Colorectal cancer demographics changing
New data released this month by the American Cancer Society signal a major shift in the demographics of colorectal cancer — a shift MSSC members have observed.
From 2013 to 2022, overall colorectal cancer rates dropped by about 1% each year, largely due to declines in older adults. But in those younger than 50, rates increased by 2.9% per year during that same period.
“I’ve definitely seen a huge increase in both cancerous and precancerous colon tumors in young people,” said Bassem Matta, MD, with Kansas Gastroenterology. “I have several young, healthy patients whom I’ve diagnosed and treated for either large precancerous colonic tumors or colon cancer.”
Lindsay Strader, DO, a colon and rectal surgeon with Wichita Surgical Specialists, has also seen an increase in younger patients. “We’re seeing more cases in patients in their 40s and 30s, and even younger,” she said.
These younger patients have led to new challenges, Strader said, “including treating colorectal cancer patients who are currently pregnant or have real concerns about future fertility.”
Though CRC incidence has risen in every generation born after the 1950s, the reasons are unclear. Genetics is a factor. Current research also focuses on inflammation associated with diet, micro-plastics and antibiotics. Matta thinks people eating more processed foods with less fiber is contributing to the problem.
A key to reducing deaths is early screening (current guidelines are age 45 for those with an average risk and earlier for those with a family history). These screenings can both prevent cancer by finding pre- cancers that are easily removed and by finding cancer early, before symptoms develop.
Nathan Tofteland, MD, is program director for the Gastroenterology Fellowship at KU School of Medicine-Wichita, which has published two abstracts analyzing data for patients under age 45 who underwent colonoscopies. He elected to undergo his first colonoscopy for cancer screening before he turned 45 due to both parents having had adenomatous colon polyps before age 60. He had two adenomas removed, one of which met the criteria for advanced adenoma.
“Had I waited until age 45 years, there would have been substantial risk that that advanced adenoma may have already progressed to colon cancer,” he said.
However, that is not the case for most younger patients. About 3 out of 4 adults younger than 50 with CRC are diagnosed when the disease is at an advanced stage, according to the American Cancer Society.
“It’s a shame that in 2026 people are not getting screened as early as they should or some younger patients are ignoring symptoms until it’s too late,” Matta said. “Nowadays, we have the technology and expertise to endoscopically resect all types of precancerous and early cancer tumors without even the need for surgery.”
Strader urged anyone with rectal bleeding, persistent change in bowel habits, anemia or unexplained weight loss to be evaluated by a physician, regardless of age. “Earlier detection of colon cancer improves survival,” she said. “It’s important for both patients and physicians to note that colorectal cancer is no longer a disease exclusive to older adults.”