Early-onset Colorectal cancer: Causes, symptoms and screening for younger adults
TOI GLOBAL DESK | TOI GLOBAL | Feb 16, 2026, 21:30 IST
Colorectal cancer is increasingly affecting younger adults. Contributing factors include a diet high in processed foods, increased alcohol consumption, and a sedentary lifestyle. The importance of a healthy gut microbiome is also being explored. Key warning signs to watch for are blood in stools and persistent abdominal discomfort. It's advisable for individuals to begin screening at age 45.
Colorectal cancer is increasingly affecting younger individuals, with actor James Van der Beek's death at age 48 in February 2026 highlighting this trend. Researchers Christopher Lieu and Andrea Dwyer explain that while the exact cause for this rise in early-onset colorectal cancer is not definitively known, lifestyle factors such as ultra-processed foods, alcohol consumption, and lack of exercise are correlated with the increase. The gut microbiome's balance or dysbiosis, is also a focus for researchers, as an imbalance can lead to inflammation and increased cancer risk.
Beyond genetics, several lifestyle factors contribute to an elevated risk of developing colorectal cancer. Diet plays a significant role, with high consumption of red meat and processed foods, coupled with insufficient dietary fiber, increasing risk. Alcohol consumption, even at less than one drink per day, is also linked to a higher cancer risk. Smoking, obesity, and a sedentary lifestyle are additional factors that elevate the risk of colorectal cancer.
The survival rate for young people with colon cancer is a subject of ongoing research, with debate among scientists regarding differences compared to those diagnosed after age 50. Early-stage detection can lead to five-year survival rates ranging from 80% to 90%. However, when cancer is detected at an advanced stage, after it has spread, survival rates decrease significantly, falling closer to 10% to 15%. One study indicated that young patients with metastatic colon cancer experienced a slightly lower survival rate than those aged 50 and older.
Early symptoms of colorectal cancer can include blood in the stool, abdominal pain, and changes in bowel habits, or a combination of these. Unexplained anemia, characterized by low red blood cell levels, is another potential indicator. These symptoms are considered warning signs that warrant medical attention. While these symptoms do not definitively confirm colorectal cancer, they should be discussed with a physician, who may recommend a colonoscopy for further evaluation.
Colon cancer screening involves an initial conversation with a healthcare team to determine the most appropriate test based on individual risk factors. Individuals with average risk, meaning no personal or significant family history of colorectal cancer, hereditary cancer, precancerous polyps, or inflammatory bowel disease, have several screening options. These include stool tests to detect blood and abnormal cells, as well as imaging scans of the colon and rectum. Screening is generally recommended to commence at age 45 and continue at regular intervals until age 75.
For individuals with a high risk of colon cancer, typically due to a personal or family history of the disease, hereditary cancer, or inflammatory bowel disease, colonoscopy is the recommended screening test. Earlier and more frequent screening may be necessary for this group. Lifestyle factors can also contribute to a higher risk profile.
Reducing the risk of colon cancer involves proactive communication and lifestyle adjustments. Discussing personal risk factors with a healthcare team, considering age, family history, and any observed signs or symptoms, is crucial for selecting the appropriate screening exam and test. Taking control of one's health through regular physical activity, a diet rich in fruits, vegetables, and fiber, and limiting processed meats is important. Maintaining a healthy weight also plays a role. Moderating or eliminating alcohol and tobacco use can further decrease colorectal cancer risk.
Sharing personal and family history of polyps or colorectal cancer with healthcare providers is vital. This information helps ensure individuals receive the correct tests at the appropriate times. Communicating this history can potentially save the lives of close family members, including children, siblings, and parents.
"Researchers have identified a number of factors associated with increasing numbers of young people developing colorectal cancer, but there is no one clear answer that explains this trend."
"Lifestyle factors like ultra-processed foods and alcohol, as well as lack of exercise, have been linked to early-onset colorectal cancer."
"However, these are correlations that aren't proven to be the cause of colorectal cancer in young adults."
"Many researchers are focusing on the gut microbiome, which is an ecosystem of microorganisms in your gut that helps your body digest food and carry out other important functions."
"When the microbes in the gut are out of balance – a condition called dysbiosis – this causes a disruption that allows for inflammation and negative health effects, including increased cancer risk."
"Beyond genetics, several lifestyle factors can increase your risk of developing colorectal cancer."
