The Rise of Early Onset Colon Cancer: More cases in young adults

A recent study published in The Journal of the National Cancer Institute shows that the incidence of colorectal cancer (CRC) in the U.S. is declining rapidly overall but curiously increasing among young adults.

“This study reveals that the demographics of colon cancer are changing,” says Benjamin Lebwohl, MD, MS, Director of Clinical Research of The Celiac Disease Center at Columbia. “We are seeing fewer new cases of colon cancer in individuals over age 50, due in large part to screening colonoscopy. But we are seeing more cases in people in their 20s and 30s than in previous decades.”

The risk of colon cancer in young adults is still much lower than for people over 50, Dr. Lebwohl notes, adding that general population screening is not recommended for the younger age bracket. “But there has been a detectable rise, and the reasons for this have not been identified.” The recent study suggests that rise in CRC in young adults has likely been fueled by steady increases in their excess body fat, but more research is needed to illuminate the cause.

“While these findings do not change current screening recommendations which are to begin screening at age 50 among average risk individuals,“ says Dr. Lebwohl, “they underscore the need to carefully assess any adult with symptoms such as persistent rectal bleeding, and to keep in mind that colon cancer can occur at any age.”

Columbia surgeons are known for treating colorectal cancer with minimally invasive options.

“For most of our patients, we use laparoscopic or robotic techniques, avoiding large incisions,” says Columbia colorectal surgeon, Steven A. Lee-Kong, MD. “We can preserve function even for those who need a permanent colostomy (an artificial opening created in the abdominal wall to bypass a damaged part of the colon). We are also experts in transanal surgery, an operation for patients with small early stage rectal cancer that hasn’t spread to the sphincter and that also preserves function. In addition, our GI surgeons can remove premalignant lesions with advanced colonoscopic techniques.

Steven Lee-Kong, MD has received advanced training in and oversees the performance of all robotic procedures in the division of colorectal surgery

Other diseases treated by the Columbia Colorectal surgical team include:

  • Crohn’s disease. Crohn’s affects 780,000 Americans, at any age and is prevalent among adolescents and young adults between the ages of 15 and 35. In Crohn’s, inflammation can appear anywhere in the digestive tract, from the mouth to the rectum. It generally affects all layers of the bowel walls.
  • Diverticulitis. Diverticulitis, an infected pouch in the colon, is diagnosed in roughly 200,000 people every year.
  • Ulcerative colitis. Affecting 900,000 Americans, this inflammatory disease affects only the inner lining of the large intestine (colon).
  • Inflammatory Bowel Disease (IBD). Affecting about 1.3 million Americans, IBD is a term applied to disorders that involve chronic inflammation of the digestive tract. The umbrella terms includes both ulcerative colitis and Crohn’s.
  • Familial Adenomatous Polyposis (FAP) is a genetic condition affecting 1 in 22,000 Americans by some estimates, and as many as to 1 in 7,000 by others. It is diagnosed when patients develop more than 100 adenomatous colon polyps—usually in their mid-teens. If FAP is not treated early, patients have a high risk of developing colorectal cancer later on, and an increased chance of contracting cancer in other organs.
Learn more about Columbia’s division of Colorectal Surgery at
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