Written by Dr. Vinay Mamidala, MBBS, MS (General Surgery), M.Ch (Surgical Oncology), FMAS — Surgical Oncologist, CION Cancer Clinics. Last medically reviewed: June 2026.

Colon cancer is no longer just an “older person’s” disease

For decades, colon cancer was thought of as something that mostly affected people over 60. That picture is changing — and India is part of the shift. Colorectal cancer (cancer of the colon or rectum) is now the fourth most common cancer in India, with an estimated 64,863 new cases and 38,367 deaths in 2022, and several Indian regions are seeing rates rise even as many Western countries see them fall.^[1] The most worrying trend is the steady increase among younger adults: Indian data show the sharpest rise in the 20–29 age group, with cases appearing more often in the lower (distal) colon and rectum.^[2] Urban areas report higher rates than rural ones, and the South is among the higher-incidence regions.^[1]

If you want a plain-language overview of the disease itself, see our guide to colon cancer types, symptoms and stages. This article focuses on why it is rising in younger people and the early signs that are too often brushed aside.

Why are cases rising in people under 50?

Unlike in older patients, most colon cancers in younger adults are not caused by an inherited syndrome — they appear to be driven largely by diet and lifestyle.^[2][3] The likely contributors are familiar:

• A shift away from traditional high-fibre, millet- and vegetable-based diets towards refined carbohydrates, processed foods, and more red and processed meat
• Rising rates of obesity and type 2 diabetes
• Falling physical activity and more sedentary work
• Regular alcohol intake and smoking
• Emerging research into changes in the gut microbiome

A small but important group of young patients do have an inherited risk — most commonly Lynch syndrome or familial adenomatous polyposis (FAP) — which is why a strong family history always deserves specialist attention.^[3]

The warning signs young adults tend to dismiss

Early colon cancer often produces vague symptoms that overlap with far more common, harmless problems such as piles (haemorrhoids) or irritable bowel syndrome. That overlap is exactly why young patients — and sometimes their first doctors — explain symptoms away for months.^[2] Watch for any of these, especially if they last longer than three weeks:

• A persistent change in bowel habit — new constipation, diarrhoea, or alternating between the two
• Blood in the stool, or dark, tarry stools
• Unexplained iron-deficiency anaemia, or persistent tiredness
• Ongoing abdominal pain, cramping, or bloating
• A feeling of incomplete emptying after passing stools
• Stools that become thinner or pencil-like
• Unexplained weight loss or loss of appetite

If any of these persist beyond three weeks, see a doctor — and don’t assume you are “too young” for it to matter. Right-sided colon cancers tend to cause anaemia and fatigue, while left-sided ones more often cause bleeding and changes in bowel habit.

Why young patients are often diagnosed late

Two things work against younger patients. First, their symptoms are frequently dismissed as minor. Second, routine age-based screening programmes are aimed at older adults, so under-45s usually aren’t screened unless they have symptoms or a family history.^[2] The result is that young colon cancers are more often found at a later stage — and stage is the single biggest factor in outcome. Caught early, colon cancer is among the most treatable cancers, with stage I five-year survival above 90%; found late, it is much harder to treat.^[4]

What you can do: screening and prevention

Colon cancer is one of the few cancers that can often be prevented, because nearly all cases begin as a small growth called a polyp that takes years to turn cancerous. Removing that polyp removes the risk.^[4]

• Know your screening age. Average-risk adults are now advised to begin screening at age 45.^[4] If you have a family history of colorectal cancer or polyps, screening usually starts earlier — ask a specialist.
• Understand the tests. A stool-based test (such as a faecal immunochemical test, or FIT) is simple and non-invasive, while a colonoscopy is the most thorough option because it can find and remove polyps in the same sitting.^[1]
• Reduce your risk. Eat more fibre, vegetables, whole grains and legumes; limit red and processed meat, fried and sugary foods, and alcohol; stay physically active; keep a healthy weight; and don’t smoke. The same habits also help prevent other digestive cancers — see how gastrointestinal cancers can be prevented.

When to see a specialist

If you have persistent symptoms, a strong family history, or you’re due for screening, speak to a colorectal specialist rather than waiting. At CION Cancer Clinics, every patient is reviewed by a multidisciplinary tumour board of surgical, medical and radiation oncologists, and the colon cancer treatment team in Hyderabad can guide you from diagnosis through recovery. A first consultation and a written second opinion are free. Call 1800 202 8726 to talk to a specialist at your nearest centre across Telangana and Andhra Pradesh.

Key takeaways

• Colorectal cancer is the 4th most common cancer in India and is rising in adults under 50.
• Most young-onset cases are linked to diet and lifestyle, not inherited genes.
• Persistent changes in bowel habit, bleeding, or unexplained anaemia lasting over 3 weeks need checking — at any age.
• Young patients are often diagnosed late because symptoms are dismissed and they fall outside age-based screening.
• Screening from age 45 (earlier with family history) and a healthy lifestyle can prevent most cases.

Frequently asked questions

Can someone in their 20s or 30s really get colon cancer?
Yes. While it’s still less common than in older adults, rates in younger Indians are rising, and the steepest increase has been in the 20–29 age group.^[2] Persistent symptoms should never be ignored because of age.

Is blood in the stool always cancer?
No — most rectal bleeding is from piles or fissures. But blood in the stool should never be assumed to be “just piles” without a proper check, especially if it lasts or comes with other symptoms.

At what age should I start screening?
Average-risk adults are advised to start at 45. If a close relative has had colorectal cancer or polyps, you usually need to start earlier — a specialist can advise based on your family history.^[4]

Does colon cancer run in families?
It can. Most cases are not inherited, but conditions such as Lynch syndrome and FAP raise the risk and call for earlier, more frequent screening and genetic counselling.^[3]

References

1. Singh A, et al. Epidemiology of colorectal cancer: a review with special emphasis on India. Indian Journal of Gastroenterology. 2025 (incidence/mortality from GLOBOCAN 2022, IARC).
2. Clinicopathologic Profile and Treatment Outcomes of Colorectal Cancer in Young Adults: A Multicenter Study From India. JCO Global Oncology. 2023.
3. Rising colorectal cancer in young adults: a warning for India. Indian Journal of Cancer. 2022.
4. American Cancer Society. Colorectal Cancer Facts & Figures (screening from age 45; survival by stage).

This article is for general information and awareness only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified oncologist about any questions regarding a medical condition. Treatment outcomes vary from person to person. Any costs mentioned are indicative and subject to change.