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Colorectal cancer is increasingly being diagnosed in adolescents and young adults, with many patients presenting with advanced-stage disease, according to new research presented at the American Academy of Pediatrics (AAP) 2026 National Conference & Exhibition.
The study, titled Clinical Presentation and Epidemiology of Pediatric and Adolescent Colorectal Carcinoma: A Pediatric Surgical Oncology Research Collaborative Study, reviewed medical records of 84 patients aged 21 or younger who were diagnosed with colorectal cancer between 2012 and 2023.
Researchers found that most patients had Stage III or Stage IV disease when their cancer was diagnosed, despite colorectal cancer being relatively uncommon in this age group.
Only 20 percent of the patients had a first- or second-degree family history of colorectal cancer, suggesting that many cases occurred without an obvious family risk, the researchers said.
The findings were presented at the AAP conference, held Oct 2-6 at the San Diego Convention Center.
Researchers said the results add to concerns over the rising occurrence of colorectal cancer among younger people and the tendency for the disease to be detected late.
Potential warning signs include abdominal or lower back pain, changes in bowel habits, unexplained weight loss and rectal bleeding.
Because colorectal cancer is still considered uncommon among children and young adults, such symptoms may initially be attributed to more common conditions, potentially delaying diagnosis.
“Colorectal cancer is, unfortunately, becoming more common in adolescents and young adults and represents a different disease than colorectal cancer diagnosed in older adults,” said Erica Arnold, a pediatric surgery research fellow and study author.
“When diagnosed, it is often aggressive, presenting with late-stage disease and associated with high rates of disease relapse and mortality,” Arnold said.
The study also found that more than one-third of the patients subsequently developed recurrent disease, while nearly half died from their cancer.
The researchers said delays in diagnosis, combined with aggressive tumor behavior, may contribute to poor long-term outcomes.
They urged clinicians and families to take symptoms such as unexplained weight loss and rectal bleeding seriously, even in younger patients.
As cancers traditionally associated with older adults are increasingly being diagnosed at younger ages, the researchers also called for closer coordination between pediatric and adult medical teams and treatment strategies specifically tailored to younger patients.