Understanding Colorectal Cancer
This page is for education and is not medical advice. Talk with your care team about your specific situation.
Colorectal cancer can happen to anyone. It doesn't show up evenly, though. Some groups get diagnosed more often, later, or younger than others. Here's who, and what it means for when you should get checked.
It's not an older person's disease anymore
Cases in adults under 50 have been climbing about 3% a year for the past decade. Colorectal cancer is now the leading cause of cancer death for Americans under 50. Nearly half of all new cases are in people under 65.
Screening starts at 45 for most people. Only about 37% of 45 to 49 year olds have actually done it.
If you're younger than 45 with symptoms — bleeding, or a change in your bathroom habits that isn't going away — that still needs to be looked at. Being young doesn't rule you out.
Race and ethnicity
The gaps here are wide, and they aren't genetic. They come down to who can reach a clinic, who has insurance, and who gets taken seriously when they describe a symptom.
American Indian and Alaska Native communities are hit hardest. Among Alaska Native people, colorectal cancer rates run more than double those of White Americans. Distance from care, underfunded health services and hard-to-get specialist referrals all play a part.
Black Americans have the next highest rates, and are more likely to be diagnosed after the cancer has already spread. Screening is only part of that. What happens after an abnormal result — how fast the follow-up happens, and where — matters just as much.
Hispanic and Asian American communities have lower overall rates. The barriers are real anyway: insurance gaps, fewer materials in the right languages, and clinics that are harder to get to. Lower average rates can also hide communities whose numbers look nothing like the average.
Genetic Factors and Family History
If a parent, sibling or child had colorectal cancer or an advanced polyp, you start screening at 40, or ten years before whatever age they were diagnosed, whichever comes first.
Some inherited conditions, like Lynch syndrome, mean starting much earlier than that. If cancer shows up repeatedly in your family, ask your doctor about genetic counseling.
Money, distance and time
Where you live and what you're insured for shapes your odds more than most people realize.
Rural areas have fewer clinics and longer drives. Uninsured people screen less. Taking time off work, arranging a ride home after sedation, or finding childcare for a prep day all get in the way, and none of that shows up in a statistic about who "chose" not to screen.
Federally Qualified Health Centers offer care on a sliding scale, and many states run free screening programs.
What we still can't measure
Every number on this page comes from data someone decided to collect. Some of it doesn't get collected at all.
US cancer registries don't record sexual orientation or gender identity. Surveys can tell us who gets screened, but there are no national figures on how many LGBTQ+ people are diagnosed with colorectal cancer, at what stage, or how many survive.
Reducing disparities in colorectal cancer outcomes means taking a personalized approach to prevention and screening. Culturally sensitive resources, accessible screening options, and community-centered education can help ensure that everyone has an equal shot at catching colorectal cancer early and reducing risk. Recognizing and addressing these unique barriers brings us closer to a more equitable future in cancer care.
When we understand how colorectal cancer impacts different communities, we can better support everyone in staying informed, empowered, and proactive about their health.
-
Colorectal Cancer Alliance: A nonprofit organization offering resources for colorectal cancer prevention, screening, and support for patients and their families, with a focus on education.
Website: https://colorectalcancer.orgFight Colorectal Cancer: An organization dedicated to raising awareness and providing educational resources, advocacy, and support for people affected by colorectal cancer.
Website: https://fightcolorectalcancer.orgAmerican Cancer Society: Comprehensive information on colorectal cancer, including risk factors, screening options, and prevention methods, with resources tailored for diverse communities.
Website: https://www.cancer.org/cancer/types/colon-rectal-cancer.htmlCancer Support Community: Provides free support services, including counseling and support groups, for cancer patients, survivors, and caregivers, with a focus on underserved communities.
Website: https://www.cancersupportcommunity.orgNational Comprehensive Cancer Network (NCCN): Offers guidelines for colorectal cancer prevention, screening, and treatment, including resources for patients and healthcare providers.
Website: https://www.nccn.org/patientresources/patient-resources/guidelines-for-patientsAmerican Indian Cancer Foundation: Focuses on cancer prevention and support for Indigenous communities, including colorectal cancer education and culturally tailored resources.
Website: https://www.americanindiancancer.orgLGBTQ+ Cancer Network: Provides culturally sensitive resources, support, and advocacy tailored to LGBTQ+ individuals affected by cancer.
Website: https://www.cancer-network.orgPatient Advocate Foundation – Colorectal CareLine: A resource for financial aid, case management, and support for colorectal cancer patients navigating treatment challenges.
Website: https://www.patientadvocate.org
-
Siegel RL, et al. Colorectal cancer statistics, 2026. CA: A Cancer Journal for Clinicians, 2026. Source for the early-onset trend, the under-65 share, and the Alaska Native comparison. https://pressroom.cancer.org/rectal-cancer-incidence-rising
SEER Cancer Stat Facts: Colorectal Cancer. National Cancer Institute. Source for all incidence and mortality rates by race and ethnicity. https://seer.cancer.gov/statfacts/html/colorect.html
George L, et al. Colorectal Cancer Screening Prevalence Among Sexual Minority Populations Following the 2021 Updated USPSTF Guidelines. AJPM Focus, 2026;5(5):100508. https://www.sciencedirect.com/science/article/pii/S2773065426000349
Arena L, et al. Sexual Orientation and Gender Identity Based Disparities in Colorectal, Cervical, and Breast Cancer Screening in the United States. Cancer, 2026. DOI 10.1002/cncr.70462.
Baker K. Collecting sexual orientation and gender identity data in cancer centers. JNCI Monographs, 2025;2025(69):73–75. https://academic.oup.com/jncimono/article/2025/69/73/8203037
Shaukat A, et al. ACG clinical guidelines: colorectal cancer screening 2021. American Journal of Gastroenterology, 2021. Source for the family-history start age.
Truth Initiative. Tobacco use in the LGBTQ+ community. https://truthinitiative.org/research-resources/targeted-communities/tobacco-use-lgbtq-community