Researchers are finally getting to the bottom of a troubling trend.
Once considered a disease of older adults, colorectal cancer has now overtaken breast and brain cancers to become the leading cause of cancer deaths among Americans under 50.
But a new study suggests that the burden isn’t spread evenly, finding that deaths among younger adults are overwhelmingly concentrated in one group.
Researchers at the American Cancer Society analyzed government data on more than 101,000 adults ages 25 to 49 who died from colon and rectal cancers between 1994 and 2023.
Over that 30-year span, the overall death rate rose from about 3 to roughly 4 per 100,000 people in the age group.
Once they dug deeper, a stark divide emerged.
The increase was driven almost entirely by people without a four-year college degree.
In this group, death rates climbed from about 4 to 5.2 per 100,000, while rates for those with at least a bachelor’s degree held steady at around 2.7 per 100,000.
Overall, the gap in death rates between people with a high school education or less and college graduates has nearly doubled since the mid-1990s.
Before you hit the course catalog, keep in mind the diploma isn’t acting as a shield.
Education level is closely tied to income and access. People without college degrees are more likely to work lower-paying jobs that don’t offer health insurance or paid time off, making it harder to get preventive care or see a doctor early.
Those disadvantages don’t stop at the workplace. They spill into daily life in ways that can raise disease risk.
For example, lower education is linked to poorer health literacy, which can make it harder to understand symptoms and navigate the medical system.
People without college degrees are also more likely to live in neighborhoods with higher exposure to environmental pollutants and fewer healthy food options or fitness facilities.
On top of that, smoking rates tend to be higher, while financial strain can drive chronic stress, another well-established risk factor for worse health outcomes.
While researchers are still trying to pinpoint exactly why colorectal cancer is rising so sharply in younger adults, many of these factors — including poor diet, pollution exposure and delayed care — are among the leading suspects.
In 2026, the American Cancer Society estimates more than 158,000 new colorectal cancer cases will be diagnosed in the US, and over 55,000 people will die from the disease.
Nearly half of those diagnoses are expected to be in people younger than 65, a sharp shift from the 1990s, when the disease was largely confined to older adults.
In response to the rising toll, the American Cancer Society lowered the recommended starting age for screening from 50 to 45 in 2021.
Doctors are also urging younger people to watch for warning signs like changes in bowel habits, unexplained weight loss, abdominal pain, blood in stool and persistent fatigue.
That awareness could be lifesaving. Three out of four colorectal cancer patients under 50 are diagnosed at an advanced stage, often because symptoms are missed or brushed off.
And when it comes to cancer, timing is everything. The later it’s caught, the harder it is to beat.
