By: Marianne Cusick, MD, associate professor and H. Randolph Bailey, MD, Chair in Colorectal Surgery at McGovern Medical School at UTHealth Houston, colorectal surgeon at UT Physicians.
Colorectal cancer, once considered a disease primarily affecting older adults, is now rising at an alarming rate among people under 50, according to experts featured in the “Ask the Expert” series by UTHealth Houston.
Colorectal Cancer is currently the second leading cause of cancer-related deaths and among the most common cancers globally. Alarmingly, it has become the leading cause of cancer-related deaths among men and women under 50, with cases in this age group increasing by nearly 3% annually.
Medical experts highlight that while colorectal cancer is often asymptomatic in its early stages, it is also highly preventable through screening and highly treatable if detected early. Approximately 1 in 24 people are expected to develop the disease in their lifetime.
Causes and Disease Progression
Colorectal cancer develops in the lining of the colon or rectum, where cells accumulate genetic mutations over time, leading to uncontrolled growth. Most cases begin as benign polyps, such as adenomatous or serrated lesions, which can progress into cancer if left untreated.
Factors such as chronic inflammation, diet, metabolic conditions, and changes in the gut microbiome may accelerate this progression.
Why Cases Are Rising in Younger Adults
Experts point to a combination of modern lifestyle and environmental factors contributing to the increase, including:
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Rising obesity and metabolic syndrome
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Sedentary lifestyles
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Diets high in processed foods and alcohol and low in fiber
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Early-life factors such as antibiotic use affecting gut microbiota
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Increasing cases of inflammatory bowel disease in younger populations
While improved awareness and diagnostics play a role, the rise is considered real and concerning, prompting discussions about lowering the recommended age for screening.
Symptoms to Watch For
Early detection remains critical, as symptoms often appear only in advanced stages. Common warning signs include:
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Persistent changes in bowel habits (diarrhea or constipation)
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Rectal bleeding or blood in stool
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Unexplained fatigue due to iron-deficiency anemia
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Abdominal discomfort, bloating, or cramping
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Unintended weight loss
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Signs of obstruction such as nausea and vomiting in later stages
Risk Factors
Risk factors include both non-modifiable and lifestyle-related elements:
Non-modifiable:
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Age
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Family history of colorectal cancer
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Personal history of polyps or cancer
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Genetic conditions like Lynch syndrome
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Long-term inflammatory bowel disease
Modifiable:
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Obesity and lack of physical activity
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Diets high in red and processed meat
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Smoking and heavy alcohol consumption
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Conditions such as Type 2 Diabetes
Expert Insight
According to Dr. Marianne Cusick, Associate Professor at McGovern Medical School at UTHealth Houston, “The key takeaway is that screening combined with healthy lifestyle choices can significantly reduce risk and improve outcomes. Awareness of family history also helps identify high-risk individuals early.”
The Way Forward
Health professionals emphasize that regular screening, early detection, and lifestyle modification are critical to reversing this trend. With rising incidence among younger populations, individuals are urged to stay vigilant, monitor symptoms, and seek medical advice promptly.
