Colorectal Cancer Now Leading Cause Of Cancer Death In Americans Under 50

Colorectal Cancer Now Leading Cause of Cancer Death in Americans Under 50
United States Colorectal cancer has surpassed all other cancer types to become the leading cause of cancer-related deaths among people under the age of 50 in the United States, according to new research published in the Journal of the American Medical Association (JAMA). The findings mark a troubling shift in cancer mortality trends for younger adults and are driving calls for urgent action on screening and prevention. A Stark Change in Mortality Patterns Researchers from the American Cancer Society (ACS) analyzed national mortality data from 1990 through 2023 and found that while overall cancer deaths in people under 50 declined by about 44% over that period, deaths from colorectal cancer increased by about 1.1% per year, making it the top cause of cancer death in this age group as of 2023. American Cancer Society 1
In the early 1990s, colorectal cancer ranked as the fifth leading cause of cancer deaths among adults under 50, but its rise has outpaced declines in other major cancers including lung, breast, and leukemia where mortality rates have fallen significantly.
Experts describe the trend as alarming, noting that colorectal cancer is increasingly affecting people in their 20s, 30s and 40s age groups historically considered at lower risk for the disease. Despite overall progress in cancer treatment and prevention, colorectal cancer is the only leading cancer for which younger adult death rates are rising. Dr. Ahmedin Jemal senior vice president of surveillance, prevention and health services research at the ACS and senior author of the study said the findings suggest colorectal cancer in younger generations “can no longer be called an old person’s disease,” noting uncertainty over what exactly is driving the trend. The ACS research shows that other major causes of cancer death in younger adults have declined over the past three decades: Lung cancer mortality dropped significantly, falling from the leading cause to a lower rank. Breast cancer deaths also declined and remain a top cause of death, particularly among women under 50.
cancer, leukemia and others also saw reductions in mortality. But these gains have not been mirrored in colorectal cancer, where deaths continue to climb even as overall cancer mortality falls.
Screening, Awareness, and Risk Factors
Health advocates say increased awareness and wider uptake of screening tests including colonoscopies and less invasive options such as stool-based tests could help detect more cases earlier, when treatment is more effective. Despite evidence that colorectal cancer can often be prevented or caught early with screening, many younger adults do not currently meet the age threshold for routine screening and may not recognize symptoms until the disease is advanced. Risk factors under investigation include lifestyle factors such as diet, obesity and sedentary behaviour, as well as environmental influences, but researchers say the precise causes of the rising trend in young adults are still not fully understood.
Health organisations including the Colorectal Cancer Alliance and other advocacy groups are urging policymakers, clinicians and the public to prioritise action on prevention, screening, and research. The Alliance highlights projections that incidence rates among younger adults could continue rising sharply without intervention.
“Today’s news confirms what experts have been predicting for years,” said the Alliance’s CEO, emphasizing the need for increased education and screening uptake, especially among people aged 45-49, who make up a large share of cases under 50.
This shift colorectal cancer overtaking other cancers as the deadliest among young Americans marks a critical public health moment. It underscores the importance of re-examining screening guidelines, expanding access to early detection, and investing in research to understand and reverse the trend.