The findings underscore how economic inequality shapes health outcomes and highlight the importance of cancer awareness and screening in younger age groups.
A study published in April in JAMA Oncology found that colorectal cancer deaths among young adults in the U.S. are concentrated among people without college degrees, suggesting socioeconomic factors drive the increase in mortality.
The American Cancer Society research, based on data from more than 101,000 deaths from 1994 through 2023, is the first national study to parse which young adults are most affected by the increase. Celebrity deaths including actor Chadwick Boseman in 2020 and James Van Der Beek earlier this year have highlighted the trend.
The Education Divide
Over the past 30 years, the overall colorectal cancer death rate in people aged 25 to 49 rose from about 3 per 100,000 to about 4 per 100,000. But the numbers diverge sharply by education level.
For young adults who completed only high school, the death rate jumped from 4 to 5.2 per 100,000. For those with at least a bachelor’s degree, the rate remained flat at 2.7 per 100,000.
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.
Socioeconomic Drivers
Education level serves as a proxy for a constellation of health and economic factors. People without college degrees tend to earn less money, have poorer diets, exercise less, and receive less medical care, experts say. Death certificates do not record income, insurance status, or most other aspects of a person’s life—but they do note education completed. Research has found that education data often aligns with income, health insurance, physical activity, and chronic disease patterns.
Disease Burden and Detection
Colorectal cancer is the nation’s second leading cancer killer, behind only lung cancer. The American Cancer Society estimates it will claim more than 55,000 lives in 2026.
The agency changed its screening guidelines in 2021, lowering the recommended age to begin screening from 50 to 45. Young adults account for roughly 3,900 colorectal cancer deaths per year, about 7% of the approximately 55,000 total deaths from the disease.
Earlier this year, American Cancer Society researchers reported that colorectal cancer mortality in Americans under 50 had increased by 1.1% annually since 2005, making it now the deadliest cancer in that age group. Scientists have not yet determined what drives the increase. Risk factors include obesity, physical inactivity, high consumption of red or processed meat, low fruit and vegetable intake, and family history of colorectal cancer.
Recognizing Symptoms
Symptoms of colorectal cancer include blood in the stool or rectal bleeding; changes in bowel habits such as diarrhea, constipation, or narrowing of stool lasting more than a few days; unintended weight loss; and abdominal pain or cramps.
The new research surfaces what experts already understood: health disparities in the United States are rooted in economic inequality. The gap in colorectal cancer deaths is one manifestation of a broader pattern in which illness and mortality cluster among those with fewer economic resources.