person holding 3d model of large instestine over abdomen. Early-onset Colorectal Cancer concept
Sean Cate
Sean Cate
May 25, 2024 ·  4 min read

More and More Young People Are Getting Early-Onset Colorectal Cancer. Here’s What You Should Know.

Colorectal cancer (CRC) has traditionally been associated with older generations, but recent trends have indicated a rise in cases among younger people. Early-onset colorectal cancer is defined as CRC in people under 50, and it has been increasing at an alarming rate globally. The good news is that CRC, in general for those over 50, has been decreasing due to better screening and awareness, but the rates among younger adults have been rising steadily since the mid-1990s and are expected to double by 2030. This makes Early-onset colorectal cancer a significant public health concern that warrants urgent attention.

Early-onset Colorectal Cancer Symptoms

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One of the major issues in addressing early-onset colorectal cancer is the lack of routine screening for individuals under 50, leading to late diagnoses. Recent studies have identified four key signs that could help in early detection: abdominal pain, rectal bleeding, diarrhea, and iron deficiency anemia. Just having one of these symptoms doubles the likelihood of an early-onset colorectal cancer diagnosis, while having three or more increases the likelihood by six times. As Dr. Yin Cao of the Washington University School of Medicine points out, raising awareness of these symptoms among both patients and healthcare providers is crucial for early detection and treatment.

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The Demographics and Risk Factors

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Early-onset colorectal cancer occurs worldwide. The rising incidence levels suggest that changes in exposure to CRC risk factors likely include diet and lifestyle, as well as like genetics. For instance, a sedentary lifestyle, obesity, smoking, heavy alcohol use, and a diet high in processed meats are all associated with increased risk. Notably, a large number of early-onset colorectal cancer cases happen randomly which only complicate screening efforts.1

Diagnostic Delays and Survival Rates

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Younger adults often dismiss early signs of CRC, mistaking their symptoms for something less severe like hemorrhoids. This leads to a delayed diagnoses, which frequently lead to the disease advancing significantly before being diagnosed properly and survival outcomes. A study highlighted that the 5-year survival rate for young patients with early-onset colorectal cancer is only 33.4%. However, if diagnosed earlier, the survival rate can be as high as 90% for localized cancers.2

Screening Recommendations and Genetic Factors

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In response to the rising early-onset colorectal cancer cases, screening guidelines now recommend starting to screen at age 45 instead of 50. However, half of these cases are diagnosed in individuals under 45, and they aren’t covered by routine screening recommendations. Since family history plays a role in determining risk; people with an immediate relative diagnosed with should start screening earlier. Genetic testing is also suggested for everyone under 50 (not just those with close family cases), as hereditary cancer syndromes like Lynch syndrome is usually also present among these patients.

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Lifestyle Changes for Early-onset Colorectal Cancer

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Addressing early-onset colorectal cancer also involves making lifestyle changes. A diet rich in fiber, consistent physical activity, maintaining a healthy weight, and reducing or removing alcohol and smoking are all excellent preventive measures. Public awareness is key when trying to address CRC of all types.

The Role of Healthcare Providers

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Healthcare providers are extremely important for detecting early-onset colorectal cancer. Dr. Haddon Pantel of Yale Medicine emphasizes that one should “consider CRC in differential diagnoses when younger patients present symptoms like rectal bleeding or changes in bowel habits.” A proactive approach should include diagnostic testing and colonoscopies for symptomatic patients.3

Future Directions in Research and Screening

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Ongoing research is necessary for a better understanding of early-onset colorectal cancer. Advances in tumor profiling and genetic testing show promising results for identifying those at higher risk. Preventive measures are being tailored by professionals like Dr. Frank A. Sinicrope of the Mayo Clinic. He explains that “individualized screening approaches based on family history and genetic predisposition could significantly improve early detection rates and reduce the incidence of advanced Early-onset colorectal cancer”.4


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The increase in cases of colorectal cancer among younger adults is a pressing public health issue. By raising awareness, promoting lifestyle changes, enhancing screening, and supporting further research, we can hope to return those numbers to a decreasing trend. Individuals and healthcare providers alike need to stay informed and vigilant to ensure any symptoms are not being overlooked. Early detection and treatment are the key to better survival rates, so get tested and get tested early.

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  1. Early-onset colorectal cancer: A review of current knowledge.” NCBI. Margarida R Saraiva, Isadora Rosa, and Isabel Claro. February 28, 2023..
  2. Study Identifies Potential Warning Signs of Colorectal Cancer in Younger Adults.” National Cancer Institute. Linda Wang. June 15, 2023
  3. Addressing the rising incidence of early-onset colorectal cancer.” Mayo Clinic. December 15, 2022.
  4. Colorectal Cancer: What Millennials and Gen Zers Need to Know.” Yale Medicine. Kathy Katella. January 17, 2024.