Early-Onset CRC Mortality Rising in Adults Under 45, With Sharp Increases in Rectal Cancer
Mortality from early-onset colorectal cancer (EoCRC) is increasing across most demographic groups in the United States, with the steepest rise seen in rectal cancer, according to a national analysis of CDC mortality data. The findings highlight shifting disease patterns in adults younger than 45 years and underscore the need for updated prevention strategies.
Investigators analyzed mortality trends from 1999 to 2023 among adults aged 20 to 44 years, with projections through 2035 using a machine learning forecasting model. Overall, mortality rates increased across most subgroups, with rectal cancer showing a faster rise than colon cancer in both men and women.
The study found that “EoCRC mortality in U.S. adults <45 years is rising rapidly,” with rectal cancer mortality “2–3 times higher than colon cancer across nearly all strata.” Among demographic groups, Hispanic and White populations experienced the largest increases, while colon cancer mortality declined among Black and Asian/Pacific Islander individuals, although rectal cancer mortality rose in these groups as well.
Geographic variation was also observed. The Western United States showed the most pronounced increase in both colon and rectal cancer mortality, while the Midwest and South demonstrated particularly steep increases in rectal cancer deaths. Age-specific trends revealed that the burden is shifting toward older young adults, especially those aged 35 to 44 years.
Projections indicate continued increases in EoCRC mortality through 2035, with rising death counts across multiple populations.
The authors emphasized that these patterns “highlight the urgent need for equity-focused prevention, early-symptom triage, and reconsideration of targeted screening strategies.”
Reference
Pathiyil MM, Raju AKV, Patel P, et al. A growing crisis: two decades of rising early-onset colorectal cancer mortality and projected trends through 2035 in US adults <45 years. Presented at: Digestive Disease Week; May 2–5, 2026; Chicago, Illinois.
