The study, "Clinical Presentation and Epidemiology of Pediatric and Adolescent Colorectal Carcinoma: A Pediatric Surgical Oncology Research Collaborative Study," reviewed the medical records of 84 patients age 21 or younger who were diagnosed with colorectal cancer between 2012 and 2023.

Only 20% of the patients had a first- or second-degree family history of colorectal cancer. Despite that, most had aggressive disease that had already progressed to Stage III or IV by the time it was diagnosed.

Symptoms Can Be Easy to Overlook

The researchers say the findings add to growing concern about colorectal cancer appearing more often in young people and frequently being detected at an advanced stage.

Possible warning signs include lower back pain, abdominal pain, changes in bowel habits, weight loss, and rectal bleeding. Because colorectal cancer remains uncommon in younger patients, these symptoms may not immediately raise suspicion and can sometimes be overlooked.

"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 study author and pediatric surgery research fellow Erica Arnold, MD. "When diagnosed, it is often aggressive, presenting with late-stage disease and associated with high rates of disease relapse and mortality."

Delayed Diagnosis Can Have Serious Consequences

Researchers found that delays in diagnosis, combined with aggressive tumor behavior, can contribute to poor long-term outcomes.

More than one-third of the patients in the study later developed recurrent disease. Nearly half died as a result of their diagnosis.

The authors say symptoms such as unexplained weight loss and rectal bleeding should be taken seriously when they occur in younger patients. As cancers typically associated with adults continue to appear at younger ages, they also stress the importance of coordinating care between pediatric and adult medical teams and developing treatment plans tailored to these patients.