Rising Cases of Colorectal Cancer in People Under 50 Prompt Calls for Earlier Screening

Health organizations in Canada are urging governments to lower the routine colorectal cancer screening age from 50 to 45 after new evidence showed a growing number of diagnoses among younger adults.

The call comes as more people in their 40s are being diagnosed with the disease, often without obvious warning signs. One such case is Michael Groves of Ottawa, whose diagnosis came as a complete shock.

In January 2021, Groves went to an emergency department complaining of abdominal pain. Doctors initially suspected appendicitis, but after medical tests ruled it out, he was sent home.

A few days later, Groves noticed blood in his stool and reported it to his family doctor. Although the pain and bleeding soon stopped, his doctor scheduled a precautionary colonoscopy for April.

At the time, Groves never imagined that the test would reveal cancer.

“I never thought it could be colon cancer,” he said in an interview.

During the colonoscopy, doctors discovered a five-centimetre tumour. Groves was diagnosed with Stage 3 colorectal cancer that had already spread to two lymph nodes.

“The shock was overwhelming,” he said. “It was devastating.”

What made the diagnosis even more surprising was that he felt completely healthy. Groves said he had no symptoms and was living an active life.

“I was running five kilometres and feeling great,” he said. “I wasn’t tired. I was just a normal guy in my 40s.”

Groves underwent surgery in which surgeons removed about a foot of his colon. He then endured a demanding six-month chemotherapy treatment and was forced to take nearly nine months away from work.

Now 54, Groves believes his cancer could have been detected much earlier if routine screening had begun before age 50.

Health advocates say his case is becoming increasingly common.

According to the Canadian Cancer Society, people under 50 today are between two and two-and-a-half times more likely to be diagnosed with colorectal cancer than previous generations.

Brandon Purcell, advocacy manager for prevention and early detection at the Canadian Cancer Society, said the trend is deeply concerning.

“We’re seeing a significant rise in colorectal cancer among younger adults,” Purcell said. “Governments need to respond so that more cancers can be detected earlier.”

Currently, routine screening programs offer a fecal immunochemical test (FIT) to people aged 50 and older. The simple at-home test involves swabbing a stool sample and mailing it to a laboratory for analysis.

If blood is detected in the sample, the patient is referred for a colonoscopy to determine whether cancer or other conditions are present.

Individuals under 50 may receive colonoscopies earlier if they have symptoms, such as blood in their stool, or risk factors like a family history of colorectal cancer.

However, advocates say expanding routine screening to people aged 45 and older could help identify cancer earlier, when treatment is far more successful.

The Canadian Cancer Society reports that colorectal cancer has a survival rate of up to 90 percent when detected early. In advanced stages, survival drops to below 15 percent.

Colonoscopies can also detect and remove precancerous polyps before they develop into cancer. According to Barry Stein, president and CEO of Colorectal Cancer Canada, it typically takes eight to ten years for a polyp to become cancerous.

Both organizations cited a recent modelling study published on March 7 in the Journal of the Canadian Association of Gastroenterology.

The research estimated that lowering the screening age to 45 could prevent more than 15,000 colorectal cancer cases and about 6,100 deaths over the next 45 years.

Darren Brenner, a professor of oncology and community health sciences at the University of Calgary and the study’s senior author, said earlier screening could also reduce healthcare costs.

The study projected savings of approximately $233 million in cancer treatment expenses, even after accounting for the additional costs of screening tests and colonoscopies.

For survivors like Groves, the message is clear: early detection can make a life-saving difference.