PARIS, France: The recent death of US actor James Van Der Beek has drawn renewed attention to a troubling medical trend: a significant rise in colorectal cancer among people under 50 – a surge that researchers say remains largely unexplained.
Van Der Beek, best known for his role in Dawson’s Creek, died last week at the age of 48 after being diagnosed with colorectal cancer, also known as bowel cancer. His passing echoes that of Chadwick Boseman, the star of Black Panther, who died from the same disease in 2020 at age 43.
According to Helen Coleman, a cancer epidemiology professor at Queen’s University Belfast, the rate of colorectal cancer diagnoses among people under 50 has risen by roughly one-third since the 1990s.
Research published last month in the JAMA journal found that colorectal cancer is now the leading cause of cancer-related death among under-50s in the United States.
While the statistics are alarming, experts caution that the increase has occurred from a relatively low base. Coleman notes that only around six percent of all colorectal cancer cases are diagnosed in people under 50, based on her research in Northern Ireland. The vast majority of cases still occur in older adults, according to AFP.
In fact, rates among older populations are stabilising or even declining in some regions due to improved screening programmes. However, younger adults may be less likely to suspect they are at risk, since colorectal cancer was long considered a disease of the elderly.
As a result, diagnoses in younger patients are often made at more advanced stages — as was the case with Van Der Beek.
What is driving the increase?
As with other cancers affecting younger people, colorectal cancer has been linked to lifestyle factors such as obesity, poor diet, lack of exercise, alcohol consumption and smoking.
However, Coleman said these risk factors alone do not fully explain the rapid rise seen over a relatively short period. Many younger patients appear to have been otherwise healthy at the time of diagnosis.
Van Der Beek himself spoke publicly about his surprise diagnosis. In a December television interview, the father of six said he had been focused on wellness practices — including saunas, cold plunges, and other health regimens — before learning he had stage three cancer.
Researchers admit that the underlying causes remain uncertain. “We don’t know,” said Jenny Seligmann, a colorectal cancer researcher at the University of Leeds.
The unanswered questions have prompted scientists to explore new avenues, including the human microbiome — the vast ecosystem of microorganisms in the gut that is still not fully understood.
A study published last year in the journal Nature identified what Coleman described as an important early clue. Researchers found that DNA mutations linked to a toxin called colibactin — produced by certain strains of E. coli bacteria — were significantly more common in younger colorectal cancer patients than in older ones.
Even so, experts stress that much more research is required. It remains unclear whether younger individuals are more frequently exposed to the toxin or whether other biological factors are involved.
Additional studies have suggested that repeated antibiotic use could be associated with early-onset colorectal cancer, though this link has yet to be definitively established.
Seligmann also noted that clinicians are observing multiple distinct subtypes of colorectal cancer among younger patients, indicating that the rise may not be attributable to a single cause. “It’s going to be very difficult to pinpoint it to one cause,” she said.
Screening and early detection
Before his death, Van Der Beek urged people to pay attention to symptoms and seek medical advice. “I want to shout from the rooftops – if you are 45 or older, talk to your doctor,” he said.
Common symptoms of colorectal cancer include persistent changes in bowel habits such as diarrhoea or constipation, blood in the stool, unexplained weight loss and ongoing fatigue.
In response to the growing number of younger cases, the United States lowered the recommended starting age for routine colorectal cancer screening from 50 to 45 in 2021.
Other countries have faced calls to follow suit. The United Kingdom and France currently begin routine screening at age 50.
Health experts emphasise that while the majority of colorectal cancer cases still occur in older adults, greater awareness among younger populations — along with continued research into potential causes — will be critical in addressing the emerging trend.
