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Colorectal Cancer Now Leading Cause of Cancer Deaths in Young Adults, Study Finds
Washington D.C. – Colorectal cancer has dramatically surged to become the leading cause of cancer-related deaths among individuals under 50 in the United States, according to a recent study published in the Journal of the American Medical Association. This alarming trend signals a significant shift in cancer mortality patterns, placing colorectal cancer seven years ahead of previous projections.
The study, led by Rebecca Siegel, senior scientific director of surveillance research at the American Cancer Society, revealed that colorectal cancer death rates in this age group have climbed by 1% annually since 2005. This increase stands in stark contrast to the overall decline in cancer death rates among those under 50, which have dropped by 44% since 1990. Among the five most common causes of cancer-related death in younger individuals, colorectal cancer was the only one to show an increase.
“It is absolutely an outlier,” stated Siegel, emphasizing the unique and concerning nature of this rise.
While the majority of colorectal cancer cases continue to affect individuals over 50, diagnoses among those in their 20s, 30s, and 40s have been steadily climbing over the past few decades. Researchers had previously anticipated that colorectal cancer would claim the top spot for cancer deaths in the under-50 demographic by 2030, a grim milestone that has now been reached in 2023.
Siegel and her team analyzed data from nearly 1.3 million cancer deaths in individuals under 50 between 1990 and 2023 from the National Cancer Institute. In 1990, colorectal cancer ranked as the fifth-leading cause of cancer deaths in this age group. By 2023, it had ascended to the first position.
Conversely, deaths from other leading causes of cancer in this demographic have seen declines. Lung cancer deaths, once the leading cause, fell to fourth, with an almost 6% annual decrease from 2014 to 2023.
Leukemia deaths dropped from third in 1990 to fifth in 2023, declining by nearly 2.5% annually during the same period. Breast cancer remained the second-leading cause overall and the primary cause in women, yet deaths declined by 1.4% annually from 2014 to 2023.
Dr. Andrew Chan, chief of the clinical and translational epidemiology unit at Massachusetts General Brigham in Boston, who was not involved in the study, noted that while successes in reducing deaths from other cancers are welcome, they do not fully explain the dramatic rise in colorectal cancer deaths. “We’ve had some successes in reducing deaths from other types of cancer, which only magnifies the increase in colorectal cancer death, but the rapid rise in colorectal cancer deaths in people younger than 50 is still quite remarkable,” Chan said, adding that these increases “really outpace the declines in death rates from other types of cancer.”
The increase in colorectal cancer cases alone also cannot account for the rising death rates, Chan explained, pointing out that breast cancer and leukemia cases increased while their death rates decreased.
Dr. Folasade May, an associate professor of medicine in the UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, described the findings as a “good-news, bad-news story, and for a colorectal cancer doctor, it’s a horror story.” While the overall decline in cancer-related deaths offers some relief, the specific increase in colorectal cancer deaths among young people is deeply concerning.
The reasons behind the increasing rates of colorectal cancer in young people remain largely unclear. Approximately 20% of colorectal cancer cases are now diagnosed in individuals aged 54 or younger, double the rate observed in 1995, according to a 2025 American Cancer Society report.
Siegel acknowledged that while the trend is undeniable, the underlying causes are still poorly understood. Research suggests potential contributing factors such as rising rates of obesity and declining physical activity, shifts in the gut microbiome, and diets high in ultraprocessed foods, which have become more prevalent since the 1980s. However, Siegel cautioned, “it’s thought that other factors are at play and that these are not the sole reason for the increase.”
Given this escalating risk, Siegel stressed the critical importance of young people being aware of their increased susceptibility to colorectal cancer and seeking screening, particularly if they experience symptoms like blood in their stool or stomach cramping. The U.S. Preventive Services Task Force recommends universal screening beginning at age 45, with earlier screening for high-risk individuals.
“Half of the people diagnosed before age 50 are aged 45 to 49, so they are screening-eligible,” Siegel emphasized, highlighting the immediate opportunity for early detection within the recommended screening guidelines.