Colorectal cancer under 50 is now the leading cause of cancer-related death among Americans younger than 50, overtaking lung and breast cancer after a rapid rise documented in a major new American Cancer Society analysis.
Colorectal cancer climbed from the fifth-leading cause of cancer death among people under 50 in the early 1990s to the first today, according to evidence published Thursday in the Journal of the American Medical Association. Researchers described the shift as a sobering milestone that challenges long-standing assumptions about who is most at risk.
“We weren’t expecting colorectal cancer to rise to this level so quickly, but now it is clear that this can no longer be called an old person’s disease,” said Dr Ahmedin Jemal, senior author of the study and senior vice president of surveillance, prevention, and health services research at the American Cancer Society.
Colorectal Cancer Under 50 Overtakes Other Leading Killers
The report shows lung cancer, once the top cancer killer for younger adults, has fallen to fourth place. Leukaemia dropped from third to fifth, while breast cancer remained the second-leading cause of cancer death overall and the leading cause among females under 50.
Researchers analysed mortality data from the National Centre for Health Statistics, examining records from more than 1 million people between 1990 and 2023 across all 50 states and the District of Columbia. The analysis focused on cancer-related deaths among individuals younger than 50, a group that historically faced lower cancer mortality rates.
Experts say the findings confirm what oncologists and epidemiologists have observed clinically for years.
“Today’s news confirms what experts have been predicting for years, as we witnessed young-onset colorectal cancer rates rising quickly and claiming too many lives,” said Michael Sapienza, chief executive officer of the Colorectal Cancer Alliance, in a statement.
Advanced Diagnoses Drive Urgent Concern
The authors said the rise in deaths is especially alarming because many younger patients are diagnosed at later stages, when treatment options are more limited. About three in four people under 50 with colorectal cancer are diagnosed with advanced disease, the report found.
Rebecca Siegel, lead author of the study and senior scientific director of surveillance research at the American Cancer Society, said immediate action could save lives even before the underlying causes are fully understood.
“While we await answers for why colorectal cancer rates are up, lives can be saved now through symptom awareness and destigmatization, and more screening uptake,” Siegel said.
The researchers urged clinicians to take symptoms such as rectal bleeding, persistent abdominal pain, and unexplained weight loss seriously in younger patients. They also called for expanded public education to counter the perception that Colorectal Cancer Under 50 affects only older adults.
Survival Improves Despite Grim Milestone
Despite the rise in Colorectal Cancer Under 50 deaths among younger Americans, the report included encouraging news. Mortality has declined for every other leading cancer-related cause of death in people under 50, including breast cancer and leukaemia, even as some incidence rates increase.
A separate annual report released last week by the American Cancer Society showed continued improvement in overall cancer survival in the United States. About seven in 10 people now survive at least five years after a cancer diagnosis, up from roughly half in the mid-1970s.
The 70 per cent figure is based on diagnoses made between 2015 and 2021 and reflects advances in early detection, treatment, and supportive care. The five-year benchmark is a standard measure for assessing cancer survival trends.
Researchers said the contrast between rising colorectal cancer deaths and improving outcomes for other cancers underscores the need for targeted prevention strategies, earlier detection, and further research into environmental, dietary, and lifestyle factors driving early-onset disease.
