New Research: Rectal Cancer Incidence Rising After Decades of Decline as Colorectal Cancer Shifts Toward Younger Generations

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Mar 02, 2026, 07:00 ET

American Cancer Society scientists stress the need for increases in research, prevention, and screening to reverse course on these troubling disease trends

ATLANTA, March 2, 2026 /PRNewswire/ -- Colorectal cancer rates in the United States are moving in two very different directions, according to a new report released today from the American Cancer Society (ACS). While the disease continues to decline among older adults, rates are rising in people under 65, particularly among younger adults, signaling a troubling shift in who is being affected.

The triennial report, Colorectal Cancer Statistics, 2026, finds that this increase is being driven largely by cancers in the distal colon (the last section, adjacent to the rectum) and the rectum. As a result, rectal cancer now makes up nearly one‑third (32% up from 27% in the mid‐2000s) of all colorectal cancer diagnoses. The findings are published today in CA: A Cancer Journal for Clinicians, the flagship journal of ACS.

"After decades of progress, the risk of dying from colorectal cancer is climbing in younger generations of men and women, confirming a real uptick in disease because of something we're doing or some other exposure," said Rebecca Siegel, senior scientific director, surveillance research at the American Cancer Society and lead author of the report. "We need to redouble research efforts to understand the cause but also circumvent deaths through earlier detection by educating clinicians and the general public about symptoms and increasing screening in people 45-54 years."

According to the report, colorectal cancer is the third most common cancer in both men and women in the U.S. and the second leading cause of cancer-related death. For adults under 50, it's now the number one cause of cancer-related mortality. In 2026, an estimated 158,850 new cases of colorectal cancer will be diagnosed, and 55,230 people will die from the disease, including 200 diagnoses each day in people younger than 65. For this year's report, ACS researchers compiled the most recent findings on population-based colorectal cancer data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program and the National Program of Cancer Registries at the Centers for Disease Control and Prevention (CDC). Combined SEER and National Program of Cancer Registries data for 1998–2022 were provided by the North American Association of Central Cancer Registries. Mortality data were from the National Center for Health Statistics, also at the CDC.

Risk factors and screening for Colorectal Cancer

According to researchers, more than one-half of colorectal cancers are attributable to modifiable risk factors, such as smoking, an unhealthy diet, high alcohol consumption, physical inactivity, and excess body weight, and are potentially preventable. Many additional cases and deaths are preventable through appropriate screening and access to high‐quality treatment. Scientists found that half of all people diagnosed before 50 are ages 45-49 years and are eligible for screening. Yet, screening prevalence in this age group is just 37%, and 3 in 4 colorectal cancers in adults younger than 50 years are diagnosed at an advanced stage (regional or distant). The 5-year survival rate for local-stage disease is 95%.

"These findings further underscore that colorectal cancer is worsening among younger generations and highlight the immediate need for eligible adults to begin screening at the recommended age of 45," said Dr. William Dahut, chief scientific officer at the American Cancer Society. "The report also shines a light on the crucial importance of continued funding for research to help discover new therapies to treat the disease and advance patient care."

Research highlights from the report include:

In 2026, an estimated 158,850 new cases of colorectal cancer will be diagnosed, and 55,230 people will die from the disease in the U.S.
Colorectal cancer incidence is rising in adults under 65 (by 3% per year in ages 20–49 and 0.4% per year in ages 50–64), driven by cancer occurrence in the distal colon and rectum.
Nearly half (45%) of new colorectal cancer cases are now occurring in adults under 65, up from 27% in 1995, signaling a major shift toward younger generations.
Three in 4 colorectal cancers in adults younger than 50 years are advanced stage (regional or distant) at diagnosis, and a little more than 1 in 4 (27%) are distant stage.
One-half (50%) of colorectal cancer diagnoses under age 50 are in people 45-49 years who are eligible for colorectal cancer screening, which prevents cancer as well as detecting asymptomatic disease.
Colorectal cancer mortality rates increased by 1% per year in both adults under 50, since 2004, and in adults aged 50-64, since 2019.
Colorectal cancer incidence and mortality continue to decrease in adults 65 and older by more than 2% per year.
Rectal cancer incidence increased in all ages combined by 1% per year from 2018 to 2022, reversing decades of decline.
Rectal cancer now accounts for about one-third (32%) of colorectal cancer diagnoses, up from one-fourth (27%) in the mid-2000s.
Alaska Native people have the highest colorectal cancer incidence (80.9 per 100,000) and mortality (31.5 per 100,000) in the U.S., more than 2-fold that of White people; American Indian people have the second-highest burden.

"Alaska Native people persistently experience a higher incidence and mortality rates than other racial and ethnic groups for colorectal cancer, with the American Indian population a close second," said Dr. Ahmedin Jemal, senior vice president, surveillance, prevention, and health services research at the American Cancer Society and senior author of the study. "We need to reduce these cancer disparities by investing in cancer research specific to this population and improving access to screening, to save more lives."

Other ACS authors participating in this study include Dr. Nikita Wagle, Jessica Star, MA, MPH, Tyler Kratzer, MPH, and Dr. Robert Smith.

Additional ACS Resources:

Cancer Statistics Report 2026
Colon and Rectal Cancer Information
Cancer Screening
CancerRisk360
Mortality Under 50 Declines for 4 of 5 Leading Cancers in U.S., but Colorectal Now Top Cancer Killer

About the American Cancer Society
The American Cancer Society is a leading cancer-fighting organization with a vision to end cancer as we know it, for everyone. For more than 110 years, we have been improving the lives of people with cancer and their families as the only organization combating cancer through advocacy, research, and patient support. We are committed to ensuring everyone has an opportunity to prevent, detect, treat, and survive cancer. To learn more, visit cancer.org or call our 24/7 helpline at 1-800-227-2345. Connect with us on Facebook, X, and Instagram.

SOURCE American Cancer Society