Deaths from rectal cancer among Americans under 45 are rising up to three times faster than colon cancer deaths in the same age group, and researchers say the trend will keep worsening through at least 2035 unless screening practices change, the Daily Mail reported.
The findings, due to be presented next month at the Digestive Disease Week conference, come from a team at SUNY Upstate Medical University in New York that analyzed more than two decades of CDC death records. Colorectal cancer is now the leading cause of cancer death in Americans under 50, a grim milestone that would have been unthinkable a generation ago, when the disease was considered an affliction of the elderly.
The numbers tell a story that should concern every family in the country. And the people hit hardest are those with the fewest resources to fight back.
Lead study author Mythili Menon Pathiyil, a gastroenterology fellow at SUNY Upstate Medical University, and her team combed through the CDC WONDER database, examining U.S. death records from 1999 to 2023 for adults aged 20 to 44. They broke the data down by age, sex, ethnicity, and region, then used machine learning to project trends through 2035.
The early findings are stark. Rectal cancer deaths climbed between two and three times faster than colon cancer deaths across every demographic the researchers studied. For adults aged 35 to 44, older millennials, rectal cancer deaths were projected to keep rising all the way to 2035, while colon cancer deaths in the same bracket increased more slowly.
Hispanic adults and people living in Western states saw the steepest rise in rectal cancer deaths. CDC data cited in the study shows Hispanic adults are less likely to undergo routine screening tests such as colonoscopies than white Americans, a gap that helps explain why the disease is caught later and kills more often in that population.
"Our study shows that rectal cancer is driving much of the increase in colorectal cancers, and it's most likely to worsen over time if we don't change what we are doing right now."
The survival math is brutal and simple. When colorectal cancer is caught early and still confined to the bowel, five-year survival rates sit at roughly 91 percent. Once it spreads to nearby tissue, that drops to 74 percent. Once it reaches distant organs, survival collapses to 13 percent.
Yet three in four younger patients are diagnosed only after the disease has already spread locally or to distant parts of the body, the American Cancer Society's latest figures show. That means the vast majority of young adults with this cancer are walking into a doctor's office already behind.
The American Cancer Society estimates bowel cancer diagnoses in adults under 50 have risen by about 3 percent a year over the past two decades. Nearly half of all colorectal cancer patients are now under 65. The disease has been climbing steadily in younger Americans for years, and the latest research suggests rectal cancer in particular is accelerating the trend.
James Van Der Beek died earlier this year at age 48 from colorectal cancer, putting a public face on the crisis. But for every celebrity case, thousands of ordinary Americans receive the same diagnosis with far less support, and far fewer options.
A separate study published in JAMA Oncology and reported by AP News sharpens the picture further. Researchers analyzed government data on more than 101,000 adults aged 25 to 49 who died of colorectal cancer between 1994 and 2023. The increase in deaths occurred almost entirely among people without a four-year college degree.
Among younger adults with only a high school education, colorectal cancer death rates rose from 4.0 to 5.2 per 100,000 over the study period. For those with at least a bachelor's degree, rates stayed flat at 2.7 per 100,000.
Dr. Paolo Boffetta of Stony Brook Cancer Center told AP it was "not totally unexpected that the death risk is concentrated in the less advantaged," but called the JAMA Oncology paper the first national study to actually demonstrate the connection.
That gap points to something deeper than genetics. As Fox News noted, researchers cautioned that a college degree does not offer biological protection. The likely drivers are socioeconomic: poorer diet, less physical activity, higher rates of obesity and smoking, and reduced access to medical care, the kinds of risk factors that cluster in communities where wages are stagnant and health insurance is thin.
Colorectal cancer is now the leading cause of cancer death for men under 50 and the second leading cause for women under 50. The burden falls hardest on working-class Americans, the same people who can least afford to miss work for a colonoscopy or absorb the cost of treatment when a diagnosis comes late.
The pattern matters for anyone who cares about cancer striking people in the prime of life. It is no longer a rare event. It is a trend.
Current screening guidelines were lowered to age 45 in recent years, a move that acknowledged the shift toward younger patients. But Pathiyil suggested the findings may support going further, earlier screening and greater use of sigmoidoscopy, which examines the lower bowel where rectal cancers form.
She framed the issue not as an overnight overhaul but as a change in medical culture:
"It's less about just changing guidelines overnight and more about changing how we think about it, recognizing that colorectal cancer in young adults is no longer rare, and it needs earlier attention."
That kind of institutional inertia costs lives. When the medical establishment treats a disease as rare in a population where it is demonstrably rising, patients get dismissed. Symptoms get attributed to hemorrhoids, stress, or diet. By the time the real diagnosis arrives, the cancer has spread.
The problem extends beyond American borders. Cancer Research UK published statistics showing rates of overall cancer diagnoses in 25- to 49-year-olds in Britain increased by 24 percent. Bowel cancer alone is responsible for roughly 17,700 deaths a year in Britain, making it the second-most common cause of cancer death across the country.
Dr. Jack Ogden, a GP at The Lagom Clinic in Bristol, has previously warned that subtle symptoms of bowel, rectal, and colon cancer are often overlooked or mistaken for other ailments. Blood in the stool, he noted, is not always immediately detectable, meaning patients may carry the disease for months without a visible warning sign.
The JAMA Oncology findings reported by Breitbart and others reinforce the same conclusion from a different angle: overall colorectal cancer death rates among younger adults rose from about 3 per 100,000 to about 4 per 100,000 over the last 30 years. That steady climb, combined with the SUNY team's finding that rectal cancer is accelerating even faster, paints a picture of a disease outrunning the system designed to catch it.
Experts are still trying to pin down the exact causes. S1 notes that no single explanation has been confirmed, possible contributing factors range from diet and obesity to environmental exposures. But the data leaves no room for complacency.
When serious diagnoses surface in public life, they tend to spark momentary concern. The challenge is translating that concern into lasting action, earlier screening, better access for working-class patients, and a medical culture that stops treating young-adult colorectal cancer as an anomaly.
The American Cancer Society's own data shows that colorectal cancer mortality in Americans under 50 has increased by 1.1 percent per year since 2005. That is not a blip. It is a generational shift, and it demands a generational response.
Pathiyil put it plainly:
"Colorectal cancer is no longer considered predominantly a disease of older adults."
Meanwhile, disruptions to cancer treatment at hospitals around the country only compound the problem for patients already struggling to get timely care.
The data is not ambiguous. The trend lines point one direction. The people dying are younger, working harder, and getting diagnosed later than they should. If the medical establishment and public health agencies cannot get ahead of this curve, the cost will be measured in lives, overwhelmingly the lives of Americans who never had the luxury of waiting.
