Colorectal Cancer Now Leading Cause of Cancer Death in Americans Under 50, Study Finds
Colorectal cancer is now the leading cause of cancer death for Americans under 50, even as overall rates in older adults continue to fall, according to a new analysis from the American Cancer Society.
The report, published in CA: A Cancer Journal for Clinicians, shows colorectal cancer (cancer of the colon and rectum) has climbed to the top spot for cancer mortality in adults younger than 50, ahead of breast and lung cancer. Overall, colorectal cancer is now the second leading cause of cancer death across all ages in the United States.
Researchers found that while colorectal cancer incidence has declined slightly overall, cases are rising sharply in younger age groups. Between 2013 and 2022, incidence increased by about 3% per year in adults aged 20–49 and by 0.4% per year in those aged 50–64. These increases are driven largely by tumors in the distal colon and rectum, with rectal cancer incidence reversing decades of decline and growing about 1% per year from 2018 to 2022.
In adults 65 and older, colorectal cancer incidence fell by about 2.5% annually from 2013 to 2022, and mortality dropped by about 2.3% annually since 2012, reflecting the impact of screening and improved treatment in this group. In contrast, deaths have been rising among people under 65: mortality has increased by about 1% per year since 2004 in those under 50, and by 1% per year since 2019 in those aged 50–64, with the steepest recent increase (about 2.3% annually) in white adults.
The study links the uptick in deaths in 50–64-year-olds to growing rates of regional and distant-stage disease, which increased by roughly 1.1%–1.3% per year from 2013 to 2022 in this age group. Scientists still do not know exactly what is driving early-onset colorectal cancer, and the authors call for urgent research into potential causes, including environmental and lifestyle factors highlighted by other oncologists.
While the causes remain unclear, the authors stress that many deaths could be prevented through earlier diagnosis and better support for younger patients.
