Colorectal cancer is no longer considered a disease that only affects older adults. In recent years, physicians have seen a rise in colorectal cancer among people under age 50, even as rates have declined in older adults due to routine screening.

“We are seeing more colorectal cancer in younger adults,” says Dr. Besma Samdani, WellSpan gastroenterologist. “While screening has helped reduce rates in older populations, cancer is increasing in people under 50.”

Experts believe several factors are contributing to this shift. Genetic risk can be inherited, and conditions such as inflammatory bowel disease increase risk. Environmental exposures and long-term lifestyle changes – including diet, physical inactivity, obesity, smoking and alcohol use – may also play a role.

Why colorectal cancer is harder to catch in younger patients

One of the most concerning aspects of colorectal cancer in younger adults is how quietly it can develop.

“Younger people may not necessarily have symptoms, or they may have very minimal symptoms,” Dr. Samdani explains.

When symptoms do occur, they are often dismissed as stress, diet changes or common digestive issues. Warning signs that should never be ignored include blood in the stool, persistent changes in bowel habits or stool shape, abdominal pain, unexplained weight loss or iron deficiency anemia.

Delayed diagnosis is more common in younger patients for several reasons. Colorectal cancer has traditionally been viewed as a disease of older adults, so symptoms like rectal bleeding or abdominal pain may initially be attributed to hemorrhoids, irritable bowel syndrome or anal tears. Younger adults are also less likely to undergo routine screening and may delay care due to busy schedules, embarrassment or insurance barriers.

“If you feel your symptoms aren’t being taken seriously, it’s okay to advocate for yourself,” Dr. Samdani said. “Be specific, ask clear follow-up questions and seek another opinion if needed. Persistent symptoms deserve attention.”

Understanding risk and the role of family history

Some people face a higher risk of developing colorectal cancer at a younger age, including those with a family history of colorectal cancer or colon polyps, inherited genetic syndromes such as Lynch syndrome and inflammatory bowel disease.

“Knowing your family’s cancer history is important,” Dr. Samdani said. “People should be aware if immediate family members have had colon cancer, especially if it has occurred across multiple generations.”

Screening can prevent cancer and save lives

It is recommended that average risk adults begin colorectal cancer screening at age 45, lowered due to rising rates in younger adults. People at a higher risk may need to begin screening earlier and be screened more frequently.

Screening options include at home stool tests and visual exams like a colonoscopy. Colonoscopies remain the most comprehensive option because it allows doctors to find and remove precancerous polyps during the same procedure.

“The most important thing to remember is that colorectal cancer is highly preventable and highly treatable when detected early,” Dr. Samdani said. “Screening doesn’t just find cancer – it can prevent it.”

Get screened and schedule your colonoscopy here.