GI Cancers Are on the Rise, With Colorectal Cancer Leading the Trend

Early-onset gastrointestinal (GI) cancers are rising globally and have become the fastest-growing category of early-onset cancer in the United States, outpacing breast cancer. According to two recent literature reviews led by researchers at Dana-Farber Cancer Institute, this increase includes colorectal, gastric, pancreatic, and esophageal cancers.

The first review, published in JAMA, offers an overview of the current understanding of early-onset GI cancers—defined as GI cancers diagnosed before the age of 50. The authors note that while colorectal cancer accounts for more than 50% of early-onset GI cases, other cancers in this category are also becoming more common in younger populations.

Among the GI cancers discussed, only colorectal cancer currently has screening guidelines for average-risk individuals in the United States. Recommendations now advise screening beginning at age 45. However, national data from 2021 suggest that adherence remains low: fewer than 1 in 5 US adults aged 45 to 49 underwent colorectal cancer screening that year.

Disparities and age trends

A second review, published in the British Journal of Surgery, focused on incidence trends from 2010 to 2019. It found a 14.8% increase in early-onset GI cancer diagnoses over the period, with some of the steepest rises seen in individuals aged 15 to 39.

The burden of early-onset GI cancers is not evenly distributed. The review identified that people who are Black, Hispanic, of Indigenous ancestry, and women are disproportionately affected. In addition, people born in 1990 are twice as likely to develop colon cancer and four times as likely to develop rectal cancer compared to those born in 1950.

Recent data from the Centers for Disease Control and Prevention reinforce this trend. The incidence of colorectal cancer in individuals aged 15 to 19 has more than tripled, and nearly doubled in those aged 20 to 24.

The authors of both reviews underscore the importance of improving screening rates, particularly among younger adults who may not perceive themselves to be at risk. They also stress the need to address disparities in cancer care and outcomes for affected populations.

Reference: Jayakrishnan T, Ng K. Early-onset gastrointestinal cancers. JAMA. 2025. doi: 10.1001/jama.2025.10218

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