Colorectal cancer at young age: a rising concern or media hype?
Isn’t colorectal cancer a disease of people over 50?
I thought it was. Of course, I had heard of unfortunate diagnoses of people I know in their late 30s or early 40s, but I assumed these were rare exceptions to the rule.
So, just how exceptional are they? Let’s take Belgium in 2022. That year, 7,190 women and men aged 50 or more were diagnosed with colorectal cancer. This is 14 times more than the 515 people under 50 who received the same diagnosis. So, it still holds true that colorectal cancer mainly affects people over 50. But let’s put this in perspective. 515 people over a year is a full high-speed train to Paris, not an ‘exception.’ It’s 334 people in their 40s, 115 in their 30s, and 66 even younger than that.
These figures have raised concerns in the medical community, sparked questions in the research community, and set off fearmongering media headlines that could read: “We’re on the verge of a cancer epidemic in young people” and invite you to click(bait) to know more. But is there any truth to the panic?
Is colorectal cancer truly increasing in young people?
The short answer is yes. There is a slow but consistent increase in the incidence of colorectal cancer in people under 50. This trend has been observed in people born after the 1950s. First seen in Australia, Canada, and the USA, most countries in Europe and globally are now experiencing the same phenomenon. The average increase in Western Europe is about 2% each year, which would translate into about 10 additional people next year in Belgium, and then another 10 the year after, and so on.
Why is this happening?
Part of the explanation comes from detrimental dietary exposure due to the rise in processed food and sweetened beverage consumption and from a more sedentary lifestyle, both of which have emerged earlier in people’s lives since the 1960s. All of this has led to increasing rates of obesity and type 2 diabetes at younger ages, which are risk factors for colorectal cancer.
But is that the full story? Unlikely. Many things have changed for people born after 1960 compared to those born earlier in the 20th century. Thanks to research already conducted, it has become clear that some exposures in the early years of life—starting in utero until young adulthood—might play a role. The list of suspects is long: pesticides, dioxins, PFAS (so-called “forever chemicals”), antibiotics, and more.
If these early-life exposures contribute to the risk of colorectal cancer at a young age, increasing our understanding of their impact and taking action will be important for future generations. Large research initiatives investigating this are ongoing and will bring more clarity, such as the PROSPECT Cancer Grand Challenge project. But for adults like me, there is also a hard truth: we cannot do anything now about what happened during our early life.
What do young people affected need?
Young people with cancer have specific treatment needs. While the biology and behavior of colorectal cancer occurring at a young age do not seem to differ significantly from cancers in older people, care and support need to be tailored to the specific challenges of this life period: the possibility of having children, the need to care for children and aging parents, and the importance of staying active and continuing to work.
If you know people in such a situation, you may want to offer support. Simply asking them what you can concretely do to relieve them or help them through this difficult period is probably the best place to start.
Take action now
Regardless of age, there are well-known protective factors to reduce the risk of colorectal cancer:
✅ Stay physically active
✅ Maintain a healthy weight
✅ Get screened. In Belgium, the recommended age is 50-74, or earlier if you have a family history of the disease.
There are also well-known risk factors to avoid:
🚫 Processed and high-calorie, low-fiber foods
🚫 Alcohol consumption
🚫 Smoking
Though cutting down on unhealthy choices that are heavily advertised and marketed is not simple—every small effort matters, and it’s never too late to start
For those who want to go the extra mile, you can:
✔ Support patient groups
✔ Share reliable information to counter misinformation
✔ Donate to cancer research
Small actions can make a big difference—both today and for future generations.
References
Changing epidemiology of colorectal cancer — birth cohort effects and emerging risk factors.
A Comprehensive Comparison of Early-Onset and Average-Onset Colorectal Cancers.
Why are so many young people getting cancer? What the data say.