"For example, someone's diet plays a role in cancer risk."
"Eating a lot of red meat and processed foods and not enough dietary fiber can increase your risk of colorectal cancer."
"Alcohol also causes cancer even having less than one drink a day can increase your cancer risk."
"Smoking, obesity and lack of exercise are other factors that increase cancer risk."
"There is a lot of debate among researchers on whether there are differences in survival rates between those with early-onset colorectal cancer survival and those who develop the disease after age 50."
"Finding cancer at an early stage can lead to five-year survival rates as high as 80% to 90%."
"When cancer is detected at an advanced stage where it has spread to other parts of the body, survival rates are closer to 10% to 15%."
"One study found that young patients with metastatic colon cancer had a slightly lower survival rate compared with those age 50 or older."
"The most common signs and symptoms for early-onset colorectal cancer are blood in the stool, abdominal pain and a change in bowel habits, or any combination of these conditions."
"Unexplained anemia, or low red blood cell levels, is another potential symptom."
"These are warning signs that people should not ignore."
"Having these symptoms does not necessarily mean you have colorectal cancer, but they are worth discussing with a physician."
"In some cases, your doctor may request a colonoscopy for further evaluation."
"The first step is to have a conversation with your health care team about which test is right for you."
"Understanding what your risk category is helps guide screening, prevention and lifestyle changes to reduce your likelihood of colorectal cancer."
"People with an average risk for colorectal cancer typically have no personal or significant family history of colorectal cancer, hereditary cancer, precancerous polyps or inflammatory bowel disease."
"They have several options for screening, including stool tests that check for blood and abnormal cells, as well as imaging scans to visualize the colon and rectum."
"Screening is recommended to begin at age 45 and should continue at regular intervals until age 75."
"People with a high risk of colon cancer typically have a personal or family history of colorectal cancer, hereditary cancer or inflammatory bowel disease."
"They may also have several lifestyle risk factors."
"Colonoscopy is the only recommended screening test for those with high risk, and earlier and more frequent screening may be necessary."
"Communication and action are key."
"Talk to your health care team about your personal risk based on your age, family history and any signs and symptoms to ensure you're matched with the screening exam and test best for you."
"Take charge of your health."
"There are lifestyle factors you can control to reduce your personal risk of colorectal cancer."
"These include regular physical activity; a diet high in fruit, vegetables and fiber, and low in processed meats; and maintaining a healthy weight."
"Moderating or eliminating alcohol and tobacco use can also reduce your colorectal cancer risk."
"Share information with loved ones and your health care team."
"Knowing your personal and family history of polyps or colorectal cancer and communicating it with your doctor can help ensure you get the right test at the right time."
"Sharing your personal history could save the lives of your children, siblings and parents."
Beyond genetics, several lifestyle factors contribute to an elevated risk of developing colorectal cancer. Diet plays a significant role, with high consumption of red meat and processed foods, coupled with insufficient dietary fiber, increasing risk. Alcohol consumption, even at less than one drink per day, is also linked to a higher cancer risk. Smoking, obesity, and a sedentary lifestyle are additional factors that elevate the risk of colorectal cancer.
The survival rate for young people with colon cancer is a subject of ongoing research, with debate among scientists regarding differences compared to those diagnosed after age 50. Early-stage detection can lead to five-year survival rates ranging from 80% to 90%. However, when cancer is detected at an advanced stage, after it has spread, survival rates decrease significantly, falling closer to 10% to 15%. One study indicated that young patients with metastatic colon cancer experienced a slightly lower survival rate than those aged 50 and older.
Early symptoms of colorectal cancer can include blood in the stool, abdominal pain, and changes in bowel habits, or a combination of these. Unexplained anemia, characterized by low red blood cell levels, is another potential indicator. These symptoms are considered warning signs that warrant medical attention. While these symptoms do not definitively confirm colorectal cancer, they should be discussed with a physician, who may recommend a colonoscopy for further evaluation.
Colon cancer screening involves an initial conversation with a healthcare team to determine the most appropriate test based on individual risk factors. Individuals with average risk, meaning no personal or significant family history of colorectal cancer, hereditary cancer, precancerous polyps, or inflammatory bowel disease, have several screening options. These include stool tests to detect blood and abnormal cells, as well as imaging scans of the colon and rectum. Screening is generally recommended to commence at age 45 and continue at regular intervals until age 75.
