The deaths of two well-known actors, both in their 40s, from colorectal disease have pushed a once-overlooked illness into the national conversation. And the timing could not be more urgent. Rectal cancer, long considered a condition of older adults, is now rising at an alarming rate among millennials and even Gen Z, reshaping what doctors thought they knew about who is at risk.
Colorectal disease is currently the leading cause of death from malignancy in adults under 50. Within that category, rectal cancer is rising faster than colon-related cases, and researchers project it could become the top cause of such deaths in people under 50 by 2035 if current trends hold.
Colorectal is a shared name for conditions occurring in the colon and the rectum. The rectum is the final stretch of the colon, located just before the anus. Because the tissue in both areas is biologically similar, the two are often grouped together. However, their locations give each a slightly different set of symptoms and treatment considerations.
Rectal cancer symptoms that should never be ignored
The most widely reported symptom is rectal bleeding. The blood may range from bright red to dark maroon and can appear in the stool, in the toilet bowl, or on toilet paper. Because this symptom overlaps with hemorrhoids or, in some cases, menstruation, many people dismiss it without a second thought.
Abdominal pain is another commonly reported symptom. Others include changes in bowel habits, persistent constipation, stools that appear thinner than usual, unexplained fatigue, weight loss, and anemia. Because the condition develops at the end of the colon, thinner stools and blood in the stool tend to appear more frequently in rectal cases than in colon-related ones.
Any shift in normal gastrointestinal function warrants medical attention, particularly when blood in the stool is involved. It is also worth noting that in some people, rectal cancer produces no symptoms at all, which is why routine screenings remain so critical.
Why rectal cancer is hitting younger people harder
Data shows a clear divide: colorectal diagnosis rates are declining in adults 65 and older while rising steeply in younger generations. The rate in people born in 2001 is higher than in those born in 1991, which is itself higher than in those born in 1981. Even among teenagers, the rate of increase has been described by researchers as remarkable, though overall numbers in that age group remain low.
Since 1988, colorectal diagnosis rates in adults under 50 have increased by 63 percent. In 1988, roughly 8 out of every 100,000 adults under 50 were diagnosed. That number has since climbed to 13 out of 100,000.
What might be driving the rectal cancer surge
Researchers believe something shifted in the environment or diet between roughly 1950 and 1990, and the effects have compounded over time. A Western diet high in animal fats, refined carbohydrates, red and processed meats, and processed sugars is considered a likely contributor. During that same period, fast food became widespread, preservatives entered the food supply in greater quantities, and plastic food containers introduced microplastics into everyday life.
Obesity and diabetes are known risk factors, though most younger people diagnosed with rectal cancer do not fall into either category. Changes in the gut microbiome, which can be influenced by dietary and lifestyle shifts over recent decades, are also being studied as a possible factor.
Reducing your rectal cancer risk
There is no guaranteed way to eliminate the risk entirely, but there are meaningful steps worth taking. Routine screening is the most important. For people at average risk, guidelines recommend starting at age 45 with either a colonoscopy or a stool-based test. Those with a parent or sibling who had colorectal disease may qualify for earlier screening.
A Mediterranean diet, low in red meat and rich in soluble fiber from beans, vegetables, fruits, seeds, and whole grains, is associated with lower risk. Limiting sugar-sweetened beverages and alcohol is also advised. Reducing reliance on plastic food containers is considered a reasonable precaution, though the direct link between microplastics and the condition is still being studied.
For anyone already managing obesity or diabetes, addressing those conditions through medication or lifestyle changes may also help lower risk.
Most importantly, do not ignore symptoms. If something feels off in your digestive health, bring it up with a doctor. And if that doctor does not take your concerns seriously, push harder. Early detection remains one of the most powerful tools available.
