An increasing number of people are dying of colorectal cancer at a young age, including those as young as 20. Actor James Van Der Beek, who was diagnosed with colorectal cancer in 2023, died at age 48 on Feb. 11, 2026, bringing the disease back into the limelight.
The Conversation U.S. asked gastrointestinal oncologist Christopher Lieu and cancer researcher Andrea Dwyer to explain what’s known about early-onset colon cancer and what young people can do to protect themselves.
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Why are more young people getting colorectal cancer?
Researchers have identified a number of factors associated with increasing numbers of young people developing colorectal cancer, but there is no one clear answer that explains this trend.
Lifestyle factors like ultra-processed foods and alcohol, as well as lack of exercise, have been linked to early-onset colorectal cancer. However, these are correlations that aren’t proven to be the cause of colorectal cancer in young adults.
Many researchers are focusing on the gut microbiome, which is an ecosystem of microorganisms in your gut that helps your body digest food and carry out other important functions. When the microbes in the gut are out of balance – a condition called dysbiosis – this causes a disruption that allows for inflammation and negative health effects, including increased cancer risk.
What increases your risk of developing colorectal cancer?
Beyond genetics, several lifestyle factors can increase your risk of developing colorectal cancer.
For example, someone’s diet plays a role in cancer risk. Eating a lot of red meat and processed foods and not enough dietary fiber can increase your risk of colorectal cancer. Alcohol also causes cancer – even having less than one drink a day can increase your cancer risk.
Smoking, obesity and lack of exercise are other factors that increase cancer risk.
What’s the survival rate for young people with colon cancer?
There is a lot of debate among researchers on whether there are differences in survival rates between those with early-onset colorectal cancer survival and those who develop the disease after age 50.
Finding cancer at an early stage can lead to five-year survival rates as high as 80% to 90%. When cancer is detected at an advanced stage where it has spread to other parts of the body, survival rates are closer to 10% to 15%.
One study found that young patients with metastatic colon cancer had a slightly lower survival rate compared with those age 50 or older.
What are early symptoms of colorectal cancer?
The most common signs and symptoms for early-onset colorectal cancer are blood in the stool, abdominal pain and a change in bowel habits, or any combination of these conditions. Unexplained anemia, or low red blood cell levels, is another potential symptom. These are warning signs that people should not ignore.
Having these symptoms does not necessarily mean you have colorectal cancer, but they are worth discussing with a physician. In some cases, your doctor may request a colonoscopy for further evaluation.
How does colon cancer screening work?
The first step is to have a conversation with your health care team about which test is right for you. Understanding what your risk category is helps guide screening, prevention and lifestyle changes to reduce your likelihood of colorectal cancer.
People with an average risk for colorectal cancer typically have no personal or significant family history of colorectal cancer, hereditary cancer, precancerous polyps or inflammatory bowel disease. They have several options for screening, including stool tests that check for blood and abnormal cells, as well as imaging scans to visualize the colon and rectum. Screening is recommended to begin at age 45 and should continue at regular intervals until age 75.
People with a high risk of colon cancer typically have a personal or family history of colorectal cancer, hereditary cancer or inflammatory bowel disease. They may also have several lifestyle risk factors. Colonoscopy is the only recommended screening test for those with high risk, and earlier and more frequent screening may be necessary.
How can you reduce your risk of colon cancer?
Communication and action are key. Talk to your health care team about your personal risk based on your age, family history and any signs and symptoms to ensure you’re matched with the screening exam and test best for you.
Take charge of your health. There are lifestyle factors you can control to reduce your personal risk of colorectal cancer. These include regular physical activity; a diet high in fruit, vegetables and fiber, and low in processed meats; and maintaining a healthy weight. Moderating or eliminating alcohol and tobacco use can also reduce your colorectal cancer risk.
Share information with loved ones and your health care team. Knowing your personal and family history of polyps or colorectal cancer and communicating it with your doctor can help ensure you get the right test at the right time. Sharing your personal history could save the lives of your children, siblings and parents.
