The recent death of “Dawson’s Creek” star James Van Der Beek, 48, fits into a troubling trend: Colorectal cancer is now the leading cause of cancer deaths in people under the age of 50. More than ever, it’s important to know how to protect yourself.
Even as the incidence of colorectal cancer has decreased by 30% since the 1980s, cases have skyrocketed in younger people, often before screening typically begins. Early-onset cancers may not be found until they’ve become more serious and difficult to treat, leading to increased death rates.
According to wellness coach and SSM Health Family Medicine Physician Dr. Roopa Shah, colorectal cancers begin with the development of pre-cancerous polyps. “Polyps are mushroom-like growths that form when cells lining the colon grow, divide, and reproduce in an unhealthy way,” she said. “They can become cancerous over time, invading the colon wall and surrounding blood vessels, and spreading to other parts of the body.”
While men and women have a fairly equal chance of developing the cancer, those with a personal or family history of the disease, or even polyps, are at a higher risk. And those with a long-term history of inflammatory bowel disease, like ulcerative colitis or Crohn’s disease, are at a higher risk, too.
Knowing the symptoms
Unfortunately, there are no symptoms for early-stage colorectal cancer, which makes active screening all the more important. “Common symptoms seen later include changes in bowel habits, such as diarrhea, constipation, or narrowing of the stool,” said Dr. Shah. “Some people will experience iron deficiency anemia, due to chronic bleeding. This causes fatigue, weakness, and pale skin.” Rectal bleeding, abdominal pain, and unexplained weight loss are also considered red flags.
Minimizing the risk through screening
Based on the increase in early-onset colorectal cancers, guidelines now recommend beginning screening at age 45, instead of age 50. That recommendation is for those with an average risk of developing the cancer. However, Dr. Shah noted, “If you have a family history or are at higher risk, screening should start sooner. Ask your doctor about your individual screening needs.”
Although we often focus on colonoscopy, there are multiple ways to screen for colon cancer. “Colonoscopy is considered the ‘gold standard’ for screening,” said Dr. Shah. “It allows for the detection and removal of pre-cancerous polyps to prevent the development of cancer.”
Still other screening techniques may be recommended. Stool-based screenings like Cologuard® or FIT (Fecal Immunochemical Test) check for blood in the stool. (The Cologuard test also checks for cancer-related DNA.)
In addition, imaging can be used. CT colonography, also known as a virtual colonoscopy, uses X-rays to view the colon. A flexible sigmoidoscopy looks at the lower third of the colon in a minimally invasive procedure. “You should talk to your doctor about which screening tool is best for you,” she added.
Controlling diet and lifestyle factors
Researchers believe that the increase in early-onset disease may be linked to our diet and lifestyle choices. “Eat a healthy diet that limits ultra-processed foods and red meats, and prioritizes fruits, vegetables, and high fiber foods,” suggested Dr. Shah. She also recommends that we exercise regularly, don’t smoke, and drink less alcohol.
Start now
March is National Colorectal Cancer Awareness Month, the ideal time to prioritize your colon health. Start by taking SSM Health’s free Colorectal Cancer Risk Assessment right now. It can help you identify potential factors that may influence your colon health. Then speak with your doctor about the findings and your next steps, including scheduling a colorectal cancer screening, if recommended.
- Leading Cancer Deaths in People Younger Than 50 Years, JAMA, January 22, 2026) https://jamanetwork.com/journals/jama/fullarticle/2844189?guestAccessKey=5eabd609-08b0-47c7-a738-916c7acdcc37&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=012226
- Colorectal Cancer Is A Major Public Health Problem, American Cancer Society, August 5, 2025, https://nccrt.org/our-impact/data-and-progress/#:~:text=Colorectal%20cancer%20incidence%20and%20mortality,respectively%2C%20during%20the%20past%20decade.
