Lead: Days before Valentine’s Day this year actor James Van Der Beek, 48, died of colorectal cancer, news that resonated with me because I was diagnosed with stage 3 colon cancer at 37. Both of us missed an early, common symptom—changes in bowel habits—that delayed our diagnoses. That missed sign is now one oncologist and advocates say more young people must watch for. Early detection can be lifesaving, and the window to act is often when symptoms first appear.
Key takeaways
- James Van Der Beek died of colorectal cancer at age 48, announced days before Valentine’s Day this year.
- The author was diagnosed with stage 3 colon cancer at 37 and required emergent care after worsening pain revealed a large tumor.
- Lifetime risk estimates: roughly 1 in 24 men and 1 in 26 women will develop colorectal cancer, according to the Cancer Research Institute.
- Since the mid-1990s, cases in people aged 20–39 have risen about 2% per year, a trend observed worldwide and under active study.
- By 2030, experts expect younger-adult cases to nearly double; projections suggest ~1 in 10 colon cancers and 1 in 4 rectal cancers may occur in people under 50 by the decade’s end.
- The American Cancer Society currently recommends routine screening beginning at age 45, lowered from 50 in 2018; this does not capture many in their 20s and 30s.
- Common early warning signs include persistent changes in bowel habits, pencil-thin stools, rectal bleeding, unexplained fatigue or anemia, and abdominal pain or bloating.
Background
Colorectal cancer — cancers that arise in the colon or rectum — historically affected older adults, but incidence in younger adults has been climbing since the 1990s. Researchers and public-health groups cite diet patterns (processed foods, red meat), sedentary lifestyles, and environmental exposures as possible contributors, though no single cause has been established. The shift prompted the American Cancer Society to lower the recommended screening age from 50 to 45 in 2018, a change intended to catch more early cases in middle-aged adults.
Screening options include stool-based tests and colonoscopy, the latter considered the gold standard because it allows direct visualization and removal of suspicious polyps. However, routine population screening still excludes most people under 45, and younger adults are less likely to be considered at risk by clinicians, which can delay diagnosis. For people with symptoms, clinicians must balance the low overall incidence in younger patients against the risk of missing an early, treatable cancer.
Main event
In my case, the first warning was a change in bowel movements. I assumed it was diet — a temporary intolerance to dairy or too many late-night pizzas — and tried adjusting what I ate. The diarrhea persisted; eventually I developed severe abdominal pain that landed me in the emergency room, where imaging revealed a large tumor and led to a stage 3 diagnosis despite no family history of colorectal cancer.
Van Der Beek described a similar initial reaction: he noticed altered bowel habits and blamed his diet and coffee intake, trying simple fixes before seeking care. He later told reporters he changed his diet and removed cream and coffee, and when symptoms did not improve he sought medical evaluation. That pattern—attributing symptoms to benign causes until they worsen—appears in many young patients’ stories.
Both cases underscore how easy it is to normalize bowel changes. Busy lives, parenting, work and denial play roles; people skip routine check-ins with clinicians or assume symptoms are temporary. In some instances clinicians may also initially pursue more common explanations (infection, medication effects, hemorrhoids) rather than ordering cancer-focused tests, which contributes to diagnostic delay.
Analysis & implications
The rise in younger-onset colorectal cancer has several implications. Public-health messaging must encourage symptom vigilance in all ages while avoiding alarmism: most young people with bowel changes do not have cancer, but persistent or progressive symptoms warrant evaluation. Clinicians should consider colorectal cancer in differential diagnoses when symptoms persist for weeks, especially when accompanied by weight loss, anemia, or bleeding.
Screening policy debates will likely continue. Lowering the screening age to 45 helped capture additional cases in middle-aged adults, but it does not address increases in people in their 20s and 30s. Universal earlier screening is costly and logistically challenging; targeted strategies — such as symptom-triggered testing, improved primary-care pathways, and greater use of noninvasive stool tests — may be more feasible short-term measures.
Research priorities include identifying environmental, microbial, dietary and genetic contributors to the rising trend. If modifiable exposures are confirmed, public-health interventions (dietary guidance, regulation of processed foods, obesity reduction strategies) could reduce incidence. Equally important is access to timely diagnostic evaluation: disparities in care and insurance coverage can magnify delays, worsening outcomes for marginalized populations.
Comparison & data
| Metric | Value / Trend |
|---|---|
| Annual increase (ages 20–39) | ~2% per year since mid-1990s |
| Lifetime risk (men) | ~1 in 24 |
| Lifetime risk (women) | ~1 in 26 |
| Projected younger-adult share by 2030 | ~1 in 10 colon cancers; ~1 in 4 rectal cancers under 50 |
| Screening age (ACS) | Begin at 45 (current guideline) |
These figures come from public-health and clinical sources tracking incidence and screening guidance. They show that while the majority of colorectal cancers still occur in older adults, the proportional rise among younger patients is large enough to change clinical practice and public messaging. The table simplifies complex trends; regional and demographic variation exists and is a focus of ongoing surveillance.
Reactions & quotes
Experts emphasize vigilance and screening. The clinician quoted below summarized the uncertainty around causes and the need for awareness:
“By 2030, cases in younger adults are expected to nearly double.”
Avni Desai, MD — Memorial Sloan Kettering Cancer Center (clinical expert)
Family and fans responded to the news of Van Der Beek’s death with grief and calls for awareness; his initial public account of symptoms is now being referenced in awareness campaigns:
“It was just a change in bowel habits… I probably need to change my diet a little bit.”
James Van Der Beek — quoted to People (entertainment news)
Clinicians stress that these short statements are important because they reflect a common sequence: symptom notice, benign attribution, delayed medical review. That delay can shift a cancer from an early curable stage to a more advanced stage requiring intensive treatment.
Unconfirmed
- The precise causes behind the increase in colorectal cancer among younger adults remain under investigation; links to diet, microbiome changes, and environmental exposures are hypotheses rather than proven causes.
- Attributing individual cases—including whether coffee, dairy or a single dietary change contributed directly to either patient’s cancer—is not supported by current evidence.
- The full timeline and medical details of Van Der Beek’s diagnosis and treatment beyond public statements have not been released publicly and remain private to his family and clinicians.
Bottom line
The shared lesson is clear: persistent changes in bowel habits are a valid reason to seek medical evaluation at any age. While most such changes are not cancer, the cost of dismissing progressive symptoms can be high. Early detection dramatically improves outcomes for colorectal cancer, and both public education and clinician suspicion must adapt to rising younger-onset cases.
If you notice ongoing diarrhea, constipation, pencil-thin stools, rectal bleeding, unexplained fatigue, or abdominal pain that lasts more than a few weeks despite simple diet changes, make an appointment and ask about stool testing or referral for colonoscopy. For policymakers and clinicians, the priority is better symptom-driven pathways, broader access to testing, and continued research to identify modifiable risks behind the trend.