Early Onset Colorectal Cancer: Why Young Adults Face Delayed Diagnoses
Early onset colorectal cancer has increased by nearly 50 percent over the last 30 years, raising serious concern among oncologists and public health researchers. A study from the University of Colorado Cancer Center, presented at the American Society of Clinical Oncology Annual Meeting in Chicago, set out to identify the factors contributing to late stage diagnoses in young patients and what can be done to improve outcomes.
Rising Incidence in Young Adults
Early onset colorectal cancer refers to diagnoses occurring in patients under 50 years of age. The reasons behind this increase are not fully understood, but leading theories include rising obesity rates in children, decreased physical activity, and changes in the gut microbiome due to increased antibiotic exposure during childhood.
“The rising incidence of colorectal cancer in young adults is concerning,” said Gurprataap Sandhu, MD, a fellow at the CU Cancer Center. “In addition to trying to identify the cause of this increase, it is crucial to diagnose these patients at an earlier stage to improve clinical outcomes.”
The numbers are striking. According to a survey conducted by the Colorectal Cancer Alliance, 82 percent of young cancer survivors were initially misdiagnosed, 73 percent were diagnosed at a later stage, 50 percent felt their symptoms were ignored, 62 percent had no family history of the disease, and 67 percent saw at least two doctors before receiving a correct diagnosis.
Prolonged Bleeding and Delayed Diagnosis
The University of Colorado study analyzed 173 patients with early onset colorectal cancer. More than half of those patients reported rectal bleeding before their diagnosis. On average, 294 days passed between the first time a patient noticed rectal bleeding and the time they received a diagnosis. By the time of diagnosis, 37.8 percent of the patients were already at Stage IV.
“Our results show that young adult patients present with a much higher rate of Stage IV colorectal cancer compared to patients who are older,” said Sandhu. “This is especially significant as Stage IV patients have a much worse prognosis and are typically incurable with a few exceptions.”
The delay between symptom onset and diagnosis is likely linked to misattribution of bleeding to hemorrhoids, a common and less serious condition. This misidentification leads patients and physicians alike to delay further investigation, allowing the cancer to progress to more advanced stages before a colonoscopy is ordered.
“Patients and primary care physicians should be made aware of this finding in order to facilitate timely referral for a colonoscopy, which may lead to earlier diagnosis, less advanced disease at diagnosis, and improved outcomes,” Sandhu noted.
Screening Age and Survival Rates
Traditionally, colorectal cancer screening began at age 50. In response to the increasing incidence of early onset colorectal cancer, the American Cancer Society lowered the recommended screening age for average risk patients to 45. This change reflects growing recognition that the disease is no longer confined to older populations.
The stakes of early detection are significant. If caught early, the average five year survival rate for colorectal cancer patients reaches 90 percent. That figure drops to just 14 percent when the disease is diagnosed at later stages. Closing the diagnostic gap for young patients is therefore not only a clinical priority but a matter of survival.
The Role of Clinical Trials in Colorectal Cancer Research
Improving outcomes for patients with early onset colorectal cancer depends on continued investment in research and clinical trials. Studies evaluating novel screening tools, targeted therapies, and biomarker driven treatment approaches are actively expanding our understanding of this disease in younger populations.
FOMAT supports oncology research across the United States, providing sponsors and CROs with access to experienced investigators and diverse patient populations. Our sites are equipped to conduct Phase I through Phase IV studies across a range of cancer indications. To learn more about our oncology capabilities or our active studies, visit fomatmedical.com.