Why colorectal cancer is rising in younger adults (James Van Der Beek's death)

• For Journalists
• News Releases
• Latest Releases
• News Release

Why colorectal cancer is rising in younger adults (James Van Der Beek's death)

Northwestern Medicine experts weigh in on the rising rates of early-onset colorectal cancer

Van Der Beek was a champion for early screening, yet his death underscores a troubling trend: Colorectal cancer deaths have been rising among Americans under 50 and it is the leading cause of cancer death in this age group.

Below is a Q&A with two of our colorectal cancer experts, Drs. Sheetal Kircher and Vitaliy Poylin. You are welcome to use it in your coverage. Both are available for interviews today and tomorrow.

Why is colorectal cancer rising in younger adults?

Kircher: "Colorectal cancer is rising in younger adults for reasons we don't yet fully understand, but the main reason it has become the leading cause of cancer death for Americans under 50 is more related to delayed diagnosis. Unlike breast or cervical cancer, most people under 50 do not expect colorectal cancer, so early symptoms, such as rectal bleeding, abdominal pain, anemia, or changes in bowel habits, are often dismissed or attributed to benign conditions. This cancer is not always more aggressive in younger people, rather, it is often diagnosed at a more advanced stage."

Poylin: "While exact causes remain unclear, theories range from environmental factors to microplastics. There is a lot of active research in trying to figure this out. These patterns have been observed around the world. The U.S. is not an exception."

Is there a medical argument for lowering the screening age even further (below 45)?

Kircher: "There is a strong medical argument for earlier, risk-based screening and evaluation, especially for people with symptoms, family history, or other risk factors, regardless of age. While population-wide screening below 45 is still being studied, clinicians should have a low threshold to pursue diagnostic testing when symptoms are present. The most dangerous approach is assuming someone is 'too young' to have colorectal cancer. Age alone should never be a reason to delay evaluation when warning signs exist."

What is colorectal cancer and why is it so deadly when caught late?

Kircher: "Colorectal cancer starts in the lining of the colon or rectum and often grows for years without obvious symptoms. When it is found early, it is one of the most treatable and curable cancers. When it is found at a more advanced state, it has often already spread to vital organs like the liver or lungs, making cure much more difficult. Importantly, we have made major advances in treatment, including more effective chemotherapy, targeted therapies, immunotherapy for select patients, and improved surgical techniques, but these treatments work best when the cancer is detected early and we oftentimes can't cure disease once it has spread to other organs."

Poylin: "Colorectal cancers are tumors that arise from the lining of the colon or rectum and often cause few or no symptoms until later stages. When symptoms do appear, they can include significant bleeding or bowel obstruction, and many cancers have already spread to other organs. While we now treat these cancers much more aggressively and effectively - with combinations of surgery and medications that have improved survival and cure rates compared with even a decade ago - our success is far greater when the disease is found early. That's why it's so crucial to undergo screening for colorectal cancer and report any unusual symptoms to your doctor."