A new study presented at the American Academy of Pediatrics annual meeting highlights a concerning trend: colorectal cancer in adolescents is often aggressive and associated with high relapse and mortality rates.
Researchers from Mass General Brigham Cancer Institute analyzed data from 34 US hospitals, tracking 84 patients aged 21 and under diagnosed with colorectal cancer between 2012 and 2023. The findings revealed that 45% of these patients died within a year, while 37% experienced cancer recurrence within the same period. In comparison, the average survival rate for bowel cancer in the UK across all age groups is around 60%.
Symptoms and delayed diagnosis
Nearly three-quarters of the adolescent patients reported back or abdominal pain, the most common symptom observed. Other reported symptoms included rectal bleeding, changes in bowel habits, and weight loss, though these were less frequent. Experts attribute the high fatality rate to delayed diagnosis, as symptoms in younger patients are often less obvious than in older adults.
Rising trends and risk factors
Colorectal cancer rates have surged exclusively in under-50s over the past two decades, with adolescents representing a particularly vulnerable subgroup. Previous research has linked the rise in early-onset colorectal cancer to factors such as poor diets, sedentary lifestyles, and increasing obesity rates. However, the new study emphasizes that adolescents face unique risks, including more aggressive cancer types and diagnostic delays.
Patient experiences
Jo Henderson, now 18, was diagnosed with advanced colorectal cancer at 17 after months of symptoms including stomach pain, bloating, and constipation. Henderson, who was not part of the study, described her initial expectations as dismissing cancer as a possibility, instead attributing her symptoms to dietary issues. Her case underscores the challenges of early detection in younger patients.
Expert recommendations
Study lead author Dr. Erica Arnold, a pediatric surgeon, stressed that colorectal cancer in adolescents is fundamentally different from the disease in older adults. She urged medical professionals to recognize less-obvious symptoms in younger patients to improve early diagnosis. Dr. Danielle Cameron, director of pediatric surgical oncology at the same institute, noted that adolescents and very young adults are at higher risk for aggressive cancers and diagnostic delays, even compared to patients in their 30s and 40s.
Global context
Worldwide, colorectal cancer rates are rising among people in their 20s and 30s. A person born in the 1990s is four times more likely to be diagnosed with colorectal cancer before age 50 than those born in the 1960s. While cases in adolescents remain exceptionally rare—accounting for fewer than 100 cases per year in the US—experts report anecdotally that rates are beginning to increase.