cancer into an equal existence with other cancers.
