Colon Cancer Is Rising in Adults Under 50 — Here’s What You Need to Know

Oncologist Swati Sikaria, MD, provides expert insights, advice.

The recent death of actor James Van Der Beek at age 48 after a battle with colorectal cancer has brought renewed attention to a troubling trend: more young adults are being diagnosed with — and dying from — this disease.

Best known for his role in “Dawson’s Creek,” Van Der Beek was diagnosed with stage 3 colorectal cancer in his mid-40s and died in February 2026, underscoring the reality that colon cancer is no longer just a disease of older adults.

In fact, since 2011 rates have been stable for those aged 50-64 years, while increasing by 2 percent per year in people younger than 50 years of age, according to the American Cancer Society. These trends are rapidly shifting the patient population younger; 20 percent (1 in 5) of cases of colorectal cancer in 2019 were in people 54 years or younger, up from 11 percent (1 in 10) in 1995.

Van Der Beek’s death has sparked widespread discussion among physicians and public health experts, highlighting the urgent need for awareness, earlier screening, and preventive action, especially among younger adults.

We spoke with Swati Sikaria, MD, hematologist and oncologist with the Hunt Cancer Center, about why colorectal cancer is rising in younger people and what steps individuals can take to protect themselves.

Q: Recent data shows colorectal cancer rates rising among adults under 50. What factors do you think are driving this increase?

Dr. Sikaria:
We don’t fully know yet, but we have some important clues. About one-third of younger patients diagnosed with colorectal cancer have a genetic cancer syndrome, but the other two-thirds do not.

We’re seeing increasing rates in young people across western countries, which raises questions about diet and environmental exposure. Several non-hereditary factors are known to increase colon cancer risk, including:

• Obesity
• Fatty liver disease and metabolic dysfunction
• Diets high in processed foods and processed meats
• Heavy alcohol consumption
• Inflammatory bowel disease
• Changes in the gut microbiome, including those related to antibiotic use

These lifestyle and environmental factors may be playing a significant role.

Q: What are the early warning signs or symptoms young adults should watch for?

Dr. Sikaria:
One of the most important warning signs is blood during bowel movements, whether mixed in with stool or visible in the toilet. Many people assume this is caused by hemorrhoids, but if you’ve never had a colonoscopy, it’s critical to get evaluated.

Other symptoms may include:

• Persistent abdominal pain
• Thin or narrow stools
• Changes in bowel habits
• Unexplained fatigue

Some colon cancers, especially those on the right side of the colon, may not cause visible bleeding. In these cases, routine blood tests may detect anemia caused by hidden bleeding.

Any persistent or concerning symptoms should be evaluated by a physician promptly.

Q: Screening recommendations have traditionally focused on older adults. Should people under 50 consider earlier screenings?

Dr. Sikaria:
Yes. In 2021, the U.S. Preventive Services Task Force lowered the recommended age for colorectal cancer screening from 50 to 45 years old, reflecting the rising incidence in younger adults.

Some individuals may need screening even earlier if they have:

• A family history of colorectal cancer
• A family history of advanced or precancerous polyps
• A hereditary cancer syndrome

If you have these risk factors, speak with your doctor about when to begin screening.

Q: Are there specific lifestyle or genetic factors that increase risk at a younger age?

Dr. Sikaria:
Family history is one of the strongest risk factors. Having a first-degree relative with colon cancer roughly doubles your risk.

Lifestyle also plays a major role. Increased risk is associated with:

• Sedentary lifestyle
• Obesity
• Poor diet
• Metabolic conditions

These factors are increasingly common among younger adults.

Q: What practical steps can young adults take now to reduce their risk?

Dr. Sikaria:
There are several important steps:

• Maintain a healthy weight
• Stay physically active
• Eat a diet rich in vegetables, fruits, and whole foods
• Limit red meat and avoid processed meats
• Reduce alcohol consumption
• Establish care with a primary care physician

Annual checkups and routine bloodwork can help detect early warning signs, such as anemia, even before symptoms appear.

Stories like James Van Der Beek’s serve as a powerful reminder that colorectal cancer can affect people at younger ages, even those who appear otherwise healthy. Awareness, early detection, and preventive lifestyle choices can make a lifesaving difference. Knowing the warning signs, understanding your personal risk, and talking with your doctor about screening are critical steps in protecting your long-term health.

Dr. Sikaria is triple board certified in internal medicine, hematology, and oncology. She earned her undergraduate and medical degrees from Georgetown University in Washington, DC where she graduated with honors. She completed her internal medicine residency at Cedars-Sinai and her fellowship in hematology and oncology at the University of Southern California.

Dr. Sikaria actively conducts clinical research, and is a principle investigator of a number of clinical trials. She leads the Torrance Memorial-Cedars-Sinai collaboration in cancer clinical trials. Her areas of interest include breast cancer, lung cancer, lymphoma, gastrointestinal malignancies, and sarcoma. She has published in the areas of sarcoma, leukemia, and breast cancer. She serves as vice-chair of the Torrance Memorial Oncology Committee. She is also a member of the blood transfusion committee and continuing medical education committee.

Dr. Sikaria is a volunteer faculty member at Harbor-UCLA where she teaches hematologists and oncologists in training. She has earned a master's certificate in Academic Medicine from the Keck School of Medicine. She believes in treating the whole person and spends quality time with each patient getting to know them and tailoring treatment plans to meet their needs.