July 2026
Colorectal cancer, which starts in the colon or rectum, was once considered a disease that mostly affected older adults. But over the past two decades, there’s been a sharp increase in cases among younger adults. Consider these statistics from the American Cancer Society Colorectal Cancer Statistics 2026 report:
- In 2022, 22% of colorectal cancer diagnoses — over one in five — occurred in people aged 54 or younger. That’s double the 11% of cases in this age group in 1995, when regular screening started.
- In people aged 20 to 49, new cases of colorectal cancer are rising by 3% each year. Meanwhile, new cases are falling by more than 2% per year in those aged 65 and older.
- Three in four new colorectal cancers in adults under age 50 are first diagnosed after the cancer has spread to regional or distant sites in the body, making it harder to treat.
- For adults under 50, colorectal cancer is now the top cause of cancer-related death. In 1998, it was the fourth leading cause of cancer death for adults in this group.
Early detection matters
Medical experts don’t yet know what is causing the spike in cases among younger adults. Unhealthy diets, smoking, heavy alcohol use, and obesity may play a role. The good news is that finding colorectal cancer early can make a big difference in treatment options and survival.
Survival often depends on the disease stage at diagnosis. For people with localized colorectal cancer — meaning it hasn’t spread nearby or to other parts of the body — the 5-year relative survival is 91%. When cancer spreads to distant sites in the body, the 5-year relative survival drops to 15%.
Screening recommendations
For people at average risk, the American Cancer Society (ACS) and the U.S. Preventive Services Task Force both recommend starting colorectal cancer screening at age 45. Screening can find cancer early, before it spreads. It can also prevent colorectal cancer: During a colonoscopy, doctors can remove precancerous polyps that can turn into cancer. They may also remove benign polyps as a precaution.
Despite the benefits, only 65% of people aged 45 and older are up to date with screening, according to the ACS report. Among people aged 45 to 49, only 37% are up to date.
Common signs and symptoms of colorectal cancer
While screening is important, it’s not always enough. Among new colorectal cancer cases in adults aged 50 and under — also called early-onset colorectal cancer — 50% occur in those under age 45, before regular screening typically starts. That’s why recognizing signs and symptoms early can be especially important.
The ACS lists these as common colorectal cancer signs and symptoms:
- Abdominal cramping or pain.
- Bowel habit changes that last more than a few days. This includes diarrhea, constipation, and narrowing of the stool.
- Rectal bleeding. Often, the blood is bright red.
- Blood in the stool, often turning it dark brown or black.
- Feeling like you need to have a bowel movement even if you just had one.
- Feeling weak or fatigued.
- Unexplained weight loss.
Red-flag warning signs in younger adults
Not everyone with colorectal cancer will have every symptom. Younger adults may not notice symptoms until the disease has spread.
According to the National Cancer Institute, four red flags of early-onset colorectal cancer include:
- Abdominal or belly pain.
- Diarrhea.
- Rectal bleeding.
- Iron deficiency anemia.
When to see a doctor
If you have any of the above signs or symptoms, schedule an appointment with your doctor. They may recommend blood and imaging tests to determine the cause.
All adults ages 18 and older should see their doctor for annual preventive care exams. During these visits, your doctor will review your medical and family history. Tell your doctor about any family history of colorectal or other cancers, which may put you at increased risk.
For people at an increased risk, colorectal cancer screening may start earlier than age 45. Risk factors can include family history of colorectal cancer, inherited genetic risk, smoking or heavy alcohol use, or obesity, according to the National Cancer Institute.
Your doctor can help decide when you should get screened, what screening option is best for you, and how often you may need screening.
