Colon cancer is now the leading cause of cancer death in people under the age of 50, according to the American Cancer Society, but what’s behind the alarming surge and why are cases shifting?
The trend was highlighted by the death of Kevin Gonzalez, an 18-year-old diagnosed with colon cancer who made headlines with a dying wish to see his parents who had been detained by ICE while trying to see him.
That wish was granted, but the teen lost his battle with the terminal cancer hours later.
Although Gonzalez’s case was rare because of his age, colon cancer is being diagnosed in younger people more often, according to the American Cancer Society.
Incidents have gone up 3% per year for adults 20 to 49, while the disease continues to decline among older adults.
Research to determine why is ongoing.
A study published in the Journal Nature in 2025, found exposure to the bacterial toxin colibactin early in life may contribute to “increasing incidence” of early-onset colorectal cancer.
Another study looked into whether microplastics could be a driver for early onset colorectal cancer.
“I didn’t always believe this microplastics concept, but the science is there, that these microplastic can be seen in the body, and we really need to understand how we can reduce that and the contribution they have into disease,” said Dr. Rajesh Keswani, the director of endoscopy at the Digestive Health Institute at Northwestern Medicine.
“The microbiome science is even more vetted over many, many years, and this is something that we can understand. That the microbiome is different in people who have early onset disease. What we don’t know is how we can change that and which of these factors are modifiable,” Keswani said.
As research continues, experts agree modifiable risk factors do exist.
“There are things that are clearly linked to increased rates of colon cancer. That’s definitely diet, increased red meat, processed meats. We know that a sedentary lifestyle, someone who’s not physically active, of course tobacco, high alcohol use,” said Dr. Ngozi Ezike, a spokesperson for the American Cancer Society.
“What we do know, is that it is a highly preventable and treatable disease,” Ezike, who is also the president and CEO of Sinai Chicago, said.
Experts attribute declining colorectal cancer rates in older adults to early detection from increased screening. The recommended age for a colonoscopy is now 45 instead of 50.
“Colonoscopy is the single test that allows us to find these lesions at a pre-cancer stage before they turn into cancer,” said Keswani.
Keswani said gastroenterologists and patients need to be vigilant, prioritizing symptoms at any age.
“You yourself can’t dismiss them. So if you’re having new rectal bleeding, new abdominal pain, your bowel habits are changing, you’re having new constipation, you never had it before, this could be a sign of something that’s going on.”
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