Colorectal cancer: A growing concern for young adults in Missouri
Gabrielle Teiner
COLUMBIA, Mo. (KMIZ)
Colorectal cancer has become the deadliest cancer for adults under 50 years old in the United States, and it’s becoming more prominent in Missouri.
According to data from the American Cancer Society, an estimated 158,850 people will be diagnosed with colorectal cancer in 2026 — 3,200 of them Missourians. More than 1,200 people across the state are projected to die from this cancer this year.
New cases projected in 2026 nationwide
New cases projected in Missouri 2026
Deaths projected nationwide in 2026
Deaths projected in Missouri 2026
158,850
3,200
55,230
1,280
Men: 84,160
Men: N/A
Men: 30,110
Men: N/A
Women: 74,690
Women: N/A
Women: 25,120
Women: N/A
“That increase has continued to accelerate,” said Dr. Nick Davidson, professor and chief of the Division of Gastroenterology at Washington University Medicine. “And now, early-onset colorectal cancer is the leading cause of cancer-related death in the U.S. in people under the age of 50, so it’s a real concern.”
Missouri accounts for around 2% of all new colorectal cancer cases nationwide. This year, there is a slight increase from 2025, when 3,010 new cases were projected across the state and 154,270 were projected nationwide.
Nationwide new cases projected in 2025
Missouri new cases projected in 2025
Nationwide projected deaths in 2025
Missouri projected deaths in 2025
154,270
3,010
52,900
1,260
Men: 82,460
Men: N/A
Men: 28,900
Men: N/A
Women: 71,810
Women: N/A
Women: 24,000
Women: N/A
“I think that we’re always surprised whenever we see someone who we think looks very healthy have colorectal cancer,” said Dr. Jean Wang, professor of medicine in the Division of Gastroenterology at Washington University and Siteman Cancer Center. “Just about five years ago, the screening guidelines changed from recommending starting to get screenings at age 50 to age 45, but now we’re seeing even younger patients, even younger than 45 years old, getting colorectal cancer.”
Birth – 49 years old
Male: 12,670 new casesFemale: 11,970 new cases
50-64 years old
Male: 27,800 new casesFemale: 19,800 new cases
65 years old and up
Male: 43,690 new casesFemale: 42,920 new cases
All ages
Male: 84,160 new casesFemale: 74,690 new cases
(Projected new U.S. cases, 2026, American Cancer Society)
Wang says the youngest patients she has seen with colorectal cancer have been in their late 20s and early 30s. For people ages 49 and under in Missouri from 2018-2022, nearly 45 men out of 100,000 and around 34 women out of 100,000 were diagnosed with colorectal cancer.
The death rate also continues to climb, with 17 men out of 100,000 and nearly 12 women out of 100,000 dying from colorectal cancer from 2019 to 2023.
Colorectal cancer is a combination of colon cancer and rectal cancer, as the two are very similar and close in proximity inside the body. Inside those organs, tumors or polyps grow. While most are non-cancerous, some can become cancerous over time. Anyone can develop a polyp, and the risk of them becoming cancerous increases as you get older.
While polyps typically don’t cause symptoms, it’s important to go see your doctor if you have any of the following symptoms, as they could indicate that you have colorectal cancer:
Blood in stool
Rectal bleeding
Changes in bowel movements (constipation or diarrhea)
Unintentional weight loss
Low blood count
Intense fatigue
“Those are some of the kinds of red flag signs that you should watch out for that would make you want to talk to your doctor about getting a colonoscopy,” said Wang. “Early colon cancer doesn’t cause any symptoms at all.”
Colorectal cancer is split into four stages, with Stage 1 being the least severe stage and Stage 4 being the most deadly.
Stages
What happens to your body
Treatment
Stage 1
Cancer cells localized just to the muscular layer of the colon and rectum (mucosa, submucosa, muscularis propria); has not spread to any lymph nodes or nearby tissue
Cancer cells (polyps) are typically removed during a colonoscopy and sent to a lab for testing to see if they are cancerous
Stage 2
Cancer has spread to the outermost layers of the colon or rectum, or has spread through the colon wall and into nearby tissue; has not spread to any lymph nodes
Chemotherapy/radiation to shrink the tumors before surgery to remove them from any affected organs. Additional chemotherapy after surgery.
Stage 3
Cancer has spread into nearby lymph nodes, but has not reached other areas of the body
Chemotherapy/radiation to shrink the tumors before surgery to remove them from any affected organs and remove affected lymph nodes. Additional chemotherapy after surgery.
Stage 4
Cancer has been carried through the lymph and blood systems to distant organs in the body, like the liver and lungs.
Chemotherapy/radiation to shrink the tumors before surgery to remove cancer-affected organs/tissue. Additional chemotherapy after surgery. Targeted therapy, immunotherapy and clinical trials.
(Source: Colorectal Cancer Alliance)
According to Wang, the survival rate for people diagnosed with Stage 4 colorectal cancer is about 15%, whereas people diagnosed with Stage 1 have a 95% chance of being cured.
“You can just have a surgery to cut out that little section of your colon and then be cured and live life normally, but if you wait too long and the cancer grows and it spreads to other parts of the body, then it’s very hard to treat,” Wang said.
Wang says it’s thought that up to 85% of colon cancers could be preventable if people followed screening guidelines, which recommend adults get a colonoscopy at age 45.
There are also stool tests you can take at home that can detect abnormalities for convenience, especially for rural areas where access to colonoscopies can be more challenging. If an abnormality is discovered, it is recommended to get a colonoscopy.
If a cancerous polyp is removed during a colonoscopy, Wang says it is critical to continue to follow up.
“Colonoscopies really aren’t that hard to do, and so, it’s really a shame whenever I see someone come in with colon cancer who had not followed up with colon screenings, and you just know that if they had come in 10 years earlier, it could have all been prevented,” Wang said.
While more younger adults are being diagnosed with colorectal cancer, researchers and experts are still working to figure out what’s driving this increase.
“Honestly, we really don’t know, said Davidson. “The answer is not one single reason that this is happening, it’s multiple.”
Davidson says more people are becoming overweight, consuming more alcohol, smoking, eating more processed foods and red meats. Those things, along with family genetics and more, are all factors in the increase in cases.
Davidson is part of a research team that looks at multiple different social and genetic factors to better understand this epidemic. The team is also part of a study that takes samples of colorectal cancer patients’ tumors, separating them into smaller tissue samples called organoids that they can grow indefinitely to study their behavior.
“The advantages of that are that we can characterize the genetic abnormalities, the mutations that arise in those samples, and then we can look at vulnerabilities in those cancer cells and hopefully design personalized forms of therapy,” said Davidson.
Watch ABC 17 News at 6 on Tuesday to hear how Missouri is at the forefront of research against the growing epidemic.