Colon cancer in younger people: what the latest research shows

Until recently, colon cancer was considered a disease of people over 50. Today, this picture is changing before the eyes of doctors worldwide: the incidence rate among patients under 50 is steadily increasing, while among older people, it is declining. In this article, we discuss what is known about the reasons for this trend and how to avoid missing the first symptoms.

What is colon cancer?

Colon cancer is a malignant tumor that develops from the cells of the mucous membrane of the colon or rectum.

In medical literature, the term "colorectal cancer" is more commonly used—it encompasses malignant neoplasms of the colon and rectum, as these regions are closely related anatomically and have similar mechanisms of development. Tumors of this type are much less common in the small intestine.

Colon cancer almost always begins with polyps—benign growths on the intestinal wall that, in the early stages, usually grow slowly and asymptomatically, but over time can degenerate into malignant tumors.

What the statistics say

According to the American Cancer Society's 2026 report, colorectal cancer incidence in people aged 20–49 is increasing by approximately 3% per year, while in people aged 65 and older, it is declining by more than 2% per year. This increase affects all ethnic groups and is primarily due to tumors of the distal colon and rectum.

The statistics are equally alarming: from 1990 to 2019, the incidence rate among people aged 20–49 increased by approximately 37% worldwide, and according to American researchers , by 2030, patients under 50 will account for up to 11% of colon cancer cases and up to 23% of rectal cancer cases. Colorectal cancer has already become the leading cause of cancer death in people under 50.

Risk factors and causes of colon cancer

Experts discuss a combination of risk factors, rather than a single cause, for the development of malignant colon tumors. Among the most discussed are:

• Diet and lifestyle. A diet high in fat and low in fiber, an excess of ultra-processed foods, a sedentary lifestyle, excess weight, and metabolic syndrome are associated with intestinal imbalance and chronic inflammation.
• Gut microbiome. Patients with early-stage cancer are more likely to have an overgrowth of certain bacteria—particularly certain strains of E. coli and other microorganisms that promote intestinal inflammation—as well as a deficiency of bacteria that produce protective short-chain fatty acids.
• Colibactin. One of the most discussed mechanisms in recent years is the toxin colibactin, produced by certain strains of E. coli. A 2020 international study found that exposure to this toxin in early childhood leaves a specific mark on the DNA of intestinal cells that may increase the risk of developing cancer decades later. A cause-and-effect relationship has not yet been definitively proven, but this hypothesis is considered one of the most promising for explaining the "younger" incidence of the disease.
• Immune system characteristics. In people under 50, the immune response to intestinal microbes may be more pronounced, potentially increasing the damaging effects of these factors.

It's important to understand that approximately 80% of cases of colon cancer in young patients are not associated with hereditary syndromes—that is, it is not a "genetic lottery" but largely a result of lifestyle and environment.

Alexander Khvoshchev, gastroenterologist at Kandinsky Clinic: «I often see patients aged 35 to 40 complaining of abdominal pain or changes in bowel habits, which they attribute to stress or diet for months. Doctors and patients themselves typically overlook colon cancer at a young age—and yet, paying attention to these symptoms in the early stages is crucial to the success of treatment.».

Symptoms of colon cancer

The clinical presentation depends on the location of the intestinal tumor and its size. The most common symptoms are:

• change in stool pattern - constipation followed by diarrhea, or vice versa;
• blood in the stool - sometimes it is visible to the naked eye, but even if the blood is hidden, it can be detected using laboratory tests;
• abdominal pain, feeling of incomplete bowel movement;
• unexplained weight loss, chronic fatigue;
• anemia without obvious cause.

In the early stages of the disease, symptoms are often absent or mild, so diagnosis is often delayed. If constipation has become persistent, it's best to see a specialist without delay. A chronic constipation diagnosis at our clinic can help determine the cause.

How is colon cancer diagnosed?

Diagnosis begins with a survey and examination by a doctor, after which laboratory and instrumental studies are prescribed.

Colonoscopy remains the gold standard: during the procedure, the doctor examines the entire colon lining and can immediately remove any polyps detected, preventing them from developing into tumors. We've written in detail about what you need to know before the procedure in our article on preparing for a colonoscopy .

