NEW YORK (AP) — The rise in colorectal cancer deaths among younger adults is concentrated among people with less education, according to a new study published Thursday in JAMA Oncology. The study found that over the last 30 years, the increase in deaths among young adults occurred almost entirely among people without a four-year college degree, a grim pattern that tracks who gets left with fewer resources, less care and more exposure to the wreckage of an unequal system.
Researchers used government data on more than 101,000 younger adults, ages 25 to 49, who died of colorectal cancer from 1994 through 2023. Overall, the colorectal cancer death rate rose from about 3 per 100,000 in that age group to about 4 per 100,000. For people who only made it through high school, the rate rose from 4 to 5.2 per 100,000, while the rate for people with at least a bachelor’s degrees did not change from 2.7 per 100,000.
Who Pays for the System
The study’s numbers draw a hard line through the social order: the burden falls on people without degrees, while those with bachelor’s degrees saw no change in their death rate. The article says experts view college degree status as a marker for other issues, since people without degrees tend to earn less money, have poorer diets, exercise less and get less medical care. The death certificates used in the research do not detail how much money a person had, or most other aspects of their life, but they do note how much schooling someone completed.
Ahmedin Jemal, the study’s first author, said the findings underscore the need for public awareness about colorectal cancer and for younger adults to heed screening recommendations. Symptoms can include blood in stool or rectal bleeding; changes in bowel habits, such as diarrhea, constipation or narrowing of stool that lasts more than a few days; unintended weight loss; and cramps or abdominal pain.
What the Data Shows
The researchers used government data on more than 101,000 younger adults, ages 25 to 49, who died of colorectal cancer from 1994 through 2023. The American Cancer Society researchers used the same government data set, and the article says the number of deaths for adults younger than 50 is around 7% of the total — about 3,900. Earlier this year, cancer society researchers reported that colorectal cancer mortality in Americans under 50 had increased by 1.1% a year since 2005, making it now the deadliest cancer in that age group.
The article says scientists do not know what is behind that increase. Risk factors include obesity, lack of physical activity, a diet high in red or processed meat and low in fruits and vegetables, and a family history of colorectal cancer. The American Cancer Society changed its screening guidelines in 2021, lowering the age U.S. adults should start getting screened from 50 to 45.
What They Call Awareness
Dr. Paolo Boffetta, a researcher at Stony Brook Cancer Center in New York who wasn’t involved in the work, said it is not totally unexpected that the death risk is concentrated in the less advantaged, but said the paper was the first national study to actually show the connection. He said, "The focus on education is really (due to) something which was available in the data."
The article said celebrity deaths, including Chadwick Boseman in 2020 and James Van Der Beek earlier this year, have highlighted the increase in colorectal cancer deaths among younger adults. That attention has not changed the basic fact that the death rate climbed while the people with the least educational access bore the sharpest increase.
The American Cancer Society estimates that more than 158,000 cases of colorectal cancer will be diagnosed in the U.S. this year. Overall, it is the nation’s second leading cancer killer, behind lung cancer, and is expected to claim more than 55,000 in 2026.
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