Colorectal cancer is rising in younger adults. Here's who is most at
risk and symptoms to watch for
[February 13, 2026]
By LAURAN NEERGAARD
WASHINGTON (AP) — Colorectal cancer is a threat not just to older adults
but increasingly to young men and women, too. It’s now the top cancer
killer of Americans younger than 50.
The deaths of “Dawson’s Creek” actor James Van Der Beek at 48 this week,
and a few years ago “Black Panther” star Chadwick Boseman at 43,
highlight the risk for younger adults.
“We’re now starting to see more and more people in the 20-, 30- and
40-year-old range developing colon cancer. At the beginning of my
career, nobody that age had colorectal cancer,” said Dr. John Marshall
of Georgetown University’s Lombardi Comprehensive Cancer Center, who has
been a cancer doctor for more than three decades.
That trend “is shaking us all, to be blunt,” said Marshall, who is also
medical consultant to the Colorectal Cancer Alliance.
Here’s what to know about colorectal cancer — at any age — and how to
protect yourself.
How common is colorectal cancer?
More than 158,000 cases of colorectal cancer will be diagnosed in the
U.S. this year, according to the American Cancer Society. Among all
ages, it’s the nation’s second leading cancer killer, behind lung cancer
— expected to claim more than 55,000 lives this year.
For the population overall, cases and deaths have inched down in recent
years. That’s thanks in part to screening tests that can spot tumors
early, when they’re easier to treat — or even prevent them if
precancerous growths are found and removed.
Who’s most at risk?
The vast majority of colorectal cancer cases and deaths still are in
people 50 and older. That older age group has seen the most progress,
with deaths dropping by about 1.5% a year over the past decade,
according to cancer society statistics.
But while it’s still relatively rare in the under-50 crowd, their
colorectal cancer diagnoses have been rising since the early 2000s.
And last month, cancer society researchers reported that colorectal
cancer mortality in Americans under 50 had increased by 1.1% a year
since 2005, becoming the deadliest cancer in that age group. This year,
the society estimates 3,890 people under age 50 will die of it.
Risk factors at any age include obesity, lack of physical activity, a
diet high in red or processed meat and low in fruits and vegetables,
smoking, heavy alcohol use, having inflammatory bowel disease or a
family history of colorectal cancer.
Marshall advises everyone to eat lots of fruits and vegetables and whole
grains. “Meat’s not evil” but eat less of it, he said.
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Actor Chadwick Boseman appears at an interview for the film,
"Marshall," in Washington on Sept. 21, 2017. (AP Photo/Pablo
Martinez Monsivais, File)
 And a recent study found that a
three-year exercise program improved survival in colon cancer
patients and reduced cancer recurrence.
What are the symptoms of colorectal cancer?
Symptoms include blood in stool or rectal bleeding; changes in bowel
habits such as diarrhea, constipation or narrowing of stool that
lasts more than a few days; unintended weight loss; and cramps or
abdominal pain.
“Don’t ignore symptoms. Get it checked,” Marshall stressed. Survival
is far more likely when colorectal cancer is diagnosed early, before
it spreads.
When to get screened for colorectal cancer
Medical guidelines say the average person should start getting
screened at age 45 — too late for some young adults.
People known to be at higher risk are supposed to talk with their
doctors about whether to start screening even earlier.
How often people need to get checked depends on the type of
screening they choose. There are a variety of options, including
yearly stool-based tests or colonoscopies that may be done every 10
years as long as no problems were found. There’s also a newer blood
test for adults 45 or older.
What’s causing the colorectal cancer rise in younger adults?
No one knows what's causing the rise in cases in younger adults. But
Georgetown’s Marshall said many young patients lack common risk
factors. He wonders if changes in young people’s gut bacteria — the
microbiome — might play a role.
Also, where cancer occurs along the question mark-shaped colon — it
starts on one side of the abdomen and swoops to the other before
ending with the rectum — influences how aggressive it is and how
it’s treated. Marshall said there’s a marked difference in where
younger and older people’s tumors tend to strike, another clue being
explored.
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