45 Is the New 50: Early Onset Colorectal Cancer Is Rising
If you are in your mid forties, you may have noticed a new message from your doctor, your insurer or even your social media feed: it is time to think about colorectal cancer screening. Age 45 is the new 50 for good reason. Early onset colorectal cancer is climbing, and colon cancer in young adults is being diagnosed more often, and later, than most people realize. At Citrus Valley Gastroenterology, our GI doctors in Covina, Glendora and Chino see every day how much earlier screening can change outcomes. Here is what the numbers show and what they mean for your timeline.
Why Did the Colorectal Cancer Screening Age Drop to 45?
For years, adults at average risk were told to begin colorectal cancer screening at age 50. That changed when the American Cancer Society lowered its recommended starting age to 45 in 2018, and the U.S. Preventive Services Task Force followed in 2021. People now call this shift the 45 is the new 50 movement, and it reflects a hard truth: colorectal cancer is no longer only a disease of older adults.
The goal is simple. Finding polyps and early tumors five years sooner gives doctors a better chance to remove them before they grow or spread. If you are between 45 and 75 and have an average risk, screening is now recommended for you.
About Colorectal Cancer: How It Starts in the Colon and Rectum
Colorectal cancer starts in the colon or the rectum, which together make up the lower part of your digestive tract. Most cases begin as small growths called polyps. Many polyps are harmless, but some slowly change over the years into cancer.
Because this process is gradual and usually silent, a screening test can find and remove polyps long before they cause symptoms. That is what makes colorectal cancer one of the most preventable cancers we treat.
Colorectal Cancer Statistics 2026: The Rate of Colon Cancer in Young Adults
The latest data from the American Cancer Society paint a clear picture. Its Colorectal Cancer Statistics 2026 report estimates about 158,850 new cases and 55,230 deaths in the United States this year. Diagnoses are falling in adults 65 and older, but they keep rising in younger groups. Key findings include:
- Colorectal cancer is now the leading cause of cancer death in adults under 50.
- The death rate in adults under 50 has risen about 1 percent per year since 2004.
- Roughly three in four colorectal cancers in people under 50 are found at an advanced stage.
- Half of all diagnoses under 50 occur in people aged 45 to 49, the group newly eligible for colon cancer screening.
- Adults younger than 65 now make up about 45 percent of new cases, up from 27 percent in 1995.
The rate of colon cancer in young adults is rising across all racial and ethnic groups. There is encouraging news too. When colorectal cancer is caught at a local stage, the five year survival rate is about 95 percent. Early detection makes the difference.
What Is Causing Early Onset Colorectal Cancer? Colorectal Cancer Research Findings
Researchers do not yet have a single answer. Colorectal cancer research points to a mix of possible factors, including diets high in ultra processed foods and processed meat, obesity, low physical activity, alcohol, smoking, antibiotic use and changes in gut bacteria. People born after the 1950s also carry a higher risk than earlier generations, which suggests something in modern life is playing a role.
Genetics matter as well. Roughly 16 to 20 percent of cases in adults under 50 are linked to inherited gene changes such as Lynch syndrome. Studies are ongoing, and no one cause explains every case. What we do know is that you cannot count on your age to protect you. Healthy habits help, but screening remains the most effective tool.
Colorectal Cancer Symptoms in Young Adults: 6 Warning Signs to Know
Because many people do not expect colorectal cancer in someone in their thirties, symptoms are often blamed on hemorrhoids, stress or irritable bowel. Do not wait until 45 if you notice any of these signs:
- Blood in the stool or rectal bleeding
- A lasting change in bowel habits, such as new diarrhea or constipation
- Abdominal pain, cramping or bloating that does not go away
- Narrow stools or a feeling that your bowel does not empty fully
- Unexplained weight loss
- Fatigue or iron deficiency anemia
Hemorrhoids can cause bleeding, but you should never assume that is the cause. A gastroenterologist can tell the difference. If you have symptoms, you need an evaluation at any age, not routine screening.
