HOUSTON – Colorectal cancer has become the deadliest cancer for U.S. adults under 50 over the last two decades, and doctors say diet, lifestyle and gaps in preventive care are helping drive the trend.
Houston Methodist gastrointestinal medical oncologist Dr. Maen Abdelrahim told KPRC 2’s Andy Cerota that while there is no single proven cause, several risk factors are clearly linked to the rise — especially regularly eating highly processed foods and red or processed meats, along with obesity and sedentary lifestyles.
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Abdelrahim said early exposure to carcinogens and changes in the gut microbiome may also play a role.
The microbiome can be altered by food choices, frequent antibiotic use and other medications, potentially triggering chronic inflammation in the colon that can, over time, lead to cancer.
Studies show colorectal cancer has a disproportionately higher impact on Black Americans. Abdelrahim said current data does not point to a unique inherited gene mutation in Black patients compared to other racial groups. Instead, he said, the disparity is largely driven by systemic issues, including less access to preventive care and screening colonoscopies, delays in diagnosis and socioeconomic barriers.
As a result, Black patients are more likely to be diagnosed at later, more advanced stages of the disease, when it is harder to treat.
“Individuals in general need to have a better access to preventive medicine, screening, colonoscopy, screening tests and close follow-up, because if you’ve been diagnosed with a cancer and you don’t have a close follow-up, the time changes from the diagnosis till you start a treatment. If that’s long, you can change your stage from curative to uncurative,” Abdelrahim said.
Abdelrahim stressed that colorectal cancer is one of the few cancers that is nearly 100% curable when it is found early through screening.
He urged adults not to ignore “red flag” symptoms and to talk with their doctors about screening, even if they are younger than 50. Warning signs include:
- A change in bowel habits, such as new or persistent constipation or diarrhea
- A change in stool caliber, including pencil-thin stools
- Blood in the stool — bright red or dark — which can indicate a lesion somewhere in the colon
- Unexplained abdominal pain
- Unintentional weight loss
- Unexplained iron-deficiency anemia, which can be a sign of right-sided colon cancer
Recent high-profile deaths, including actor James Van Der Beek at 48 and Catherine O’Hara at 71, have renewed attention on the disease and the importance of recognizing symptoms early and getting timely screening.