For too long, colorectal cancer has carried the unfortunate label of an “older person’s disease.” It’s a perception that is dangerously outdated and, frankly, costing lives.
As someone embedded in the fight against cancer, working to improve outcomes and support patients, I can tell you unequivocally — we must change this narrative now.
The rising incidence of colorectal cancer in people under the age of 50 is one of the most alarming trends in modern oncology. What was once rare in young adults is now a painful reality, and we are seeing diagnoses and deaths at increasingly younger ages.
This isn’t just a blip on the radar — it’s a profound shift that is real and demands our immediate attention. It could fundamentally change how we approach screening and conversations about cancer risk.
Let’s look at the numbers. While overall colorectal cancer rates are declining in older adults, they are rising sharply in younger populations.
Since the mid-1990s, the incidence of colorectal cancer in people under 50 has increased by about 1% to 2% each year. This isn’t a small statistical anomaly; it means that approximately 1 in 10 colorectal cancer diagnoses are now made in individuals under the age of 50.
Even more startling, colorectal cancer is now the leading cause of cancer deaths for men under 50 and the second leading cause for women under 50. These statistics paint a stark picture: younger people are not just getting colorectal cancer more often, they are also succumbing to it at an alarming rate.
The current screening guidelines, which recently lowered the age at which to begin screening from 50 to 45, are critical. But they are just that — guidelines.
They are designed for the average-risk individual. What we’re seeing, however, is that “average risk” is no longer a simple, static concept. For a growing number of young people, waiting until 45 is simply too late.
This isn’t about fearmongering — it’s about empowerment through knowledge. It’s about arming younger generations with the understanding that they are not immune, and that proactive conversations can be lifesaving.
The power of prevention and timely intervention, principles that resonate deeply as we confront this emerging challenge in younger populations, should be highlighted. Identifying cancer at its earliest stages dramatically improves the chances of successful treatment and long-term survival.
So, what does this mean for you, whether you’re in your 20s, 30s or early 40s? It means you need to be an active participant in your health journey and advocate for yourself.
Don’t wait until you hit a magic number on the calendar to start thinking about colorectal cancer.
If you have a family history of colorectal cancer or polyps, particularly in a first-degree relative, your risk is elevated, and screening should begin at 40 or earlier.
If you or a family member have a history of inflammatory bowel disease (Crohn’s disease or ulcerative colitis) or known genetic syndromes like Lynch syndrome or familial adenomatous polyposis (FAP), your screening timeline must be accelerated.
These are clear indicators for earlier and more frequent surveillance, and your doctor needs to be aware of them.
But it’s not just about obvious risk factors. In fact, in many cases, there are often no obvious risk factors.
It’s important to listen to your body and take seemingly innocuous symptoms seriously. Young people, often healthy and active, are prone to dismissing symptoms as “stress” or “just a bug.”
This delay in seeking medical attention is tragically common and can allow cancer to progress to a more advanced stage.
Be aware of persistent changes in your bowel habits, rectal bleeding, unexplained abdominal pain, unintentional weight loss or fatigue. These symptoms, especially in combination, warrant a thorough evaluation.
My hope, and the message I want to impart, is for you to be vigilant, to challenge assumptions and to be your own best advocate. We, as health care providers, must also evolve our thinking. We need to be quicker to consider colorectal cancer in younger patients and not simply dismiss their concerns.
The conversations we have with our doctors are partnerships. Go prepared, share your full family history and describe any symptoms without downplaying them.
If you feel dismissed, don’t hesitate to seek a second opinion. In the landscape of modern medicine, personalized care and patient empowerment are paramount. That means being proactive about understanding your unique risk profile and taking control of your health narrative.
The tide is turning, but we need every individual to join us in this critical effort. Don’t wait until 45 or 50 to think about colorectal cancer.
Listen to your body, understand your risks, talk to your family about their colonoscopy history and results and start the conversation with your doctor today. Your future self will thank you.
Christine Molmenti, PhD, MPH is a cancer epidemiologist and co-director of Northwell’s Early-Onset Cancer Program.
