Rectal Cancer Is Rising in Young Adults and Nobody Knows Why

Colorectal cancer is hitting younger people. Nearly half of new diagnoses now occur in people under 65, up from 27% in 1995. Rates are dropping in older adults while climbing in younger ones.

But the really concerning part is rectal cancer specifically. It's rising across all age groups. Between 2018 and 2022, rectal cancer diagnoses jumped 1% per year in every age group. Now it accounts for nearly one-third of all colorectal cancer diagnoses, up from 27% in the mid-2000s.

Doctors don't know why this is happening.

"We didn't have an epidemic of young people with colon or rectal cancer up until recently," said Dr. Arif Kamal, chief patient officer for the American Cancer Society. "It's really a phenomenon in the last five years or so that we've started to see this."

The report published Monday shows colorectal cancer rates since the late 1990s have increased 3% each year for people ages 20 to 49. They've increased 0.4% per year for adults 50 to 64. But they've decreased 2.5% per year for adults 65 and older.

The Symptoms Are Hard to Ignore

Rectal tumors cause more dramatic symptoms than colon tumors. Colon cancer symptoms can be vague—fatigue, abdominal pain, bloating, unexplained weight loss. Easy to dismiss.

Rectal cancer symptoms are harder to ignore. Bright red blood on toilet paper or in the toilet bowl. Urgent need to use the bathroom even right after going. These are signs something is seriously wrong.

Kamal said knowing your body and reporting symptoms to your doctor early is crucial even though doctors don't know what's driving the increase.

Most Young People Aren't Getting Screened

The U.S. Preventive Services Task Force lowered the screening age from 50 to 45 in 2021. But only about a third of people 45 to 49 are actually getting screened.

That's a problem. Three-quarters of colorectal cancers in people under 50 are diagnosed after the disease has already progressed to an advanced stage. Catching it early makes a massive difference in survival rates.

People with family history of the disease, precancerous polyps, or inflammatory bowel disease should consider screening even earlier.

Now that diagnoses are trending younger, the recommended screening age might need to drop further. "There will be decisions to be made within the next couple years, for sure," Kamal said.

The Diagnosis Gap

Andreana Holowatyj at Vanderbilt University Medical Center points out young patients are presenting with symptoms, but there's a 4 to 6-month gap between symptom presentation and diagnosis. That's alarming.

Caitlin Murphy, a cancer epidemiologist at the University of Chicago, said patients get stuck in referral loops. "They get referred to this person who then refers them to this person, and just goes on and on and on for months," Murphy said.

Four to six months is a long time for cancer to grow and spread while someone waits for diagnosis.

What You Can Control

Colorectal cancer is the number one cause of cancer death in people under 50. The new report estimates 158,850 new colorectal cancers will be diagnosed in 2026. Approximately 55,230 patients will die from it. Nearly a third of those deaths will be in people under 65.

More than half of colorectal cancers link to controllable risk factors. Smoking. High alcohol consumption. Lack of exercise. Excess body weight. Dietary changes help too—boost fiber, vegetables, fruit, and whole grains. Cut back on processed meats.

These aren't guarantees. People who do everything right still get cancer. But more than half of these cancers connect to lifestyle factors people can modify.

The Bottom Line

Colorectal cancer is killing more young people than any other cancer. Rates keep rising. Doctors don't know why. But they know symptoms require immediate attention and screening saves lives by catching cancer early.

This is happening to younger adults now. Not just older people. The shift is real and the reasons remain unknown.

If you are having any unusual bowel symptoms, don’t hesitate to reach out to your doctor. It is nothing to feel embarrassed about. And getting checked early could be life saving.

Curious for more stories that keep you informed and entertained? From the latest headlines to everyday insights, YourLifeBuzz has more to explore. Dive into what’s next.