An Oxford-based specialist is calling for greater awareness of bowel cancer risks among younger adults, as new data highlights a rise in early-onset cases.
Marking Bowel Cancer Awareness Month, Professor James East, Consultant Gastroenterologist and Medical Director at Welbeck Oxford, has urged increased vigilance, particularly for those under 50 and in higher-risk groups.
In England, screening through the NHS currently begins at age 50 using the faecal immunochemical test (FIT). However, growing evidence suggests this threshold may miss at-risk individuals, particularly as diagnoses in younger adults continue to rise.
In the United States, screening now begins earlier, with recommendations starting at 45, and in some high-risk cases as early as 40. According to research from the American Medical Association, bowel cancer has become the leading cause of cancer-related death among adults under 50.
Recent data indicates a sustained increase in early-onset colorectal cancer over the past two decades, with both diagnosis and mortality rates rising in younger populations, even as other major cancers decline in the same age group.
Professor East said: “In the US, screening is already recommended from 45. This reflects a clear shift in disease patterns, with colorectal cancer now the leading cause of cancer death in under 50s.”
Experts believe a combination of lifestyle, environmental factors and delayed diagnosis may be contributing to the trend. Younger patients are less likely to be routinely screened, and symptoms can often be mistaken for less serious conditions.
“Younger patients are not routinely screened and symptoms are often attributed to benign conditions, leading to later diagnosis,” Professor East warned.
Bowel cancer typically develops over 10 to 15 years from precancerous polyps, offering a significant window for prevention. Early detection is key, with survival rates exceeding 90 per cent at stage one but dropping below 20 per cent at stage four.
Symptoms may include changes in bowel habits, bleeding, weight loss, fatigue and abdominal pain, although early stages may present no symptoms at all.
Professor East added that risk factors include family history, inflammatory bowel disease, smoking and lifestyle influences. While diet and exercise may reduce risk, they do not eliminate it.
Looking ahead, Welbeck Oxford’s new clinic, set to open in 2026, will offer advanced endoscopy services, including AI-assisted detection and high-definition imaging.
Professor East concluded: “One in 20 people will develop bowel cancer. Screening saves lives, but only if people take part. If you are eligible, do not delay. If you are younger but at higher risk, seek advice and consider earlier assessment.”
