Rectal cancer deaths are rising, especially among younger adults and Latino people, outpacing colon cancer mortality, according to a study presented at Digestive Disease Week (DDW 2026). These findings highlight the need to rethink screening strategies and pay more attention to early symptoms, experts say.

“Colorectal cancer is no longer considered predominantly a disease of older adults,” Mythili Menon Pathiyil, MBBS, of SUNY Upstate Medical University, lead author of the new study, said in a DDW news release. “Rectal cancer, especially, is becoming a growing problem in younger individuals, and we need to act early to reverse this trend.”

Colorectal cancer is often regarded as a single entity, but research increasing shows that cancer of the rectum, or terminal section of the large intestine, is distinct from cancer further up in the colon.

The rise in colorectal cancer among younger adults has received much attention, but scientists still do not understand the reasons for the recent increase. A recent report from the American Cancer Society showed that colorectal cancer incidence (new cases) is rising among adults under 65, even as it continues to decline among older people. The increase is largely driven by cancers in the distal, or lowest, part of the colon and the rectum. Rectal cancer now accounts for about one third of all colorectal cancer diagnoses.

Importantly, rectal cancer is not the same as anal cancer, which affects the anal canal and opening, which are made up of a different type of cells than the colon and rectum. Most anal cancer is caused by human papillomavirus (HPV), making it more akin to cervical cancer. Gay men and people with HIV are at higher risk for anal cancer, but the incidence is rising fastest among older women. Early symptoms of rectal and anal cancer may be similar—bleeding, pain, changes in bowel habits—but the two malignancies require different prevention, screening and treatment approaches. In particular, the HPV vaccine can prevent anal but not rectal cancer.

The new study finds that rising rectal cancer incidence is mirrored by trends in mortality. Pathiyil and colleagues analyzed U.S. death records from 1999 to 2023 for adults ages 20 to 44 using the Centers for Disease Control and Prevention WONDER database. They calculated annual changes in mortality rates by sex, race/ethnicity, region and age group, then used a machine learning model to project trends through 2035 if current patterns hold.

The analysis revealed a steady increase in colorectal cancer deaths overall, but rectal cancer mortality is rising two to three times faster than colon cancer mortality across all demographic groups. Latino adults, white adults, younger adults and those living in western states saw the steepest rise in rectal cancer deaths. Among adults ages 35 to 44, rectal cancer mortality is projected to escalate through 2035, while colon cancer mortality rises more slowly. 

If current trends continue, rectal cancer deaths could overtake colon cancer deaths in the next decade.

These findings support rethinking screening strategies, including greater use of flexible sigmoidoscopy to detect rectal cancer, and promoting increased awareness, according to Pathiyil.The American Cancer Society and U.S. Preventive Services Task Force recommend colorectal cancer screening starting at age 45 for people at average risk, but recent trends suggest earlier screening may be warranted. She advises young adults and primary care providers to pay more attention to early symptoms, which can be mistaken for hemorrhoids or other problems in younger patients. 

“It’s less about just changing guidelines overnight and more about changing how we think about it, recognizing that colorectal cancer in young adults is no longer rare, and it needs earlier attention,” Pathiyil said. “Our study shows that rectal cancer is driving much of the increase in colorectal cancers, and it’s most likely to worsen over time if we don’t change what we are doing right now.”

Click here to learn more about colorectal cancer.