COLORECTAL cancer is now the leading cause of cancer death in men and women in the USA under the age of 50 combined.
Overall cancer mortality rates have fallen by 44% in people younger than 50 in the USA over the past three decades, according to a new study by the American Cancer Society.
Colorectal cancer mortality has proved an outlier, increasing annually by more than 1% since 2005 until it became the leading cause of cancer death in men and women combined in 2023.
American Cancer Society Research
Researchers analysed the annual number of cancer deaths per 100,000 men and women under 50 for the top five cancer-related deaths in the USA from 1990 to 2023.
Data from the National Center for Health Statistics provided that more than 1.2 million people died from cancer in the relevant demographic and time frame.
The study only used national-level ecologic data but nonetheless gave valuable insight into the optimisation of colorectal cancer screening programmes.
Colorectal Cancer
Most early-onset gastrointestinal cancers are associated with modifiable risk factors including obesity, poor-quality diet, sedentary lifestyle, smoking, and alcohol consumption.
Nonmodifiable risk factors include family history, hereditary syndromes, and inflammatory bowel disease for patients with early-onset colorectal cancer.
Gastrointestinal cancers have become the fastest-growing type of early-onset cancers diagnosed in the USA, and research is increasingly denouncing colorectal cancer as a disease only associated with older age.
Other Leading Causes
Other cancers with the highest mortality rates include breast, lung, and brain cancers, and leukaemia.
Colorectal cancer deaths were the only ones in the relevant group to increase from 1990 to 2023, marking a surge from ranking as the fifth most common cause of cancer-related death from 1990 to 1994.
Screening Implications
American Cancer Society researchers emphasised that colorectal cancer screening before the age of 50 has been associated with reduced incidence and mortality as well as early diagnosis.
Screening was recommended to begin at age 45 for people at average risk and earlier for people with a high-risk genetic or family history.
References
Siegel RL et al. Leading cancer deaths in people younger than 50 years. JAMA. 2026;335(7):632-634.
Jayakrishnan T, Ng K. Early-onset gastrointestinal cancers: A review. JAMA. 2025;334(15):1373-1385.
American Cancer Society. Mortality under 50 declines for 4 of 5 leading cancers in U.S., but colorectal now top cancer killer, new ACS study finds. 2026. Available at: https://pressroom.cancer.org/under-50-mortality-declines. Last accessed: 22 February 2026.
