Colorectal Cancer Awareness: Addressing the Rise among Young Adults

Colorectal cancer was thought of as a disease that mainly affects people over 60. But the reality today is very different. Younger adults are being diagnosed at rates that were unheard of a generation ago. Though this might seem strange to someone under 50, it is one reason awareness is important. Knowledge of why this increase occurs, the symptoms to look out for, and ways to minimise risk is helpful in such cases.

Early-onset colorectal cancer refers to cancer of the colon or rectum diagnosed in individuals younger than 20s, 30s, 40s, and 50s. It is called early-onset colorectal cancer (EOCRC), or sometimes "young-onset CRC".

Step 1: Abnormal cells begin forming small growths on the walls of the colon or rectum.

Step 2: Over time, some polyps can turn cancerous.

Step 3: If it is left undetected, the cancer can grow, invade surrounding tissue, and spread to other parts of the body.

Unlike typical cases linked to ageing, early-onset cases can be due to genetic, lifestyle, and environmental influences.

Recent data indicate a clear upward trend globally and in India.

Important statistics:

• According to the National Cancer Institute, colorectal cancer rates in people under 50 have doubled since the 1990s^[1]

• A study published highlights that early-onset colorectal cancer now accounts for 10–12% of all colorectal cancer cases globally. The World Health Organisation (WHO) reports colorectal cancer is the third most diagnosed cancer and the second leading cause of death worldwide.^[2]

In India, data from cancer registries show a gradual rise in incidence among younger populations, particularly in urban areas.

India-Specific Data

• In India, colorectal cancer is the fourth most common type of cancer, accounting for 64,863 cases and 38,367 deaths in the year 2022. (Indian Journal of Gastroenterology, Springer Nature, 2025)[Daphne Di3] ^[3]

• According to an Indian study conducted at the State Cancer Institute, IGIMS, Patna, and published in the Journal of Cancer Research and Therapeutics (2024), about one-third (33.4%) of patients of colorectal cancer were aged below 40 years with a median age of only 30 years.^[4]

Trend Snapshot

These numbers indicate that colorectal cancer is no longer confined to older age groups.

The exact cause is still being studied, but several contributing factors have been identified. They can be classified as:

Lifestyle-related factors:

• A diet that is high in processed foods and red meat

• Low fibre intake

• Sedentary lifestyle

• Obesity and metabolic disorders

Environmental and biological factors:

• Changes in gut microbiome

• Increased antibiotic use is affecting gut health

• Exposure to pollutants

Genetic factors:

• If there is a family history

• Hereditary conditions like Lynch syndrome

Delayed diagnosis is a major concern in early-onset colorectal cancer.

Reasons for delayed diagnosis include: Symptoms are often dismissed as minor, especially in younger individuals. Awareness about colorectal cancer is limited, routine screening has not previously been advised for those under 50, and people also feel hesitant to consult with a doctor about bowel-related concerns.

Ignored symptoms include: Persistent abdominal pain, blood in the stool, sudden increase in weight loss, and changes in bowel habits.

When these signs are overlooked, diagnosis is often delayed, which can complicate treatment.

Recognising the rising trend, screening recommendations are evolving.

There is an update with the screening protocols. Several global bodies now recommend starting screening at age 45 instead of 50. And individuals with a family history may need earlier screening

Screening methods for colorectal cancer include:

• Colonoscopy

• Stool-based tests

• CT colonography

Why early screening for colorectal matters:

• It helps to detect precancerous polyps

• It enables early intervention

• Improving survival rates significantly

While cancer cases cannot be completely prevented, there are lifestyle changes that can reduce risk.

Dietary habits:

• Eating more foods that have fibre, like fruits, vegetables, and whole grains.

• Reduce processed and red meat consumption.

• Stay hydrated.

Lifestyle modifications:

• Engaging in exercise for at least 150 minutes/week

• Maintain a healthy weight

• Limit alcohol consumption

• Avoid smoking

Health monitoring:

• Be aware of family medical history

• Do not ignore persistent symptoms

• Consult a doctor when in doubt

Knowing about the disease can actually save your life when it comes to CRC. The fact is that there is little awareness of the disease in India, even among well-educated or health-conscious people. There is embarrassment regarding symptoms such as bloody stools.

Key contributions of campaigns:

• Educating young people about symptoms.

• Prompting people to visit physicians.

• Spreading information on colorectal cancer screening.

• Decreasing stigma surrounding discussion about bowel-related disease.

World and national efforts:

• Campaigns of the WHO for the prevention of cancer

• Campaigns of public health in India that emphasize early detection

• Digital information dissemination, social networking, and health websites

Increased awareness can directly influence earlier diagnosis and better outcomes.

You should not wait for symptoms to worsen before seeking medical advice.

Consult a doctor if you experience:

• Bloody stool, even once.

• Pain in the digestive system.

• Feeling tired without a reason.

• Changes in bowel habits that persist for over two weeks.

High-risk individuals should act earlier:

• Family history of colorectal cancer

• Personal history of inflammatory bowel disease

• Known genetic syndromes

Getting a check-up from a professional in the early stages can make a difference in outcomes.

The increase in cases of colorectal cancer in young adults is a health concern. While the exact causes are being studied, lifestyle patterns, delayed diagnosis, and lack of early screening play important roles. The science points to a convergence of modern lifestyle habits, dietary changes, and rising obesity and low awareness as the key drivers. The good news is that many of these risk factors are within our control.

Listen to your body, know your family history, and don't brush off persistent digestive issues and symptoms. And if you're approaching 40, have a conversation with your doctor about screening.

Disclaimer: This article is for general informational and educational purposes only and does not replace professional medical advice, diagnosis, or treatment. If you have symptoms or concerns about your colorectal cancer risk, consult a qualified healthcare professional.