5 Things to Know About Colorectal Cancer

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the US, but it doesn’t have to be.1 With early detection and proactive lifestyle choices, many cases are preventable or treatable. However, cases are rising among younger adults, making awareness more critical than ever.

March is Colorectal Cancer Awareness Month | Image credit: Africa Studio - stock.adobe.com

In recognition of Colorectal Cancer Awareness Month, here are 5 essential things to know about the disease.

1. Early Detection Saves Lives

The US Preventive Services Task Force (USPSTF) recommends that patients aged 45 to 49 years be screened for CRC, with studies suggesting increased screening has been associated with a decrease in both incidence and mortality related to CRC.2 Therefore, it is important that patients in this age group have access to screenings.

Now, there are more ways than ever to get screened for CRC, including stool-based tests, visual exams, and blood-based tests. Each of these screening options plays a crucial role in identifying colorectal cancer at its earliest, most treatable stages.3 Additionally, artificial intelligence (AI)–powered tools show promise in advancing early detection. For example, an AI model called C the Signs achieved a sensitivity of 93.8% and a specificity of 19.7% in identifying patients at risk of CRC, according to research presented at this year’s ASCO Gastrointestinal Cancers Symposium.4 Notably, the model identified 29.4% of these patients as high-risk up to 5 years earlier than primary care physicians.

2. It’s Not Just an Older Person’s Disease

CRC is increasingly affecting younger adults, with diagnoses among those under age 55 years nearly doubling over the past decade, according to the American Cancer Society (ACS).5 A recent ACS study reveals that advanced-stage CRC cases in the US rose by 8% from the mid-2000s to 2019, highlighting a troubling shift in disease progression. The percentage of diagnoses in individuals younger than age 55 years grew from 11% in 1995 to 20%—or 1 in 5 cases—by 2019. At the same time, progress against CRC has slowed, with annual mortality declines dropping from 3% to 4% in the early 2000s to just 2% in the past decade.

“Unfortunately, we've seen a large uptick in young onset CRC,” Michael Sapienza, CEO of the Colorectal Cancer Alliance, told The American Journal of Managed Care® (AJMC®). “CRC is now the number 1 cancer killer for men under 50, and it's the number 2 cancer killer for women under 50, and we honestly don't really know why. We do think that it's what we call multifactorial, so there's probably multiple factors that play a part.”

3. Lifestyle Plays a Big Role in Risk Reduction

Lifestyle choices play a significant role in CRC risk, and many of these factors are considered modifiable risks—meaning they can be changed to lower the likelihood of developing the disease, Sapienza explained. A fiber-rich diet that includes plenty of fruits, vegetables, and whole grains supports a healthy colon and may help reduce cancer risk. In contrast, a diet high in red and processed meats has been linked to an increased likelihood of CRC. Limiting alcohol consumption and avoiding smoking are also crucial, as both have been shown to contribute to cancer development. By making these proactive changes, individuals can take important steps toward lowering their CRC risk and maintaining overall digestive health.

4. Genetics and Family History Matter

Approximately 25% of all patients with CRC have a close relative with the disease, according to the Colon Cancer Coalition.6 This risk is particularly high for those with a first-degree relative who has been diagnosed with the disease. The risk is even higher if the relative was diagnosed before age 50 years or if multiple family members have had CRC. In addition to family history, certain inherited genetic syndromes can greatly increase susceptibility. Conditions such as Lynch syndrome, familial adenomatous polyposis, and MUTYH-associated polyposis are known to elevate CRC risk by causing the development of numerous precancerous polyps or making individuals more prone to aggressive tumor growth.

Because of these genetic factors, those with a family history of CRC or a known genetic mutation should speak with their doctor about earlier and more frequent screenings to detect and prevent the disease at its earliest stages.

5. Innovations in Treatment Are Improving Survival

Thankfully, new treatments like immunotherapy and targeted therapies are changing the landscape to improve CRC care. Although immunotherapy has been highly effective in cancers like melanoma and lung cancer, it currently benefits only about 4% to 5% of patients with CRC, Sapienza said. However, new combination trials are exploring ways to unlock the immune system, making these therapies effective for a broader range of patients.

“We're seeing early signs in clinical trials that we've had certain patients that have gone on to specific clinical combination clinical trials, where we're seeing true progress,” Sapienza said. “Hopefully, we will continue to do that as well.”

Beyond immunotherapy, targeted therapies are also making strides. One breakthrough is the approval of a BRAF-targeted therapy, marking the first new frontline treatment for metastatic CRC in over 20 years, according to Sapienza. This treatment applies only to the 4% to 6% of patients with the BRAF mutation, but it represents a crucial step toward personalized medicine.

References

1. Colorectal cancer. World Health Organization. July 11, 2023. Accessed March 6, 2025. https://www.who.int/news-room/fact-sheets/detail/colorectal-cancer#:~:text=Colon%20cancer%20is%20the%20second,rates%20and%20quality%20of%20life

2. Bonavitacola J. CRC screening increases in patients aged 45 to 49 after USPSTF recommendation. AJMC. October 7, 2024. Accessed March 6, 2025. https://www.ajmc.com/view/crc-screening-increases-in-patients-aged-45-to-49-after-uspstf-recommendation

3. Colorectal cancer screening tests. American Cancer Society. Updated February 28, 2025. Accessed March 6, 2025. https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/screening-tests-used.html

4. Steinzor P. Unlocking early colorectal cancer detection with artificial intelligence. AJMC. January 23, 2025. Accessed March 6, 2025. https://www.ajmc.com/view/unlocking-early-colorectal-cancer-detection-with-artificial-intelligence

5. Masciadrelli M. Why are colorectal cancer rates rising among younger adults? Yale School of Medicine. March 29, 2023. Accessed March 6, 2025. https://medicine.yale.edu/news-article/with-colorectal-cancer-rates-rising-among-younger-adults-a-yale-cancer-center-expert-explains-there-may-be-more-factors-behind-this-worrisome-trend/#:~:text=Credit:%20Robert%20A.,Historically%2C%20Dr

6. Colon cancer risk factors. Colon Cancer Coalition. Accessed March 6, 2025. https://coloncancercoalition.org/prevention/reduce-your-risk/#:~:text=Both%20men%20and%20women%20are,regular%20screening%20is%20so%20important