Alarming shift in cancer mortality
Colorectal cancer has become the leading cause of cancer death in adults under 50, according to the American Cancer Society's Colorectal Cancer Statistics 2026 report published in CA: A Cancer Journal for Clinicians. The disease now surpasses all other cancers in mortality for younger adults, with an estimated 158,850 new cases and 55,230 deaths projected for 2026 — including nearly 200 diagnoses each day in people under 65.
Rising incidence in younger adults
While overall colorectal cancer incidence has declined by 0.9% annually since 2013 — driven by a 2.5% annual decrease in adults 65 and older — rates in adults aged 20-49 are rising by 3% annually. The increase is concentrated in the distal colon and rectum, with rectal cancer now accounting for 32% of all colorectal diagnoses, up from 27% in the mid-2000s. Mortality in under-50 adults has increased by 1% annually since 2004.
Causes and screening recommendations
The American Cancer Society now recommends regular colorectal cancer screening starting at age 45 for average-risk adults. Researchers are investigating potential causes for the rise in young-onset cases, including dietary patterns, obesity, sedentary lifestyles, and gut microbiome changes. Black Americans face the highest incidence and mortality rates of any racial or ethnic group in the US, highlighting persistent disparities in screening access and care.