Early-Onset Colorectal Cancer Is Rising in Canada: Why Symptom Recognition & Screening Earlier Matter

March marks Colorectal Cancer Awareness Month, a time to highlight one of the most common and preventable cancers in Canada. Colorectal cancer (CRC) begins in the colon or rectum, often developing from precancerous polyps over time. 

Colorectal cancer (CRC) is the 4^th most commonly diagnosed cancer in Canada and the 2^nd leading cause of cancer-related deaths in men and women combined. It is estimated that, in 2025, there will have been 26 400 new diagnoses and colorectal cancer will have claimed the lives of 9,100 individuals. 

Early-Onset Colorectal Cancer on the Rise

Traditionally viewed as a disease affecting older adults, colorectal cancer is increasingly being diagnosed in younger Canadians. Cases of early onset colorectal cancer (EOCRC), which is defined as diagnoses in individuals under the age of 50, are on the rise, challenging long-held assumptions about who is at risk. While most colorectal cancer cases still occur in individuals over 50, the trend among younger populations is striking. Canadians born after 1980 are now 2 to 2.5 times more likely to be diagnosed with colorectal cancer before age 50 compared to earlier generations. At the same time, incidence and mortality rates are declining among older adults, largely due to the success of established screening programs, highlighting the importance of symptom recognition and early detection.  

The EOCRC Challenge  

A key challenge with EOCRC is that it is often detected at a later stage. When caught early, colorectal cancer is highly treatable. The five-year survival rate exceeds 90% at stage I but drops sharply to just 11% at stage IV. Despite this, a 2022 survey by CCC found that nearly three-quarters of respondents under 50 were diagnosed at stage III or IV, when treatment options are more complex and outcomes are less favorable. 

This later-stage diagnosis in EOCRC patients is often due to the fact that symptoms, such as: rectal bleeding, persistent changes in bowel habits, abdominal pain or cramping, unexplained weight loss, fatigue, or a feeling that the bowel does not empty completely, can be subtle and easily dismissed or attributed to less serious conditions, particularly in younger adults. Recognizing these warning signs and advocating for yourself by seeking timely medical evaluation can be crucial for early detection and improved outcomes. 

The Case for Screening at 45 

Currently, colorectal cancer screening programs in Canada target individuals aged 50 to 74 who are considered at average risk. However, this threshold no longer reflects the evolving reality of the disease. Countries such as the United States and Australia have already lowered their screening age to 45, based on strong evidence that earlier detection can significantly reduce both incidence and mortality. 

Every Canadian Can Take Action 

In response to this growing concern, Colorectal Cancer Canada (CCC), through its Screen at 45 campaign, is calling on governments across the country to lower the routine screening age from 50 to 45 for Canadians at average risk. Lowering the screening age to 45 is a critical step toward addressing the rise of EOCRC. Increasing awareness among younger Canadians about symptoms, risk factors, and family history is equally essential. 

Colorectal cancer does not discriminate by age. Screening guidelines should reflect that reality. 

About Colorectal Cancer Canada 

Colorectal Cancer Canada is Canada’s not for profit organization dedicated to colorectal cancer patients and their families. To learn more about Colorectal Cancer Canada, signs and symptoms or the Screen at 45 campaign please visit www.colorectalcancercanada.com. 

Learn more about signs and symptoms and the Screen at 45 initiative at www.colorectalcancercanada.com.