Rectal Cancer Deaths Rising Alarmingly Among Young Adults

Rectal cancer mortality rates are increasing two to three times faster than colon cancer deaths among Americans aged 20 to 44, according to new research that highlights a growing health crisis affecting younger generations.

A study to be presented at Digestive Disease Week 2026 in Chicago reveals that this trend is particularly concerning for older millennials, with projections showing rectal cancer mortality will continue to escalate through 2035 for those between 35 and 44 years old.

“Colorectal cancer is no longer considered predominantly a disease of older adults,” explained lead author Mythili Menon Pathiyil, a gastroenterology fellow at SUNY Upstate Medical University. “Rectal cancer, especially, is becoming a growing problem in younger individuals.”

The research team analyzed Centers for Disease Control and Prevention (CDC) death records spanning 1999 to 2023. Using machine learning models to forecast future trends, they discovered the mortality gap between rectal and colon cancers is widening across all demographics.

Hispanic adults and residents of Western states have experienced the steepest increases in rectal cancer deaths, according to the findings. This regional and demographic variation suggests potential environmental or lifestyle factors that may contribute to the disparity.

A particularly troubling aspect of this trend is the significant diagnostic delay often experienced by younger patients. While older adults typically begin treatment within a month of symptoms appearing, young adults face an average seven-month delay before receiving care.

Dr. Rachel Gordon, a New York-based colorectal and general surgeon at Episcopal Health Services, noted that young people are increasingly being diagnosed with rectal cancers at more advanced, aggressive stages. “We’re seeing a combination of lifestyle and environmental exposures, including diet and changes in the gut microbiome, potentially playing a role,” said Gordon, who was not involved in the study.

Medical experts point to a concerning pattern where primary care providers often dismiss warning signs in younger patients. Symptoms such as rectal bleeding or changes in bowel habits are frequently attributed to benign conditions like hemorrhoids, leading to critical delays in diagnosis and treatment.

“If something doesn’t feel right, or if you experience symptoms such as rectal bleeding, persistent changes in bowel habits, narrow stools, a feeling of incomplete bowel emptying, abdominal pain, unexplained weight loss or fatigue, it’s important to see your doctor promptly,” Gordon advised.

The findings come amid increasing concern about colorectal cancer rates in younger populations generally. In recent years, medical organizations have lowered the recommended age for beginning colorectal cancer screenings from 50 to 45 for average-risk individuals. However, this research suggests that current screening strategies may need further evaluation to address the specific rise in rectal cancer.

Public health experts point to several potential factors behind the increase, including dietary changes, sedentary lifestyles, increased obesity rates, and alterations in gut microbiome composition. The Western diet, high in processed foods and low in fiber, has previously been linked to increased colorectal cancer risk.

The study’s findings underscore the importance of raising awareness about colorectal cancer symptoms among both the public and medical professionals. Early detection remains critical for improving survival rates, particularly for rectal cancer where treatment options and outcomes may differ from colon cancer.

“Our study shows that rectal cancer is driving much of the increase in colorectal cancers,” Pathiyil emphasized. “It’s likely to worsen over time if we don’t change what we are doing right now.”

The research highlights the urgent need for targeted education, improved diagnostic protocols, and potentially earlier screening for high-risk individuals to address this growing health concern among younger Americans.