Rising Rates of Gastrointestinal Cancer in Young Adults
Gastrointestinal cancers, which encompass colorectal, gastric, and pancreatic cancers, are increasingly prevalent among young adults, though the reasons remain largely unclear. The potential causes warrant further investigation, according to experts. A review published in JAMA on Thursday highlights that gastrointestinal cancer has become the fastest-growing cancer among adults under 50 in the United States.
This review offers one of the most comprehensive overviews of gastrointestinal cancer trends, synthesizing data from a major international cancer database alongside 115 studies published from January 2014 to March 2025. The authors stress the importance of adhering to colorectal cancer screening guidelines. They recommend that individuals at average risk begin screening—typically through colonoscopy or stool tests—at age 45. As screening for pancreatic, stomach, and esophageal cancers remains infrequent in the U.S., the authors are exploring innovative ways to broaden screening access.
“This underscores the necessity of improving screening and early detection,” stated Dr. Kimmie Ng, co-author and director of the Dana-Farber Cancer Institute’s Young Onset Colorectal Cancer Center.
According to the findings, colorectal cancer is the most frequently diagnosed early-onset gastrointestinal cancer, with approximately 185,000 cases worldwide in 2022, including nearly 21,000 in the U.S. This reflects a 2% annual increase since 2011, as reported by the American Cancer Society. “This is unprecedented in this age group, and we are witnessing a significant rise among individuals in their 20s, 30s, and 40s,” commented Dr. John Marshall, chief medical consultant for the nonprofit Colorectal Cancer Alliance, which was not involved in the study. A notable case is actor Chadwick Boseman, who was diagnosed with colon cancer in 2016 and passed away at age 43 four years later.
Emerging research indicates a rise in early-onset cases of pancreatic, stomach, and esophageal cancers as well. Previous studies suggest that the incidence of these gastrointestinal cancers is disproportionately higher among Black and Hispanic populations. Pancreatic cancer, known for its high mortality rate, shows that only 13% of patients survive five years post-diagnosis. Although colorectal cancer is the most common, healthcare providers possess a better understanding of the factors contributing to early-onset cases compared to other cancers.
“Understanding the dynamics of colorectal cancer has given us insights into its initiation,” noted Dr. Scott Kopetz, a professor of gastrointestinal medical oncology at the University of Texas MD Anderson Cancer Center. He posited that multiple factors likely contribute to the increase in early-onset cases. “There isn’t one overarching theory,” he said.
The recent review in JAMA suggests that lifestyle factors such as obesity, sedentary behavior, inadequate nutrition, tobacco use, and alcohol consumption are largely associated with early-onset gastrointestinal cancers. A specific study highlighted that women who consumed more sugary beverages during puberty faced a heightened risk of developing early-onset colorectal cancer. “The behaviors and exposures during childhood and adolescence likely contribute to the cancer risks seen in young adults,” remarked Dr. Ng.
Health Secretary Robert F. Kennedy Jr. has raised concerns about the correlation between sugary drinks and health issues, including cancer. Recently, President Donald Trump announced that Coca-Cola would switch to cane sugar instead of U.S. corn syrup; however, the company did not confirm this change to NBC News.
Dr. Marshall speculated that the uptick in early-onset colorectal cancer may be linked to shifts in gut microbiota. Factors such as diet, antibiotic usage, microplastics, and chemical exposures could impact these bacteria, yet scientists lack a clear understanding of what constitutes a healthy microbiome and its implications for health. This area is ripe for research.
The review by Dr. Ng found that between 15% and 30% of individuals with early-onset gastrointestinal cancer carry hereditary genetic mutations, indicating a propensity to develop cancer earlier. She advocates for genetic testing for all patients diagnosed under 50.
Despite improvements in treatment and screening that have boosted overall survival rates for gastrointestinal cancer, the review indicates that younger patients often experience poorer outcomes. This trend persists despite receiving more comprehensive treatment, including surgeries, radiation, and aggressive chemotherapy regimens. One reason cited is that primary care physicians may overlook symptoms such as abdominal pain, constipation, heartburn, and reflux in younger patients, delaying diagnosis.
“In my experience, when young individuals present with non-specific symptoms, there tends to be a lack of consideration for colorectal or other gastrointestinal cancers, leading to more advanced-stage diagnoses,” said Dr. Howard Hochster, director of gastrointestinal oncology at Rutgers Cancer Institute and RWJBarnabas Health. However, Dr. Ng pointed out that younger patients still display worse survival rates, even when accounting for the stage of diagnosis. “This leads us to contemplate whether cancers that arise in younger individuals might possess unique biological characteristics that render them more aggressive or less responsive to treatment,” she concluded.
Source: www.nbcnews.com
