Colorectal Cancer Cases Rise in Young Adults as Screening Recommendations Shift

Strategic Insights -

A recent surge in early-stage colorectal cancer diagnoses among adults under 50 has been linked to increased screening, but experts say more work is needed to understand the underlying causes of the trend. In 2018, the American Cancer Society updated its guidelines to recommend screening starting at age 45, and in 2021, the US Preventive Services Task Force lowered the recommended age to start screening from 50 to 45. Despite the shift, the overall rise in colorectal cancer cases among younger adults remains a concern, with more than half of those diagnosed under 50 not being eligible for screening due to age.

Key Takeaways:

  • In 2019, 20.8% of US adults ages 45-49 were up to date on colorectal cancer screening, increasing to 33.7% in 2023, according to a study published in JAMA.
  • The prevalence of early-stage colorectal cancer diagnoses among adults 45-49 increased from 9.4 cases per 100,000 people in 2019 to 11.7 per 100,000 in 2021 and then to 17.5 per 100,000 in 2022 (Source: American Cancer Society).
  • Dr. Joseph Rinaldi, a gastroenterologist, said that lowering the screening age "has likely facilitated earlier detection of cancers that might have been missed, but there is still more work to do to identify the driving factors behind the ongoing overall rise of colorectal cancer in younger ages."
  • Kelly Spill, a 33-year-old mother of three, was diagnosed with stage III rectal cancer at age 28 in 2020 and credits self-advocacy for her successful treatment and remaining cancer-free.
  • The most common symptom of colorectal cancer is rectal bleeding, and other important symptoms include persistent bowel habits, abdominal cramping, or pain (Source: American Cancer Society).
  • Current options for colorectal cancer screening include a stool-based fecal test, traditional colonoscopy, virtual colonoscopy, or sigmoidoscopy procedure (Source: American Cancer Society).

Statistics:

  • In the United States, 1 in 23 men and 1 in 25 women will be diagnosed with colorectal cancer in their lifetime (Source: American Cancer Society).
  • The share of US adults ages 45-49 who are up to date on colorectal cancer screening increased from 20.8% in 2019 to 33.7% in 2023.
  • The prevalence of early-stage colorectal cancer diagnoses among adults 45-49 increased from 9.4 cases per 100,000 people in 2019 to 11.7 per 100,000 in 2021 and then to 17.5 per 100,000 in 2022.
  • More than half of all colorectal cancers in the US are attributable to modifiable risk factors, including smoking, maintaining a healthy body weight, physical activity, excessive alcohol consumption, and diet (Source: American Cancer Society).

Sources:

  • American Cancer Society, "Screening Tests for Colorectal Cancer" (cited as "American Cancer Society")
  • JAMA, "Colorectal Cancer Screening Rates and the Effectiveness of Screening" (cited as "JAMA")
  • National Colorectal Cancer Roundtable, "Screening Guidelines and Recommendations" (cited as "National Colorectal Cancer Roundtable")