entists have warned that expanded research, stronger prevention efforts, and wider screening were needed to help reverse these troubling rise in colorectal cancer in young adults. A new report by the American Cancer Society (ACS) said this generational shift is accelerating and eroding decades of progress in treatment.
For much of the past century, colorectal cancer was considered a disease of older age, but that picture is changing rapidly, as nearly half of all new colorectal cancer diagnoses in the United States now occur in adults younger than 65, a dramatic increase from just over one-quarter in the mid-1990s, and the disease has become the leading cause of cancer death in adults under 50.
While colorectal cancer rates continue to decline among older Americans, they are climbing in adults younger than 65, particularly those under 50, suggesting that the decadeslong success against one of the nation’s deadliest cancers is becoming increasingly concentrated in older generations.
The trend is being driven largely by cancers arising in the distal colon, the final section of the colon, and the rectum. As a result, rectal cancer now accounts for nearly one-third of all colorectal cancer diagnoses, up from about one-quarter two decades ago.
In the findings, published in CA: A Cancer Journal for Clinicians, senior scientific director of Surveillance Research at the American Cancer Society and lead author of the report, Rebecca Siegel said “after decades of progress, the risk of dying from colorectal cancer is climbing in younger generations of men and women, confirming a real uptick in disease because of something we’re doing or some other exposure.
“We need to redouble research efforts to understand the cause but also circumvent deaths through earlier detection by educating clinicians and the general public about symptoms and increasing screening in people 45-54 years.” Researchers estimate that 158,850 Americans would be diagnosed with colorectal cancer in 2026 and 55,230 would die from the disease.
Although colorectal cancer remains the third most common cancer in both men and women, its burden is increasingly shifting toward younger adults, with about 200 people under age 65 diagnosed every day.
According to the ACS report, more than half of colorectal cancers are linked to risk factors that people may be able to change, including smoking, poor diet, heavy alcohol use, lack of physical activity, and excess body weight. Many cases and deaths could also be prevented through recommended screening and access to high-quality treatment.
ACS scientists found that half of the people diagnosed before age 50 are ages 45 to 49 and already qualify for screening. Even so, only 37% of people in this age group are up to date with screening, and 3 in 4 colorectal cancers in adults younger than 50 are found after the disease has already reached an advanced stage (regional or distant).
When colorectal cancer is found at a local stage, the five-year survival rate is 95 percent. “These findings further underscore that colorectal cancer is worsening among younger generations and highlight the immediate need for eligible adults to begin screening at the recommended age of 45,” said Dr. William Dahut, chief scientific officer at the American Cancer Society.
“The report also shines a light on the crucial importance of continued funding for research to help discover new therapies to treat the disease and advance patient care.” In 2026, an estimated 158,850 new colorectal cancer cases and 55,230 deaths from the disease are expected in the United States, the report says.
Colorectal cancer incidence is rising in adults younger than 65, with an annual increase of three percent among people ages 20 to 49 and 0.4 percent among people ages 50 to 64. This increase is being driven by cancers in the distal colon and rectum. Adults younger than 65 now account for nearly half, or 45 percent, of new colorectal cancer cases.
In 1995, that share was 27 percent, showing a major shift toward younger generations. Among adults younger than 50, 3 in 4 colorectal cancers are diagnosed at an advanced stage (regional or distant), and slightly more than one in four, or 27 percent, are diagnosed after the cancer has spread to distant sites.
Half of colorectal cancer diagnoses in people younger than 50 occur among those ages 45 to 49, who are eligible for screening that can prevent cancer as well as detect disease before symptoms appear. Colorectal cancer death rates have increased by one percent per year among adults younger than 50 since 2004 and among adults ages 50 to 64 since 2019.
Among adults 65 and older, both colorectal cancer incidence and mortality continue to fall by more than two percent per year. Across all ages combined, rectal cancer incidence rose by one percent per year from 2018 to 2022, reversing decades of decline. Rectal cancer now makes up about one third, or 32 percent, of colorectal cancer diagnoses, compared with one fourth, or 27 percent, in the mid 2000s.
Alaska Native people have the highest colorectal cancer incidence, at 80.9 per 100,000 people, and the highest mortality, at 31.5 per 100,000 people, in the United States. Those rates are more than twice as high as those among White people. American Indian people have the second-highest burden.
“Alaska Native people persistently experience a higher incidence and mortality rates than other racial and ethnic groups for colorectal cancer, with the American Indian population a close second.
“We need to reduce these cancer disparities by investing in cancer research specific to this population and improving access to screening, to save more lives,” said Dr. Ahmedin Jemal, senior vice president, Surveillance, Prevention, and Health Services Research at the American Cancer Society and senior author of the study.
