Study recommends continued work to address risk factors, especially among non-white populations
RENTON, Wash. [June 16, 2026] — The rate of early onset colorectal cancer (EOCRC) among those under 50 continues to rise despite more colonoscopies being ordered for this demographic, according to a new Providence study recently published in ScienceDirect.
In addition, EOCRC is rising faster among Black, Hispanic and other underrepresented populations.
“These findings point toward a true and worsening epidemiologic shift and highlight the need for more equitable approaches to prevention, risk assessment, early detection and screening strategies,” said Brian Diskin, M.D., study co-author and complex general surgical oncology fellow at Providence Saint John’s Cancer Institute in Santa Monica, California.
Funded by the Hearst and Stand Up To Cancer foundations, the study reviewed records for nearly 2,800 Providence patients who were matched on sex and age, half with EOCRC and half without the disease, between 2017 and 2023. It found that, while colonoscopies are being ordered for younger patients at a higher rate recently, early onset colorectal cancer rates are higher still.
“The finding that stood out most to me was that colonoscopy utilization increased substantially among adults under age 50, yet disparities in early-onset colorectal cancer persisted and, in some populations, even worsened over time,” said Dr. Diskin. “One question has been whether the rise in early-onset colorectal cancer is simply because we are performing more colonoscopies and therefore finding more cancers. Our findings suggest that explanation is insufficient. Colonoscopy utilization increased dramatically, but the burden of early-onset colorectal cancer continued to rise disproportionately, particularly among Hispanic, Black, and other minority populations.”
The study also found that healthcare access alone doesn’t completely explain the trends. Although more frequent medical visits were associated with lower overall odds of EOCRC, Hispanic patients maintained a higher predicted risk of non-hereditary EOCRC across nearly all levels of healthcare engagement. Hispanic patients diagnosed with EOCRC also had worse survival outcomes – by about four months – than non-Hispanic patients.
“Environmental, biological, socioeconomic, dietary and structural factors likely contribute to the rising rate of EOCRC,” said Dr. Diskin. “Overall, I think the study adds to the growing evidence that early-onset colorectal cancer reflects a true epidemiologic shift rather than merely a byproduct of increased screening. Based on our findings, we advocate for equity-focused detection strategies, improved risk stratification, targeted outreach to high-risk populations, and ongoing efforts to reduce barriers to screening and timely diagnostic evaluation.”
This study builds on the team’s previous study which showed that symptoms, medical history, and demographic characteristics were important considerations for risk stratification.
About the Author
More Content by Providence News Team
