Eighty of every hundred teenagers and young adults in a new US study were already at stage III or IV when doctors found their colorectal cancer. The work looked at 84 patients aged 21 or younger and was presented at the American Academy of Pediatrics 2026 National Conference in San Diego.
The findings are a snapshot of a rare disease, not a measure of how common it is. But they add to a worry researchers keep voicing: bowel cancer in young people is rising, and it is often caught late.
What the researchers did
According to the American Academy of Pediatrics release, carried by ScienceDaily, the team reviewed medical records of 84 patients aged 21 or younger who were diagnosed with colorectal cancer between 2012 and 2023. Contemporary Pediatrics reports the records came from 34 institutions, gathered through the Pediatric Surgical Oncology Research Collaborative.
Patients with a known inherited predisposition, including genetic syndromes, were excluded. So were those with inflammatory bowel disease diagnosed before the cancer. The study therefore describes so-called sporadic cases.
The median age at diagnosis was 16.5 years. Of the 84 patients, 65 had colon cancer and 19 had rectal cancer, and 47 were male, according to Contemporary Pediatrics.
Late diagnosis, high toll
Medscape reported that 51% of patients had stage III disease and 29% had stage IV. Contemporary Pediatrics put the number with stage III or IV disease at 67 of 84. Five-year overall survival was 47%, according to Medscape.
Contemporary Pediatrics reported that by the end of the study period, 45.2% of the patients had died of colorectal cancer. Another report on the study said more than a third later had a recurrence.
Family history did not explain much of it. Only 20% of patients had a first- or second-degree relative with colorectal cancer, the release said. Most still had aggressive disease.
Symptoms that were slow to be pursued
Symptoms had lasted a median of 12 weeks before diagnosis, Medscape reported. Contemporary Pediatrics gave a wide range, from 2 to 24 weeks for the middle half of patients. Median time to colonoscopy was 13 weeks.
The release lists rectal bleeding, weight loss and abdominal pain among the signs that can be overlooked. Because the cancer is uncommon at this age, those symptoms may not immediately raise suspicion, the researchers said.
Study author Erica Arnold, a pediatric surgery research fellow at Nationwide Children’s Hospital in Columbus, Ohio, told Medscape the results support treating colorectal cancer in adolescents and young adults as a distinct disease from that seen in older adults. In the release she described it as often aggressive, with late-stage presentation and high rates of relapse and death.
Limits of the data
The study is retrospective, meaning it looked back at existing records rather than following patients forward. It covers people already diagnosed at participating centers, so it cannot show how many young people have the disease or how fast the rate is climbing. Findings presented at a conference may also change before formal publication, and the sources reviewed here do not say whether the work has been peer reviewed.
The sources also do not say whether earlier diagnosis would have changed outcomes in these patients. Tumor biology may play a role. The authors’ description of a distinct disease points in that direction, but the reports do not detail the evidence.
What the study does show is a gap between the first symptoms and a diagnosis, in a group where doctors seldom expect to find this cancer. The researchers’ message, as relayed in the release, is that persistent symptoms in young people should not be dismissed.