Rising Colorectal Cancer Deaths Among Younger Adults

The increase in colorectal cancer deaths among younger adults is particularly concerning, especially among those with lower educational attainment. This suggests that socioeconomic elements may be contributing to this troubling trend, as highlighted by a new study.

High-profile cases, like the deaths of Chadwick Boseman in 2020 and James Van Der Beek earlier this year, have drawn attention to the rise in colorectal cancer mortality in this demographic. However, this study claims to be the first to clearly identify which groups are being most affected by this alarming increase.

Over the past three decades, researchers have found that the rise in deaths from colorectal cancer in young adults predominantly affects those without a four-year college degree. It’s worth mentioning that having a degree doesn’t necessarily safeguard individuals from colon cancer. Rather, experts suggest it’s a reflection of other factors: people with lower education often earn less, have less healthy diets, are less active, and don’t receive adequate medical care.

While it might seem expected that the burden of disease falls on the less advantaged, this study, published in JAMA Oncology, is the first at a national level to establish this connection, according to Dr. Paolo Boffetta from Stony Brook Cancer Center, who wasn’t part of the research.

According to data analyzed from more than 101,000 younger adults aged 25 to 49 who died of colorectal cancer between 1994 and 2023, the overall death rate in this age group rose from about 3 to 4 deaths per 100,000. Among those who completed only high school, the figure jumped from 4 to 5.2 per 100,000, while the rate remained stable at 2.7 per 100,000 for individuals with at least a bachelor’s degree.

Ahmedin Jemal, the lead author of the study, stressed the importance of increasing public awareness about colorectal cancer and encouraging younger adults to follow screening recommendations.

Symptoms of colorectal cancer can be quite varied and may include blood in the stool, changes in bowel habits—like persistent diarrhea or constipation, unexplained weight loss, and abdominal discomfort.

This year, the American Cancer Society predicts over 158,000 new cases of colorectal cancer will be diagnosed in the U.S. Overall, it stands as the second leading cause of cancer-related deaths in the nation, trailing only lung cancer, and it’s anticipated to take over 55,000 lives in 2026. Among adults younger than 50, deaths account for about 7% of the total—roughly 3,900 individuals. Earlier reports have shown that colorectal cancer mortality in under-50 Americans has risen by approximately 1.1% each year since 2005, making it the deadliest cancer in that age bracket now.

The specific reasons for this increase remain unclear, but risk factors identified include obesity, insufficient physical activity, diets high in red or processed meats but low in fruits and vegetables, and family histories of the disease.

In response to these alarming trends, the American Cancer Society updated its screening guidelines in 2021, lowering the recommended starting age for screenings from 50 to 45.

Interestingly, while investigators focused on education level in this study, it raises the question of why other factors weren’t considered. Death certificates typically do not capture financial details, but they do indicate the level of education achieved. Previous research has linked education to income, health insurance status, physical activity levels, and chronic diseases, meaning education can often serve as an indicator, even if it doesn’t cover every facet, such as whether someone had health insurance.

In Boffetta’s words, “The focus on education is really due to the data available.”