Why Are More Under-50s Getting Colorectal Cancer?

AFP/APP

Paris: The recent death of James Van Der Beek has once again drawn attention to a troubling trend: colorectal cancer is rising among people under 50, and experts are still unsure why.

The former Dawson’s Creek star died last week at 48 after battling the disease, also known as bowel cancer. His passing follows that of Chadwick Boseman, the Black Panther actor who died of the same cancer in 2020 at age 43.

According to Helen Coleman, a cancer epidemiology professor at Queen’s University Belfast, the rate of colorectal cancer diagnoses among people under 50 has risen by roughly one-third since the 1990s.

Research published last month in the Journal of the American Medical Association found that colorectal cancer is now the leading cause of cancer death among under-50s in the United States.

While the statistics are concerning, experts caution against panic. Coleman noted that the increase comes from a relatively low starting point. The vast majority of colorectal cancer cases still occur in older adults. In Northern Ireland, for example, only about six percent of cases are diagnosed in people under 50.

At the same time, rates among older people are stabilising or even declining in some regions, largely due to improved screening programmes.

However, younger adults are less likely to suspect they may be at risk, as the disease was long considered one that primarily affects the elderly. As a result, diagnoses in younger patients often occur at later stages, when the disease is more advanced.

What Is Driving the Rise?

Colorectal cancer has traditionally been linked to lifestyle factors such as obesity, poor diet, physical inactivity, alcohol use and smoking. But researchers say these factors alone do not fully explain the sharp increase seen in younger populations.

“It is difficult to account for such a significant change in a relatively short period of time,” Coleman said.

Many younger patients appear otherwise healthy. Van Der Beek himself said in a television interview that he had embraced wellness routines before his stage-three diagnosis in 2023.

The unanswered questions have led scientists to explore other potential causes, including the gut microbiome — the complex ecosystem of microbes living in the digestive system.

A study published last year in the journal Nature identified what researchers described as a potentially important clue. It found that DNA mutations linked to colibactin — a toxin produced by certain strains of E. coli bacteria — were more common in younger colorectal cancer patients than in older ones.

However, researchers caution that much more investigation is needed. It remains unclear whether younger people are more exposed to the toxin or whether other factors are at play.

Some studies have also suggested that repeated antibiotic use could be associated with early-onset colorectal cancer. Meanwhile, clinicians report seeing a range of different tumour subtypes, indicating there may not be a single explanation.

Jenny Seligmann, a colorectal cancer specialist at the University of Leeds, said the complexity of cases makes it unlikely that one factor alone is responsible.

“It’s going to be very difficult to pinpoint it to one cause,” she said.

For now, the rise in colorectal cancer among younger adults remains a medical mystery — and a growing public health concern.

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