For individuals with a high risk of colon cancer, typically due to a personal or family history of the disease, hereditary cancer, or inflammatory bowel disease, colonoscopy is the recommended screening test. Earlier and more frequent screening may be necessary for this group. Lifestyle factors can also contribute to a higher risk profile.
Reducing the risk of colon cancer involves proactive communication and lifestyle adjustments. Discussing personal risk factors with a healthcare team, considering age, family history, and any observed signs or symptoms, is crucial for selecting the appropriate screening exam and test. Taking control of one's health through regular physical activity, a diet rich in fruits, vegetables, and fiber, and limiting processed meats is important. Maintaining a healthy weight also plays a role. Moderating or eliminating alcohol and tobacco use can further decrease colorectal cancer risk.
Sharing personal and family history of polyps or colorectal cancer with healthcare providers is vital. This information helps ensure individuals receive the correct tests at the appropriate times. Communicating this history can potentially save the lives of close family members, including children, siblings, and parents.
"Researchers have identified a number of factors associated with increasing numbers of young people developing colorectal cancer, but there is no one clear answer that explains this trend."
"Lifestyle factors like ultra-processed foods and alcohol, as well as lack of exercise, have been linked to early-onset colorectal cancer."
"However, these are correlations that aren't proven to be the cause of colorectal cancer in young adults."
"Many researchers are focusing on the gut microbiome, which is an ecosystem of microorganisms in your gut that helps your body digest food and carry out other important functions."
"When the microbes in the gut are out of balance – a condition called dysbiosis – this causes a disruption that allows for inflammation and negative health effects, including increased cancer risk."
"Beyond genetics, several lifestyle factors can increase your risk of developing colorectal cancer."
"For example, someone's diet plays a role in cancer risk."
"Eating a lot of red meat and processed foods and not enough dietary fiber can increase your risk of colorectal cancer."
"Alcohol also causes cancer even having less than one drink a day can increase your cancer risk."
"Smoking, obesity and lack of exercise are other factors that increase cancer risk."
"There is a lot of debate among researchers on whether there are differences in survival rates between those with early-onset colorectal cancer survival and those who develop the disease after age 50."
"Finding cancer at an early stage can lead to five-year survival rates as high as 80% to 90%."
"When cancer is detected at an advanced stage where it has spread to other parts of the body, survival rates are closer to 10% to 15%."
"One study found that young patients with metastatic colon cancer had a slightly lower survival rate compared with those age 50 or older."
"The most common signs and symptoms for early-onset colorectal cancer are blood in the stool, abdominal pain and a change in bowel habits, or any combination of these conditions."
"Unexplained anemia, or low red blood cell levels, is another potential symptom."
"These are warning signs that people should not ignore."
"Having these symptoms does not necessarily mean you have colorectal cancer, but they are worth discussing with a physician."
"In some cases, your doctor may request a colonoscopy for further evaluation."
"The first step is to have a conversation with your health care team about which test is right for you."
"Understanding what your risk category is helps guide screening, prevention and lifestyle changes to reduce your likelihood of colorectal cancer."
"People with an average risk for colorectal cancer typically have no personal or significant family history of colorectal cancer, hereditary cancer, precancerous polyps or inflammatory bowel disease."
"They have several options for screening, including stool tests that check for blood and abnormal cells, as well as imaging scans to visualize the colon and rectum."
"Screening is recommended to begin at age 45 and should continue at regular intervals until age 75."
"People with a high risk of colon cancer typically have a personal or family history of colorectal cancer, hereditary cancer or inflammatory bowel disease."
"They may also have several lifestyle risk factors."
"Colonoscopy is the only recommended screening test for those with high risk, and earlier and more frequent screening may be necessary."
"Communication and action are key."
"Talk to your health care team about your personal risk based on your age, family history and any signs and symptoms to ensure you're matched with the screening exam and test best for you."
"Take charge of your health."
"There are lifestyle factors you can control to reduce your personal risk of colorectal cancer."
"These include regular physical activity; a diet high in fruit, vegetables and fiber, and low in processed meats; and maintaining a healthy weight."
"Moderating or eliminating alcohol and tobacco use can also reduce your colorectal cancer risk."
"Share information with loved ones and your health care team."
"Knowing your personal and family history of polyps or colorectal cancer and communicating it with your doctor can help ensure you get the right test at the right time."
"Sharing your personal history could save the lives of your children, siblings and parents."