Colorectal cancer has quietly moved into the top spot as the leading cancer killer for Americans under 50, and Salt Lake City doctors are not keeping quiet about it. Local gastroenterologists say too many younger patients are showing up with advanced disease, often after ignoring vague symptoms or skipping screenings that could have caught problems early. Their message to residents is blunt: do not shrug off warning signs, and talk with your primary-care provider about screening before cancer has a chance to spread, as per JAMA.
National data show the shift
A research letter in JAMA reports that colorectal cancer has become the top cause of cancer-related death in people younger than 50. The American Cancer Society’s Colorectal Cancer Statistics, 2026 report projects about 158,850 new colorectal cancer cases and 55,230 deaths this year, and notes that incidence is climbing fastest among younger adults, especially in the distal colon and rectum. Mortality in people under 50 has been ticking up at roughly 1% per year, even as death rates for most other common cancers continue to fall. Public-health groups say those numbers are a big part of why there is renewed focus on screening and earlier detection right now.
Salt Lake clinicians urge not to ignore symptoms
“Colon cancer is a life-threatening disease, but it's a highly curable form of cancer and has a 90% survival rate when detected early,” Dr. Nathan Merriman said in an interview with KSL. Nurse practitioner Emily Van Komen told the outlet that roughly three quarters of cases occur in people with no family history, and that younger adults are making up a higher share of rectal cancer diagnoses.
The KSL piece, produced in partnership with Intermountain Health, highlights the red flag symptoms local clinicians most want to hear about: rectal bleeding, anemia, persistent abdominal pain, unexplained weight loss and changes in bowel habits. Providers around Salt Lake City say that getting those symptoms checked quickly can be the difference between an early, highly treatable cancer and a late-stage diagnosis that is much harder to manage.
Screening: start at 45 and follow up
National guidelines now call for average-risk adults to begin colorectal cancer screening at age 45, a change the U.S. Preventive Services Task Force adopted in 2021. Colonoscopy is widely regarded as the most comprehensive option because it lets clinicians see the entire colon and remove precancerous polyps during the same procedure, a view supported by professional endoscopy groups.
The American Cancer Society reports that screening rates are lagging among younger eligible adults. Only about 37% of people ages 45 to 54 are up to date, which means many cancers are still being discovered at more advanced stages. For those who start with noninvasive stool-based tests, experts stress that any positive result should be followed by a colonoscopy so the evaluation is complete.
Why younger generations are at greater risk
Researchers describe what is known as a birth-cohort effect. Age-period-cohort analyses indicate that people born around 1990 now face roughly twice the risk of colon cancer and about four times the risk of rectal cancer compared with those born around 1950, according to prior studies. Scientists suspect the rise has multiple drivers, and are looking closely at diet, increasing obesity and metabolic disease, sedentary habits, and tobacco and alcohol use, among other factors.
Patient advocates and clinicians point out that most colorectal cancers are sporadic rather than inherited. In practical terms, that means having no family history does not take someone off the hook and instead underscores the importance of routine screening and paying attention to new or persistent symptoms.
What to do now
If you are 45 or older, clinicians recommend talking with your primary-care provider about which colorectal screening option fits you best. If you are younger than 45 but notice red flag symptoms such as rectal bleeding or ongoing changes in bowel habits, they advise asking for an evaluation rather than waiting to see if things “just go away.”
At-home stool tests such as FIT can be a reasonable first step for some people, but a positive result should lead to colonoscopy so doctors can confirm what is going on and remove any polyps that are found, according to the National Cancer Institute. Intermountain Health and other local systems offer screening resources and help patients navigate colonoscopy scheduling and follow-up, and many hospital systems run programs to support uninsured or underinsured patients in getting tested. For those with inflammatory bowel disease or a family history of early colorectal cancer, providers may recommend starting screening before age 45.
The overall message from national experts and Salt Lake City clinicians is clear: with young-onset colorectal cancer on the rise, awareness and timely screening matter more than ever. Detecting cancer early dramatically improves the odds of a cure, so residents who have symptoms or fall into the recommended screening ages are being urged not to put off that conversation with their doctor.
