Colorectal Cancer Rising Rapidly in Younger People


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By Anish A. Sheth, MD  

Colorectal cancer is often thought of as a disease that primarily affects older adults.

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However, recent studies have shown a concerning increase in the incidence of colorectal cancer in younger people, particularly those under the age of 55.

March is Colorectal Cancer Awareness Month and an opportune time to talk with your doctor about steps you can take to prevent cancer, including screening for colonoscopy.

Penn Medicine Princeton Medical Center’s (PMC) Direct Access Colonoscopy Program helps speed the scheduling of routine screening colonoscopies — outpatient procedures that generally take only 15 or 20 minutes.

Swift Shifts

Colorectal cancer is the third most commonly diagnosed cancer and the third leading cause of cancer death in both men and women in the U.S., according to the American Cancer Society.

In 2023, there will be an estimated 153,200 new cases of colorectal cancer diagnosed in the U.S. and 52,550 people will die from the disease.

Moreover, a new report released this month by the American Society indicates that colorectal cancer is swiftly shifting to a more advanced disease and to younger individuals.

Specifically, the report indicates that diagnoses of colorectal cancer in people younger than 55 have nearly doubled over the past two decades, rising from 11% in 1995 to 20% in 2019.

In addition, the proportion of individuals in the U.S. diagnosed with advanced stage colorectal increased from 52% in the mid-2000s to 60% in 2019.

Symptoms Can be Vague

Most colorectal cancers start out as polyps or growths on the inner lining of the colon or rectum. Polyps don’t usually cause symptoms, but some can change into cancer over time.

The symptoms of colorectal cancer can be vague and may mimic other digestive issues.

Common symptoms include:

  • Changes in bowel habits.
  • Blood in the stool.
  • Abdominal pain or cramping.
  • Unexplained weight loss.
  • Fatigue.

If you experience these symptoms, it is important to seek medical attention, no matter your age.

Screening and Prevention

One of the best ways to prevent colorectal cancer is through screening. The American Cancer Society recommends that people at average risk of developing colorectal cancer start regular screening at age 45.

Those with a family history of the disease should begin screening earlier in consultation with their physician.

There are several screening options available, including stool-based tests and colonoscopy. With colonoscopy, doctors can find and remove polyps before they become cancerous.

In addition to screening, there are other steps people can take to reduce their risk for colorectal cancer.

  • Eat a variety of fruits, vegetables, and whole grains. Limit red and processed meats.
  • Limit alcohol consumption. As the American Cancer Society notes, it is best not to drink alcohol. For people who do drink, they should have no more than one drink per day for women or two drinks per day for men.
  • Not smoking. Quitting smoking can reduce your risk for colorectal cancer as well as many other cancers and health problems.
  • Maintain a healthy weight.
  • Get regular moderate to vigorous exercise. Increasing the amount and intensity of your physical activity could decrease your risk. Limiting your sitting and lying down time may also reduce risk, according to the American Cancer Society.

Direct Access Colonoscopy at PMC

The Direct Access Colonoscopy Program, available through the PMC Center for Digestive Health, allows individuals to schedule a screening colonoscopy without first having an office visit with a gastroenterologist if they meet the following criteria:

  • Age 45 or over.
  • Have a family history of colorectal cancer, are 40 or older, and have not been screened in the past.
  • Have no significant heart, lung, liver, or kidney disease.
  • Are not on blood-thinning medications other than routine aspirin.
  • Have no history of stroke or blood clots.
  • Do not have active asthma.

Individuals who meet the Direct Access Colonoscopy criteria can call (609) 853.6390, option 2, to make an appointment for a colonoscopy at PMC locations in Plainsboro, Princeton, and Monroe.

Individuals who do not meet these criteria, or those who have specific gastrointestinal complaints, should schedule an appointment to see a gastroenterologist prior to scheduling a colonoscopy.

To find a gastroenterologist affiliated with Penn Medicine Princeton Health call (888) 742.7496 or visit

Anish Sheth, MD., is board certified in gastroenterology. He is Chief of Gastroenterology and Co-Medical Director of the Center for Digestive Health at Penn Medicine Princeton Health.

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