For decades, colorectal cancer was considered a disease that primarily affected people over 50. That’s no longer the case.
Across the United States, diagnoses are increasing among adults in their 20s, 30s, and 40s. Today, about 1 in 5 new colorectal cancer cases occurs in someone under 55. While overall rates have declined in older adults — largely because of screening — early-onset colorectal cancer is moving in the opposite direction.
The recent diagnosis and death of 48-year-old actor James Van Der Beek brought national attention to this shift. But this trend isn’t about one person. It’s about a generation that wasn’t historically considered at risk.
The goal is simple: understand the risk, recognize the signs, and respond early.
Why Younger Adults?
Researchers are still working to fully understand why rates are rising in younger populations. What we do know is that several factors appear to contribute to the increases in diagnoses:
- Diets high in processed and red meats
- Sedentary lifestyles
- Obesity
- Smoking and heavy alcohol use
- Family history of colorectal cancer
- Inherited conditions such as Lynch syndrome
“We’re seeing more patients in their 30s and 40s than we did even a decade ago,” says Matthew Ng, MD, colorectal surgeon at the GW Cancer Center. “Many of them are otherwise healthy and active. The key difference is often that symptoms are overlooked — by patients and sometimes even providers — because of age.”
That delay matters.
Listen to What Your Body Is Telling You
Colorectal cancer often starts quietly. Early symptoms can be subtle or mistaken for common digestive issues.
Pay attention to:
- Blood in your stool or rectal bleeding
- Persistent changes in bowel habits — diarrhea, constipation, or narrower stools
- Ongoing abdominal pain or cramping
- Unexplained weight loss
- Fatigue that doesn’t improve (which may signal anemia)
None of these symptoms automatically means cancer. But they do mean your body is asking for attention.
“If something feels different and it doesn’t resolve, don’t ignore it,” Ng says. “You know your body better than anyone. Persistent symptoms deserve evaluation.”
Screening Is Prevention
The good news: colorectal cancer is one of the most preventable cancers.
Screening can detect precancerous polyps before they ever turn into cancer. That’s why national guidelines now recommend that people at average risk begin screening at age 45, and earlier if there’s a family history or other risk factors.
Screening options include colonoscopy and non-invasive stool-based tests. Your provider can help determine what’s right for you. If you’re under 45 and experiencing symptoms, screening guidelines don’t apply — evaluation does.
The Takeaway: Be Proactive
This rise in younger diagnoses is not about panic. It’s about awareness.
- Know your family history.
- Don’t dismiss persistent symptoms.
- Talk to your provider about screening at 45 — or earlier if you’re at higher risk.
- Make small lifestyle changes that support long-term colon health: move more, eat fiber-rich foods, limit processed meats, reduce alcohol, and avoid smoking.
Colorectal cancer is treatable, especially when caught early. The most powerful steps you can take aren’t dramatic. They’re simple.
Pay attention.
Ask questions.
Get checked.
