Deaths from cancer among younger Americans are on a decline, with one notable exception.
For the last three decades, colorectal cancer has surged to claim the top spot as the leading cause of cancer-related deaths for those under 50, surpassing breast, lung, brain cancers, and leukemia, according to a recent study.
“It’s evident this isn’t just an illness affecting older adults,” said Dr. Ahmedin Jemal, an executive at the American Cancer Society and the study’s senior author, in a statement.
Analysts reviewed over 1.2 million deaths and found that the overall cancer death rates in this age group dropped by 44% from 1990 to 2023.
This decline is largely attributed to significant reductions in four of the five major cancer-causing agents, which saw an annual decrease of 6%.
Yet, colorectal cancer is the exception—its rates have been climbing by 1.1% annually over this same period, shifting from the fifth to the leading cause of cancer mortality.
“Even with the increase in breast cancer cases, the consistent rise in colorectal cancer deaths among those under 50 is particularly alarming, especially when contrasted with the sharp reductions seen in lung and breast cancer,” stated Rebecca Siegel, the lead author of the report and a senior director at the American Cancer Society.
Interestingly, colorectal cancer rates among younger Americans are still rising, even though older adults have seen a decline in colorectal cancer rates.
“While we’re still trying to figure out why this trend is occurring, with three out of four individuals under 50 being diagnosed with advanced disease, we can take immediate action by recognizing symptoms, breaking stigma, and promoting screening,” noted Siegel.
Colonoscopy remains the standard approach for screening colorectal cancer, as it allows for both detection of the disease and the removal of precancerous growths during the same procedure.
The usual recommendation for average-risk individuals to begin screening was age 50, but the American Cancer Society revised this to age 45 in 2018 due to an uptick in cases among younger people. Other health organizations have followed suit.
Medical professionals now suggest that young patients discuss the results of their colonoscopy with family members.
“We don’t have clear risk factors for early-onset colorectal cancer,” claimed Dr. Christine Mormenti, a cancer epidemiologist and co-director of the Northwell Health Early Onset Cancer Program, who wasn’t part of the study.
While some research points to connections between this type of cancer and lifestyle factors like ultra-processed foods, obesity, smoking, alcohol consumption, and sugary beverages, many young patients don’t match that profile at all.
“They often describe themselves as healthy, eating well and staying active,” Mormenti explained. “Without established risk factors, understanding family history is the best strategy for preventing early-onset colorectal cancer.”
Estimates from researchers suggest that 16% of early-onset colorectal cancers are tied to genetic conditions that elevate risk.
“That’s just a piece of the puzzle,” Mormenti stated. “Another 14% is linked to family histories of colorectal cancer in first-degree relatives.”
The remaining 70% are believed to be sporadic, yet Mormenti highlighted a finding that revealed a startling 18% occurrence of advanced polyps in first-degree relatives of young-onset cancer patients.
“Knowing that the colonoscopy of a family member revealed a polyp—rather than cancer—could potentially save a life,” she added. “Screening guidelines for colorectal cancer and advanced polyps are similar, so early detection in relatives might also occur.”
Individuals with a family history of colon cancer or other associated risks, like aggressive polyps, are often advised to start screening at age 35, which is 10 years earlier than the age at which the youngest affected family member would be diagnosed.
Nearly 19 million colonoscopies are performed annually in the United States, but only 2 to 10 percent result in the discovery of advanced polyps. As a result, it’s important for those diagnosed with such polyps to recommend that their siblings undergo screening starting at age 35—especially if they are approaching 45.
In 2026 alone, the American Cancer Society predicts there will be 108,860 new colon cancer cases and 49,990 new rectal cancer cases in the United States.
Combined, these two types of cancer are expected to claim around 55,230 lives.
