Deaths from rectal cancer are rising fast among people in their 20s, 30s, and 40s, according to new data highlighted by NBC News, and the trend is getting worse, not better.
From 1999 to 2023, rectal cancer deaths in adults aged 20 to 44 have increased sharply, growing 2 to 3 times faster than colon cancer deaths in the same age group. This surge is now the main force behind the broader rise in early onset colorectal cancer.
The trajectory is clear. Cases among people under 50 have been climbing at about 3% per year since the late 1990s. The American Cancer Society projects 158,850 new colorectal cancer cases and 55,230 deaths in 2026, with nearly one third of those deaths occurring in people under 65. If current trends hold, rectal cancer deaths could overtake colon cancer deaths by 2035.
The biggest problem is late detection. About 75% of patients under 50 are diagnosed at an advanced stage, when treatment becomes more difficult and survival rates drop. On average, there is a 7 month delay between first symptoms and diagnosis.
Experts are not sugarcoating it.
Ben Schlechter described it plainly: “This is a medical crisis.”
Mythili Menon Pathiyil confirmed rectal cancer is rising significantly faster than colon cancer.
Andreana Holowatyj says researchers urgently need to understand what is driving the disease at a biological level to reverse the trend.
What is causing it remains unclear. Many younger patients have no family history or obvious risk factors. Scientists are looking at possible links to modern lifestyle and environmental exposure, including diet, obesity, ultra processed foods, changes in gut bacteria, and long term habits that may have started decades ago.
Some groups are being hit harder. Hispanic adults are seeing the steepest rise in death rates among all demographics.
Symptoms are often ignored or misread fatigue, bloating, abdominal pain, unexplained weight loss, and more specific warning signs like blood in stool or a constant urge to use the bathroom. Many younger people do not suspect cancer, and that delay is proving costly.
Screening now officially starts at age 45, but doctors stress that younger people with symptoms should not wait. Early detection makes colorectal cancer highly treatable. Late detection is what is driving the deaths.
Right now, colorectal cancer is the leading cause of cancer death in Americans under 50, a major shift from previous decades.
