Experts have revealed the reason why an increasing number of young adults are now found to be suffering from late-stage colon cancer. 

Early onset colorectal cancer has become the leading cause of cancer-related deaths for men under 50 and the second-leading cause for women under 50 in the US. 

Over 50,000 Americans are expected to die from colorectal cancer this year, while 150,000 are predicted to be diagnosed with the disease.

While still a minority, experts remain concerned about increasing cases among younger people as officials estimate 2,600 new cases among those under 50. 

Studies also suggest that cases in people between 20 to 24 have risen by 185 percent while the CDC noted a 333 percent increase in cases among teenagers between 15 to 19 as of 2024. 

Cases are also expected to double between 2010 and 2030, after having risen two percent a year since the early 2000s. 

But now, researchers from the Dana-Farber Cancer Institute and Harvard Medical School found that patients with early-onset colorectal cancers often experience delays in diagnosis because neither physicians nor patients initially suspect that they are suffering from the disease.

As a result, doctors are more likely to diagnose patients when they are at advanced stages of the disease – leading to aggressive forms of treatment and lower chances of survival. 

According to research, reasons such as non-obvious symptoms, lack of routine screening and confusion with other conditions such as irritable bowel syndrome and Crohn’s disease can contribute to a delay in diagnosis. 

And not only do young people experience a delay in diagnosis but they also endure hardships unique to their age group such as infertility, medical debt and mental health struggles. 

Over 50,000 Americans are expected to die from colorectal cancer this year, while 150,000 are predicted to be diagnosed with the disease

Lead author Sara K. Char, a clinical fellow in Hematology and Oncology at Dana-Farber Cancer Institute, said: ‘The incidence of GI cancers in adults younger than age 50 is rising globally. 

‘Ongoing research efforts investigating the biology of early-onset GI cancers are critical to developing more effective screening, prevention, and treatment strategies.’

The researchers conducted a comprehensive literature review of multiple studies focusing on early-onset colorectal, esophagogastric and pancreatic cancers from across the world. 

Additionally, they also reviewed previous studies on rare early onset gastrointestinal GI cancers including appendix and neuroendocrine tumors. 

The scientists particularly focused on studies that highlighted the risk factors, common patterns, observable traits and underlying genetic reasons that cause colon cancer. 

Results showed that one of the most common reasons why young people were not being treated during early stages of colon cancer was due to late diagnosis. 

Most colorectal cancers start as colon polyps – tumors in the wall of the colon – that are usually non-cancerous and can be removed during colonoscopies.

However, sometimes these tumors can turn cancerous if left untreated for prolonged periods of time, according to John Hopkins University.

Additionally, colorectal cancers do not show symptoms in the early stages – making regular screening tests such as a coloscopy essential to ensure good colon health. 

However, the CDC recommends that people should begin to get colonoscopies at the age of 45 and repeat every five years. 

The agency notes that people under the age of 45 suffering from Crohn’s disease, ulcerative colitis or have a family history of colon cancer should also get tested. 

But the CDC has no such recommendations for young people experiencing symptoms that may not have a family history of colon cancer or are suffering from related diseases – leading to delayed diagnosis.  

And common symptoms such as abdominal pain, changes in bowel habits (diarrhea, constipation), rectal bleeding and weight loss can also be misdiagnosed as IBS or Crohn’s disease. 

Lead author Sara K. Char, a clinical fellow in Hematology and Oncology at Dana-Farber Cancer Institute

A lack of clear early symptoms combined with irregular screening can lead to delays in colon cancer diagnosis. 

Along with this, the researchers involved in this study also revealed the toll a cancer diagnosis can take on a young adult – which can further fuel delays in diagnosis or treatment.  

The scientists noted that despite being in their peak earning years, young patients are more likely to experience financial hardship because of their cancer diagnosis due to treatment costs. 

In a 2024 survey, the American Cancer Society Cancer Action Network found that nearly half of cancer patients and survivors had medical debt of over $5,000 despite most of them being insured. 

They also found that those with cancer-related medical debt are three times more likely to be behind on recommended cancer screenings. 

Furthermore, 27 percent of those surveyed with cancer-related medical debt have gone without adequate food and 25 percent have skipped or delayed care. 

Nearly 50 percent of people saw their credit scores decrease and 30 percent had difficulty qualifying for loans – making their financial condition even worse. 

Aggressive forms of treatment can also damage a patient’s chances of having a children as excessive radiation can damage and kill reproductive cells and tissues in the body

Though official guidelines for early-onset and average-onset cancers are the same, researchers emphasized that younger patients are more likely to receive aggressive colon cancer treatment, often without a survival advantage. 

These aggressive forms of treatment can also damage a patient’s chances of having a children as excessive radiation can damage and kill reproductive cells and tissues in the body. 

Though the American Society of Clinical Oncology recommends that oncologists discuss treatment-related fertility concerns with patients of reproductive age, a recent study found that 50 percent of patients reported that their doctors did not talk to them about the impact of their disease or treatment on having future children. 

This can make it difficult for couples’ or individuals to conceive over time and impact their quality of life. 

The study also found that early-onset colorectal cancer survivors are also more likely to report problems with anxiety, body image and sexual dysfunction compared to advanced onset survivors. 

They are also more likely to report worse social functioning and physical quality of life. 

Additionally, male patients with early onset colorectal cancers are more likely to suffer depression than those diagnosed with average onset colorectal cancers.

As a result, the involved researchers concluded that ‘a better understanding of underlying etiologies, optimized screening strategies and improved survivorship support is necessary’ for young adults. 

The study was published today in BJS journal by Oxford University Press.