Colorectal Cancer Screening Age 45: When to Start Colon Cancer Screening
Your timeline depends mostly on your personal risk.
Screening Timeline for Average Risk Adults
If you have no symptoms, no personal history of polyps or inflammatory bowel disease and no strong family history, begin screening at 45 and continue through age 75. After a normal colonoscopy, the exam is typically repeated in 10 years. Between 76 and 85, talk with your doctor about whether to continue.
Recent estimates suggest only about 37 percent of adults aged 45 to 49 are up to date on screening, so many people in this age group are still overdue.
Screening Timeline If You Have a Family History or Higher Risk
Start earlier if a parent, brother, sister or child had colorectal cancer or advanced polyps. Many guidelines suggest beginning at 40, or ten years before the age your relative was diagnosed, whichever comes first. You may also need earlier and more frequent exams if you have Crohn’s disease, ulcerative colitis, a known genetic syndrome or a personal history of polyps. Every family history is different, so a visit with a gastroenterologist is the best way to set your own schedule.
Colon Cancer Screening Options: Colonoscopy vs FIT and Stool DNA Tests
Several tests can screen for colorectal cancer:
- Colonoscopy: Examines the entire colon and removes polyps during the same visit. Usually repeated every 10 years if normal.
- FIT (fecal immunochemical test): A yearly at home stool test that looks for hidden blood.
- Stool DNA test: An at home test repeated every one to three years, depending on the product.
Any abnormal stool test must be followed by a colonoscopy. For many people, colonoscopy is the preferred choice because it can both find and prevent cancer in a single procedure. If you choose colonoscopy, good preparation makes it much easier. Our team provides prep instructions in English and Spanish, along with instructional videos on our website.
Colon Cancer Screening in Covina, Glendora and Chino With Our GI Doctors
Since 1985, Citrus Valley Gastroenterology has provided compassionate digestive care to families in our community. Our board certified gastroenterologists perform colonoscopy, upper endoscopy and treatment for rectal bleeding, hemorrhoids and other digestive conditions at our offices in Covina, Glendora and Chino.
Whether you are turning 45, have a family history or have symptoms that worry you, we will help you understand your risk and choose the right test. You can read more about colon cancer screening and rectal bleeding at Citrus Valley Gastroenterology, review prep instructions and request an appointment online.
FAQs:
1. What age should you start colon cancer screening?
Adults at average risk should start colon cancer screening at age 45 and continue through age 75. People with a family history of colorectal cancer, inflammatory bowel disease or a genetic syndrome may need to begin earlier, sometimes at 40 or before. Your gastroenterologist can set the right starting age for you.2. Why is colon cancer increasing in young adults?
Doctors do not know the exact cause. Research points to diet, obesity, inactivity, alcohol, smoking, antibiotic use, changes in gut bacteria and inherited gene changes. Generations born after the 1950s face higher risk than earlier ones, which suggests lifestyle and environmental exposures play a role. Studies are still underway.3. What are the first signs of colon cancer in young adults?
Common early signs include blood in the stool, rectal bleeding, a lasting change in bowel habits, abdominal pain or cramping, narrow stools, unexplained weight loss and fatigue. Many overlap with hemorrhoids or digestive upset, so see a doctor if symptoms last more than a few weeks.4. What is the best test for colon cancer screening?
Colonoscopy is considered the most thorough test because it examines the entire colon and removes polyps during the same procedure. Stool tests such as FIT and stool DNA are less invasive options, but any abnormal result requires a follow up colonoscopy. The best test is the one you will complete on schedule.5. How often do you need a colonoscopy?
If your colonoscopy is normal and you are at average risk, you typically repeat it every 10 years. If polyps are found, you have a family history or you have inflammatory bowel disease, your doctor may recommend repeat exams more often, depending on your findings.Published on 22 Oct, 2026
