Colorectal cancer is now the number one cause of cancer death in adults under 50, according to a 2026 report from the American Cancer Society.
Here are 20 numbers to know
1. In 2016, 45% of new diagnoses are projected to be in people under 65, up from 27% in 1995
2. In 2022, 22% of CRCs were diagnosed in people under 55, double the 11% share in 1995 even as this age group shrank as a share of the general population
3. An estimated 24,640 new CRC cases will occur in under-50s in 2026, made up of 14,810 colon and 9,830 rectal cases. An estimated 3,890 under-50s will die from CRC in 2026
4. Incidence in 20 to 49 year olds has risen from 1-2% annually since the mid-1990s. Incidence accelerated to 3% per year from 2013 and 2022, and then spiked to 6.4% per year from 2019 to 2022.
5. Localized-stage diagnoses jumped 12.4% per year from 2019 to 2022, driven by new screening of 45–49 year olds. Regional-stage diagnoses up 3.4% per year since 2011 and distant-stage diagnoses up 2.7% per year since at least 1998.
6. The rise is dominated by left-sided tumors — sigmoid colon and rectum Sigmoid colon cancer and rectal cancer in 20–49 year olds nearly doubled between 1998 and 2022)
6. Distal colon cancer rose 6.4% per year in young adults between 2019 and 2022, but proximal tumors increased only 26% over the same period.
7. According to the report, risk is tied to birth year, not diagnosis year. Every generation born after roughly 1950 in the US carries higher risk
8. The 50–64 age group is now seeing rising incidence, because the high-risk 1960s birth cohort has entered middle age
9. Three in 4 patients under 50 are diagnosed with advanced disease, and 27% of under-50s are diagnosed with distant metastases compared to 21–23% of older patients.
10. Younger patients are more likely to present with hematochezia, iron deficiency anemia and abdominal pain
11. One study cited in the report found a 40% longer time to diagnosis in under-50s compared with older patients, reflecting both longer symptom duration and longer workup time. Barriers include lower symptom awareness and insurance-related delays, more common in younger adults.
12. Death rate in under-50s has increased 1% per year since 2004
13. The death rate varies by race, declining 0.6% a year in Black individuals, but rising 1.6% a year in White individuals, 1.9% a year in Hispanic individuals and 2.6% a year in American Indian individuals
14. Nearly one third of the projected 55,230 CRC deaths in 2026 will be in people under 65
15. Despite later-stage diagnosis, under-50s have similar or better 5-year survival than older patients.
16. The biggest gap is at the distant stage — 23% survival in under-50s compared to 17% in 50-64 year olds and 10% in 65+.
17. Sixteen to 20% of under-50 CRC is linked to hereditary or germline mutations.
18. Known risk factors like obesity, physical inactivity don’t fully explain the trend. According to the report, they’re more associated with colon than rectal tumors, yet rectal cancer is driving the rise.
19. Only 37% of 45-49 year olds are up to date with screening, up from 20% in 2019, while 45-49 year olds represent 50% of all CRC diagnoses before age 50.
20. Prevalence of advanced adenomas is similar in 45-49 and 50-54 year olds at first screening. Studies show 21-50% reduction in CRC incidence and 39% reduction in mortality from screening before age 50.
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