Colorectal cancer is killing more young adults, but stigma keeps them from talking about it

Key facts

• Colorectal cancer is now the type most likely to kill people under age 50.
• Rick Rivers was diagnosed at age 31; his family never told him his grandfather died of the disease.
• Dr. Neil Parikh, a gastroenterologist at Hartford Hospital, calls the rising incidence a 'baffling paradox' because the cancer is entirely preventable.
• Colonoscopies and fecal tests like FIT or Cologuard can catch colorectal cancer early enough for easy treatment.
• Black people have higher rates of colorectal cancer and are more likely to die from it.
• Dr. Parikh says stigma and reluctance to discuss bowel function are major barriers to screening among younger adults.

A cancer that can be prevented, yet kills more young people

Colorectal cancer is now the leading cause of cancer death among people under 50 in the United States, a trend that has baffled doctors because the disease is highly preventable. Dr. Neil Parikh, a gastroenterologist at Hartford Hospital in Connecticut, describes the situation as a 'baffling paradox.' Tumors in the colon and rectum typically take years to develop, and routine screening — either by colonoscopy or stool-based tests such as FIT or Cologuard — can detect precancerous polyps early enough to remove them before they become dangerous. 'This is a cancer that if you find a polyp — a little pimple on the inside — and you remove it, you can prevent it,' Parikh says. 'Yet we're seeing this rise.'

The Rivers family: a case study in silence

Rick Rivers, a father of three from Williamstown, New Jersey, was diagnosed with colorectal cancer at age 31. He says no one in his family ever told him that his grandfather had died of the same disease. 'There's a shame factor to talk about certain areas of your body and them not functioning the way that they're supposed to,' Rivers says. Cancer was a taboo topic in his household, unlike diabetes, which the family discussed openly. Rivers is Black, a demographic that faces higher incidence and mortality from colorectal cancer. The silence around his family history, combined with the stigma of discussing bowel function, delayed any conversation about risk or screening until it was too late for him.

Stigma as a public health barrier

Dr. Parikh argues that the biggest obstacle to early detection is not insurance limitations or lack of awareness, but the persistent reluctance to talk about the lower digestive tract. 'We need to talk more about poop,' he says bluntly. He observes a peculiar cultural pattern: young children find flatulence hilarious, adults spend decades suppressing any public mention of bowel function, and then elderly relatives talk freely about constipation and bowel habits. 'I mean, it's just a strange thing we do as humans,' Parikh says. This silence is most acute among the very age group now at rising risk: people in their 30s and 40s. 'The last time another 40-year-old told me they had a good bowel movement … that's a rare conversation,' he notes.

Warning signs that go unspoken

Clinically, younger adults are less likely to report warning signs such as bloody stools or changes in bowel regularity.layed diagnoses at a time when the cancer is more advanced and harder to treat. The disease is entirely preventable if caught early, yet incidence keeps climbing. While genetics, environment, diet, and weight all play a role, Dr. Kyle Fortinsky, a physician lead, says the most common cause of colorectal cancer is people not getting screened. Screening rates remain low among younger adults, in part because they do not perceive themselves as at risk and in part because they avoid the topic altogether.

What comes next: breaking the taboo

Patient advocates and doctors are pushing for more open conversations about colorectal health, especially among younger adults and in communities of color. They urge people to ask about family history and to discuss any changes in bowel habits with a physician. For Rick Rivers, the lesson is clear: silence can be deadly. He hopes that by sharing his story, others will feel empowered to talk about a part of the body that society has taught them to ignore. 'There's a shame factor,' he says, 'but it shouldn't be that way.'

The bottom line

• Colorectal cancer is now the leading cancer killer of people under 50 in the U.S., despite being highly preventable.
• Stigma around discussing bowel function prevents many younger adults from seeking screening or reporting symptoms.
• Black Americans face higher rates of colorectal cancer and are more likely to die from it, yet family history often goes unmentioned.
• Simple screening tests like colonoscopy or FIT can detect precancerous polyps years before they become dangerous.
• Doctors and patient advocates call for normalizing conversations about poop and bowel health to save lives.
• Rising incidence among younger adults suggests that current screening guidelines and public awareness efforts are insufficient.