After James Van Der Beek’s death following a 2½-year fight with colon cancer, doctors and researchers are sounding the alarm about rising colorectal cancer in younger adults, the likely drivers behind the trend, common warning signs, and why screening matters now more than ever.
Van Der Beek revealed he received a stage 3 colon cancer diagnosis that was made official in August 2023 after a colonoscopy, and that he went public in November 2024. His experience highlights how quickly cancer can progress and how easy it is to miss early signals when you assume symptoms are minor or age-related.
The actor said his first red flag was a change in bowel movements that he dismissed as a coffee issue. “Before my diagnosis, I didn’t know much about colorectal cancer,” the actor said. “I didn’t even realize the screening age [had] dropped to 45; I thought it was still 50.”
Recent studies have found a troubling rise in colorectal cancer cases among people under 50, and the American Cancer Society now lists it as the leading cause of cancer-related death for men and women 50 and younger. That’s a dramatic change from the 1990s, when colorectal cancer ranked much lower in terms of mortality for younger adults.
Researchers point out that while overall cancer deaths in this age group have fallen since 1990, colorectal cancer is the exception with increasing mortality. Dr. Aparna Parikh has said, “But it seems to be an interplay of a person’s risk factors, overall makeup and early exposures,” and added, “The exposures include dietary exposures, environmental exposures and possible antibiotic exposures, as well as lifestyle factors in the right host.”
Alcohol consumption over a lifetime has been linked to higher colorectal cancer risk, and other established contributors include family history, obesity, tobacco use, inflammatory bowel disease, and a diet heavy in red and processed meats as well as the presence of polyps. These ingredients together create a risk profile that helps explain why younger people are showing up with advanced disease.
On TV, Dr. Marc Siegel emphasized both genetics and modern diet as culprits, saying, “There is a genetic issue, but there’s also ultraprocessed foods — a new study out of Mass General shows a high diet in that… [you’re] 45% more likely to have colon cancer.” He also highlighted meat and processed foods as risk multipliers and urged lowering screening ages to catch disease earlier.
There are clear numbers attached to dietary risk: studies show roughly a 30% increased risk with diets higher in processed meats and about a 20% increase with more red meat. “These are the villains here,” he said. “That, plus genetics. And I’m urging everyone out there — change the age for screening to 45, or even below if you have risk factors. That’s really key.”
Clinicians stress that bowel changes are the most important early warning sign to watch for and that many cancers develop with little or no symptoms. Other signs that should prompt evaluation include fatigue from anemia, persistent abdominal discomfort, rectal bleeding or blood in stool, unexplained weakness, and weight loss.
“Many colorectal cancers develop silently, without obvious symptoms,” Barnell said. “By the time symptoms appear, the disease may already be advanced.” That reality makes prevention and routine screening pivotal, especially because early lesions can often be removed before they turn into cancer.
“Colonoscopy at age 45 onwards, at five- to 10-year intervals, has been shown to lead to early detection of polyps that have the potential to become malignant, and to allow for their removal as an effective means of minimizing the risk of malignant transformation,” Friedman said. Yet screening rates still lag, particularly in rural, low-income, and minority communities.
“screening compliance in the U.S. remains below national targets, and gaps are widest in rural, low-income and minority communities,” one expert noted, stressing that access and awareness are big parts of the problem. “Most people don’t like talking about bowel habits, but paying attention to changes can save your life,” the doctor said. “Screening gives us the chance to find problems early — often before you feel sick — and that can make all the difference.”
Doctors continue to recommend colonoscopy as the gold standard for detecting and removing precancerous polyps, and they advise that anyone with risk factors talk to their clinician about earlier screening. With shifts in incidence and the pace of disease in younger adults, the message is simple: notice changes, reduce modifiable risks where possible, and get screened on a sensible schedule.
