Rising Colorectal Cancer Cases Among Younger Adults in the United States
A new report shows a shift in colorectal cancer trends in the United States. While historically the disease afflicted older adults, increases are now observed among younger people. The Colorectal Cancer Statistics 2026, published by the American Cancer Society, notes that while overall cancer incidence has fallen since 2013, driven largely by declines among those aged 65 and over, cases in people under 65 are rising, with the largest surge among 20- to 49-year-olds.
Rebecca L. Siegel, Senior Scientific Editor for Surveillance Research at the American Cancer Society and the lead author of the report, said the change in disease pattern is occurring rapidly. She noted that the burden of colorectal cancer is increasingly shifting to younger age groups in the United States.
Colorectal cancer is the third most common cancer in the United States, and the second leading cause of cancer death overall, after lung cancer. Among adults under 50, colorectal cancer is the leading cause of cancer mortality in that age group.
The report estimates about 158,850 new cases of colorectal cancer will be diagnosed in the United States in 2026, with around 55,230 deaths anticipated.
Looking at long-term trends, overall incidence declined by about 0.9% per year from 2013 to 2022. However, age-specific trends differ: among those aged 65 and over, incidence fell by about 2.5% per year; among those aged 50–64, cases rose by about 0.4% per year; and among those aged 20–49, increases averaged about 3% per year.
Currently, around 45% of colorectal cancer cases occur in people aged 64 or younger, up from about 27% in 1995.
In addition to the overall rise in younger ages, researchers noted a rise in rectal cancer, which had been decreasing for decades. From 2019 to 2022, rectal cancer incidence rose by about 1% per year across all age groups. Rectal cancer now accounts for roughly 32% of all colorectal cancer diagnoses, up from about 27% two decades ago.
The researchers also found that around 75% of colorectal cancer cases in people under 50 are diagnosed at a late stage, and roughly 27% are metastatic at diagnosis, meaning cancer has spread to other organs.
While the precise causes of the uptick among younger people remain unclear, researchers point to several modifiable lifestyle factors. Siegel noted that more than half of colorectal cancer cases relate to risk factors that could be altered. These include overweight and obesity, insufficient physical activity, smoking, unhealthy diets, excessive alcohol consumption, and consumption of red or processed meat.
Birth-cohort analyses indicate that colorectal cancer risk declined in the early 20th century, reaching a nadir around 1950, but has risen again in subsequent generations.
Experts emphasise the importance of screening and early detection to curb incidence. The USPSTF recommends that individuals at average risk begin colorectal cancer screening at age 45. Yet data show only about 37% of people aged 45–49 have had screening, and roughly half of all cases in people under 50 occur in the 45–49 age bracket.
People with a family history of colorectal cancer or other risk factors are advised to begin screening earlier.
Early detection matters because five-year survival for colorectal cancer diagnosed at an early stage can reach around 90%. Colonoscopy can also identify and remove polyps before they become cancerous, helping to prevent the disease.