LiveSmart: Colorectal Cancer – On the Rise Among Millennials and Gen Z

[Written by Ragavan Siddharthan, MD, Capital District Colon & Rectal Surgery, St. Peter’s Health Partners Medical Associates.]

Colorectal cancer remains the second leading cause of cancer-related death in the United States. Over the past two decades, there has been considerable improvement attributed to clear screening guidelines, as well as advancements in surgical and medical therapies. Early-stage colorectal cancer has a significantly better prognosis compared to late stage, underscoring the importance of screening.

Despite these advancements, there has been a notable increase in colorectal cancer among young patients, typically under the age of 45-50, which is the typical screening age in the United States.

Dr. Ragavan Siddharthan

Unfortunately, early-onset colorectal cancer is more likely to present at an advanced stage and in locations, such as the rectum, which are more challenging to treat. The overall incidence of colorectal cancer has risen in patients younger than 50 and is now estimated to account for 25 percent of newly diagnosed rectal cancers.

In fact, epidemiological studies indicate the estimated risk of early-onset colon cancer has doubled, and the risk of early-onset rectal cancer has quadrupled for individuals born after 1990. Colorectal cancer is now the leading cause of cancer death in younger men and the second leading cause in younger women. This rise has been observed globally, not just in the United States.

The primary question is: why? Why is the rate of colorectal cancer increasing so much in the younger population? Unfortunately, there is no clear answer. Researchers are diligently working to uncover explanations.

Current hypotheses include dietary changes over the last two decades, including increased consumption of processed foods or high-sugar beverages, obesity/sedentary lifestyle, changes in the colonic microbiome, or alterations in immune responses potentially due to allergens or antibiotics. In reality, it is unlikely that there is a single clear cause; rather, it is likely multifactorial.

Despite not knowing the precise cause for the rise in early-onset colorectal cancer, there are several proactive measures you can take to protect yourself and your family.

Firstly, listen to your body. The National Cancer Institute has identified four common signs in patients with early-onset colorectal cancer. Having one of these signs is associated with twice the likelihood of being diagnosed with colorectal cancer than having none of the signs:

  1. Changes in bowel habits such as new onset diarrhea or constipation
  2. Blood in your stool
  3. Anemia/weakness
  4. Generalized abdominal pain

Actions you can take to reduce your risk include increasing your activity level, quitting smoking, and reducing the consumption of processed foods. Colorectal issues may be uncomfortable to discuss, but it remains a significant cancer that can affect anyone at any age. The best protection you can have for yourself is to remain vigilant and discuss any concerns with your doctor.

Capital District Colon & Rectal Surgery (CDCRS) is located on the St. Peter’s Hospital campus at 319 South Manning Blvd., Suite 310, in Albany. The physicians at CDCRS are specialty-trained colorectal surgeons who diagnose and treat colon and rectal problems with excellence and compassion, working in collaboration with a multidisciplinary team for the best outcomes possible.

For information, visit us at or call (518) 438-2776.

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