Colorectal cancer now leading cause of cancer deaths in younger Americans

Mercy gastroenterologists urge screenings for prevention and early detection

Colorectal cancer (CRC) has become the leading cause of cancer deaths among Americans under 50, surpassing breast cancer and several other major cancers, according to new national data.

More than 1.2 million U.S. adults under age 50 died of cancer between 1990 and 2023. In 2023 alone, nearly 4,000 people ages 20 to 49 died from colorectal cancer – slightly more than from breast cancer and far more than from other common cancers in this age group.

While mortality rates for most major cancers in younger adults have steadily declined throughout the last three decades, colorectal cancer is the only leading cancer showing an increase. Once the fifth‑leading cause of cancer death among younger adults in the early 1990s, it now ranks number one for men and women combined.

Experts say the trend is alarming given that colorectal cancer has long been seen as a disease affecting older adults. Rising incidence in younger people has accelerated research into potential causes and intensified calls for improved prevention and early detection.

A primary driver of rising mortality is late diagnosis: Three out of four patients under 50 are diagnosed at an advanced stage, when fewer treatment options are available. For this reason, health professionals urge individuals to pay attention to symptoms – such as rectal bleeding and persistent abdominal pain – and seek prompt medical evaluation.

“We’re seeing more young adults with advanced colorectal cancer,” said Mercy Gastroenterology Clinic’s Bhavya Akhauri, MD. “The symptoms are often subtle, and people tend to dismiss them. Early evaluation can make the difference between a curable diagnosis and a life‑threatening one.”

Screening remains the gold standard for preventing colorectal cancer or catching it early. Current national guidelines recommend screening beginning at age 45 for people at average risk or earlier for those with a family history or known genetic risk factors.

“A colonoscopy remains our most powerful tool, not just for early detection, but for prevention,” Dr. Akhauri said. “Removing a precancerous polyp can prevent cancer altogether. That’s an advantage we don’t have with most cancers.”