Colorectal Cancer Is Rising in Teens, and Nearly Half of Advanced Cases End in Death, New Study Finds

The numbers behind the headlines

Researchers at Mass General Brigham Cancer Institute in Boston tracked 84 patients age 21 and under diagnosed with colorectal cancer at 34 U.S. hospitals between 2012 and 2023. The findings, presented at the American Academy of Pediatrics' annual meeting, are stark: 45.2% of patients died from the disease, and the cancer returned in 36.9% of cases, according to the Daily Mail and the New York Post.

The median age at diagnosis was 16.5. More than half of patients had already reached stage 3 by diagnosis, meaning the cancer had spread locally, and 29% were stage 4, meaning it had reached distant organs, the New York Post reported.

Most of these kids had no family history to flag them as high-risk. Daily Mail reported that just one in five patients had a parent, sibling, or grandparent with colorectal cancer, meaning 80% came out of nowhere by the usual risk calculus doctors use.

Why diagnosis takes too long

Dr. Erica Arnold, a pediatric surgeon and the study's lead author, said colorectal cancer is "unfortunately, becoming more common in adolescents and young adults and represents a different disease than colorectal cancer diagnosed in older adults," according to the Daily Mail. "When diagnosed, it is often aggressive and associated with high rates of relapse and mortality," she said.

The most common symptom wasn't rectal bleeding. It was back or abdominal pain, reported by 74% of patients, per Daily Mail's reporting on the study. Changes in bowel habits showed up in 45% of cases, unexplained weight loss in 40%, and rectal bleeding in 38%.

Those symptoms mimic hemorrhoids, IBS, or a gluten issue, things doctors and patients alike don't associate with cancer in a 16-year-old. Jo Henderson, now 18 and from Seekonk, Massachusetts, told NBC News she spent months getting tested after symptoms of stomach pain, bloating, and constipation before her diagnosis of advanced colorectal cancer at 17. "I was expecting a gluten allergy, lactose intolerance," she said. "Literally anything but cancer."

John Veale, diagnosed with stage 4 colon cancer at 31 after six months of blood in his stool he chalked up to hemorrhoids, told the Association of American Medical Colleges he had "a lot on my plate" between work and grad school when symptoms started around Christmas 2024.

A broader review of 81 studies covering more than 24.9 million people under 50, cited by OncoDaily, found the median time from first symptom to diagnosis was four months, with delays of four to six months common across early-onset colorectal cancer generally.

A genuinely rare disease, still climbing

Colorectal cancer in people under 20 remains exceptionally rare. NBC News reported it affects roughly one in a million people in that age bracket, fewer than 100 cases a year nationwide. Dr. Danielle Cameron, director of pediatric surgical oncology at Mass General Brigham Cancer Institute, who worked on the study, told NBC that cases in adolescents are "still very, very rare," even as she and colleagues are watching the numbers tick up.

But the long-term trend above age 20 is not small. The New York Post reported colorectal cancer rates have risen fivefold among kids 10 to 14, tripled among teens 15 to 19, and nearly doubled among young adults 20 to 24 over the past two decades. Per American Cancer Society data cited by the AAMC, the share of all colorectal cancer diagnoses occurring in people under 55 has doubled, from 11% in 1995 to 22% in 2022.

Dr. Kimmie Ng, founding director of the Young-Onset Colorectal Cancer Center at Dana-Farber Cancer Institute, called the trend "an absolute mystery and one of the big unanswered questions in medicine right now," per the AAMC. She describes a "birth cohort effect," where someone born in 1990 carries quadruple the rectal cancer risk and more than double the colon cancer risk of someone born in 1950. Her leading hypothesis is obesity, noting that obesity rates among 20-to-39-year-olds have more than doubled in recent decades. No single cause has been proven, and researchers are still investigating diet, microbiome changes, and environmental exposures.

Where diagnostics are headed, and where they aren't yet

Separately, Stanford University researchers published a new urine test, called uRARE-seq, in Nature Medicine on October 2, aimed at detecting bladder cancer, a disease that strikes roughly 85,000 Americans a year according to the American Cancer Society. The test, which reads RNA signals from tumor cells rather than hunting for DNA mutations, correctly flagged cancer in 95% of patients and correctly cleared 90% of healthy participants in a review of nearly 700 urine samples. Dr. Maximilian Diehn of Stanford, the study's senior author, said the approach can also indicate how aggressive a tumor is, though he cautioned "more clinical studies will be required to prove" it leads to earlier diagnosis.

No comparable noninvasive screening tool exists yet for colorectal cancer in adolescents, and colonoscopy, the standard diagnostic step, isn't something doctors reach for quickly in a 16-year-old complaining of stomach pain. Dr. Arnold's study team is pushing providers to take unexplained weight loss and rectal bleeding seriously in young patients rather than defaulting to the most common, least alarming explanation. Whether that shift in clinical suspicion happens fast enough to catch the next case before it reaches stage 4 remains the open question.