Signs of Colorectal Cancer on the Rise in Young Adults

You might need a colonoscopy sooner than you think

Colorectal cancer isn’t just a disease older people get. In fact, it’s becoming more common in adults under 50.

Over the past few decades, rates of colorectal cancer, which includes rectal and colon cancer, have been on the rise in younger adults — shocking them with a diagnosis they never expected.

“Since colorectal cancer is associated with older people and symptoms are similar to other conditions, some younger adults delay care,” says Duane Deivert, DO, gastroenterologist at Geisinger Wyoming Valley Outpatient Specialty Center. “But if you have symptoms, don’t wait to see your doctor. Hopefully it’s not cancer, but if it is, early detection offers the best chance for successful treatment.”

If you’re under 45, a colonoscopy probably isn’t on your radar. Here’s why getting screened early might be a good idea.

Why colorectal cancer rates are rising in young adults

Colorectal cancer isn’t just being diagnosed in adults over age 50 anymore.

Cases of rectal and colon cancer have been increasing by 1 to 2 percent each year among adults ages 20 to 39, according to the National Cancer Institute. As many as 1 in 5 people diagnosed with colorectal cancer are between the ages of 20 and 50. Cases appear to be rising more in younger men than women.

“A recent study in JAMA (Journal of the American Medical Association) shows colorectal cancer mortality is increasing in patients under 50 years old and is now the most common cause of cancer death in this age group,” says Dr. Deivert.

There’s likely no single cause of the rise. A mix of lifestyle, genetic and environmental factors appear to be driving the increase.

Colorectal cancer risk factors behind the increase

While no one knows for sure, these colorectal cancer risk factors may be driving the rise in young adults:

A sedentary lifestyle
High-fat, low-fiber diets, heavy in processed foods and meats
Excessive alcohol consumption
Smoking
Obesity

Other potential causes include:

Being African American
Environmental factors like air quality
Exposure to certain chemicals like PFAs and microplastics
Frequent antibiotic use

“Many of these risk factors disrupt your gut microbiome, which is the trillions of healthy bacteria living in our gut that work to keep us healthy,” says Dr. Deivert. “Changes in your microbiome cause inflammation, which can lead to cancer over time.”

Signs of colorectal cancer

In the early stages of colorectal cancer, you might not have any symptoms — or only subtle ones. You may notice minor changes in your bowel habits, like constipation or diarrhea.

But as the disease progresses, signs of colorectal cancer can include:

Rectal bleeding or blood in your stool
Persistent cramping, gas or abdominal pain
Feeling that your bowel doesn’t empty completely
Unexplained weight loss
Weakness or fatigue, possibly due to low iron levels

And because these symptoms can be common and attributed to other conditions like hemorrhoids or irritable bowel syndrome, you and your healthcare provider probably aren’t thinking about colorectal cancer.

That means because colonoscopies aren’t recommended until age 45, your healthcare provider may not order one. But if you’re having symptoms that aren’t going away, a screening is a good place to start.

“Many people with colorectal cancer don’t notice symptoms until the late stages of the disease,” says Dr. Deivert. “That’s why early detection and prevention are key. If something feels off for more than a few weeks, schedule a visit with your healthcare provider.”

Preventing colorectal cancer

You can’t change your age or genes. But you can make small changes to your everyday life that can make a big impact on lowering your risk. Not sure where to start? Consider trying these 7 tips:

Get screened

The American Cancer Society recommends regular colorectal cancer screening starting at age 45 for average-risk adults. But if you have a family history, genetic predisposition or other risk factors, your provider may recommend earlier or more frequent screenings.

Routine screenings help catch colorectal cancers earlier, when they’re easier to treat.

“Most colorectal cancers start as an abnormal growth on the inner lining of the colon or rectum, called a polyp,” says Dr. Deivert. “Regular screenings can detect polyps. If your screening reveals any, they can be removed before they turn into cancer.”

There are several types of screening tests for colorectal cancer, including colonoscopy and at-home screening tests. Talk with your provider about which one is right for you.

Eat a balanced diet and increase fiber

Be sure to include a variety of fruits, vegetables and whole grains in your daily diet. These foods are high in fiber and contain vitamins, minerals and antioxidants, which may play a role in preventing colorectal cancer.

“Fiber feeds the healthy bacteria in our gut,” says Dr. Deivert. “And taking care of your gut is important to reduce your risk of many chronic diseases, including colorectal cancer.”

Another good way to reduce your risk? Avoid processed foods and meats, which lead to inflammation and alter the gut environment.

Stop smoking and reduce alcohol consumption

Avoiding harmful substances like tobacco and alcohol can help lower your risk.

If you smoke or vape, your provider can work with you to find options to help you quit.

And if you drink alcohol, cutting back to no more than 1 drink per day for women and 2 for men — or avoiding it altogether — makes a big impact on your health.

Move your body

Try to get at least 30 minutes of light-to-moderate exercise on most days, and add strength training on 2 or more days. Brisk walking, swimming and lifting weights are all good ways to get moving. Talk to your healthcare provider before starting an exercise program.

Maintain a healthy weight

Staying at a healthy weight can lower your risk of developing colorectal cancer, too. A healthy diet, portion control and regular exercise make weight management much easier. But if you’re not sure where to begin, talk to your provider.

Manage stress and prioritize sleep

Poor sleep and chronic stress affect hormone balance and immune function. Getting 7 to 9 hours of sleep every night and incorporating relaxation techniques are proven stress-reducers. Some relaxing options to try: deep-breathing exercises, meditation and yoga.

Have a conversation

The good news? Colorectal cancer is often preventable and treatable, especially when caught early. So work with your provider to decide when it’s best for you to start colorectal cancer screenings.

“The important takeaway is that young people can and do get colorectal cancer,” says Dr. Deivert. “Talking to your healthcare provider about your family history and potential symptoms can help you lower your risk.”