If the diagnosis is confirmed, the doctor will order a CT or MRI of the abdominal cavity. These tests will show how deeply the tumor has grown into the intestinal wall: whether it is confined to the superficial layer or has penetrated the muscularis and adjacent organs, whether there are enlarged lymph nodes, and whether there are signs of metastases, including to the liver. Cancer cells are capable of spreading through the lymphatic system, and assessing this process is a key step in accurately understanding the disease. Additionally, the doctor may order a blood test for tumor markers. This does not replace a colonoscopy, but it helps assess the progress of the disease after treatment.

Anvar Makhmudov, surgeon-proctologist at Kandinsky Clinic:

«For colon cancer detected in its early stages, the survival rate is over 90%, and the chances of a full recovery are high if the tumor is detected early—that's the whole point of screening. I encourage patients not to be afraid of colonoscopy: modern anesthesia makes the procedure comfortable, and the examination allows for the immediate removal of a polyp during the procedure. This often prevents the development of colon cancer in the future.».

The earlier a malignant tumor is detected, the higher the chances of a full recovery. Therefore, any unexplained symptom is a reason to consult a doctor rather than wait for the condition to improve on its own.

Treatment methods for colon cancer

The main method of treating bowel cancer at most stages is surgery : the doctor removes the affected area of ​​the intestine along with adjacent tissue and lymph nodes.

Radiation therapy is often used for rectal cancer, helping to shrink the tumor before surgery or reduce the risk of recurrence afterward. In later stages, treatment includes chemotherapy, targeted drugs, and immunotherapy. The choice of treatment depends on the tumor type, its location, and the patient's overall condition. The treatment plan is determined by an oncologist in consultation with a surgeon and gastroenterologist.

When to start screening

Given the rising incidence among young people, many countries have lowered the age at which screening can begin to 45 years, rather than the previously established age of 50. It's worth starting earlier than the recommended age if:

• there are close relatives with bowel cancer or polyps;
• inflammatory bowel disease diagnosed;
• there are hereditary syndromes that increase the risk;
• symptoms (abdominal pain, constipation, blood in the stool) persist for more than a few weeks without an obvious cause.

You can start with a consultation with a gastroenterologist in Dubai.

Diagnosis and treatment of colon cancer at Kandinsky Clinic

Kandinsky Clinic — многопрофильная клиника в Дубае, где диагностикой и лечением рака кишечника занимаются гастроэнтеролог Александр Хвощёв и хирург-колопроктолог Анвар Махмудов.

В клинике доступна полная диагностика ЖКТ: консультация специалиста, анализ кала на скрытую кровь, колоноскопия, лабораторные исследования и визуализация.

Подробнее о врачах и услугах можно узнать на сайте клиники. Если вы хотите пройти скрининг, получить помощь на любой стадии заболевания или второе мнение по уже поставленному диагнозу, запишитесь на консультацию через WhatsApp +971555660877 или по телефону +97145631200.

Kandinsky Clinic is a multidisciplinary clinic in Dubai where gastroenterologist Alexander Khvoshchev and proctologist Anvar Makhmudov specialize in the diagnosis and treatment of colon cancer.

The clinic offers a full gastrointestinal diagnostic service : specialist consultations, stool tests for occult blood, colonoscopy, laboratory tests, and imaging.

You can learn more about the doctors and services on the clinic's website. If you'd like a screening, assistance at any stage of your illness, or a second opinion on an existing diagnosis, schedule a consultation via WhatsApp +971555660877 or by phone +97145631200

Sources

• American Cancer Society. Colorectal cancer statistics, 2026. CA: A Cancer Journal for Clinicians
• Pleguezuelos-Manzano C., Puschhof J., Rosendahl Huber A., et al. Mutational signature in colorectal cancer caused by genotoxic pks+ E. coli. Nature, 2020; 580(7802):269-273
• Pan H., Zhao Z., Deng Y., et al. The global, regional, and national early-onset colorectal cancer burden and trends from 1990 to 2019: results from the Global Burden of Disease Study 2019. BMC Public Health, 2022; 22:1896
• Bailey C.E., Hu C.Y., You Y.N., et al. Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975-2010. JAMA Surgery, 2015; 150(1):17-22

Медицинский редактор: Ольга Поликина, главный врач Kandinsky Clinic, кандидат медицинских наук (Лицензия DHA: № 08705887-001)

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