Rising Colorectal Cancer Deaths in Younger Adults Linked to Education Levels

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NEW YORK — A new study reveals that the alarming increase in colorectal cancer deaths among younger adults is primarily affecting those with lower education levels, suggesting that socio-economic factors may be contributing to this trend.

Notable celebrity deaths, such as Chadwick Boseman in 2020 and James Van Der Beek earlier this year, have drawn attention to the rising incidence of colorectal cancer in younger populations. However, this research is the first to identify the specific demographics most impacted by this concerning rise.

Over the past 30 years, the study indicates that the increase in colorectal cancer deaths among young adults has predominantly occurred in individuals without a four-year college degree.

While obtaining a college degree does not inherently prevent colon cancer, experts suggest it serves as an indicator of broader issues: individuals without degrees typically earn lower incomes, maintain poorer diets, engage in less physical activity, and receive less medical care.

The concentration of risk among less advantaged groups isn't surprising, but this paper, published on April 16 in JAMA Oncology, is the first national study to establish a clear connection, according to Dr. Paolo Boffetta, a researcher at Stony Brook Cancer Center who was not involved in the study.

Researchers from the American Cancer Society utilized government data on over 101,000 young adults, ages 25 to 49, who died from colorectal cancer between 1994 and 2023.

During this period, the colorectal cancer death rate in this age group increased from approximately three per 100,000 to about four per 100,000. However, for individuals who completed only high school, the rate rose from four to 5.2 per 100,000, while it remained unchanged at 2.7 per 100,000 for those with at least a bachelor’s degree.

Ahmedin Jemal, the study's lead author, emphasized the importance of raising public awareness about colorectal cancer and encouraging younger adults to follow screening recommendations. Symptoms may include blood in the stool or rectal bleeding, changes in bowel habits lasting more than a few days, unintended weight loss, and abdominal pain.

The American Cancer Society estimates that more than 158,000 cases of colorectal cancer will be diagnosed in the U.S. this year, making it the second leading cancer killer in the country after lung cancer, with projections of over 55,000 deaths by 2026.

Deaths among adults under 50 account for approximately seven percent of the total, totaling around 3,900. Earlier this year, researchers noted that colorectal cancer mortality in Americans under 50 has increased by 1.1 percent annually since 2005, now making it the deadliest cancer in that age group.

While the reasons behind this increase remain unclear, risk factors include obesity, physical inactivity, a diet high in red or processed meats and low in fruits and vegetables, as well as a family history of colorectal cancer.

In 2021, the American Cancer Society revised its screening guidelines, lowering the recommended starting age for screenings from 50 to 45.

The researchers chose to focus on education levels rather than other factors because death certificates typically do not include detailed information on an individual’s income or other life aspects, but they do record educational attainment. Previous studies have shown that education levels often correlate with income, health insurance status, physical activity, and chronic disease rates.

Thus, education serves as a useful proxy, although it cannot capture other variables, such as health insurance coverage. "The focus on education is really (due to) something which was available in the data," Boffetta noted.

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