- Colorectal cancer in people under age 50 is on the rise and is now the leading cause of cancer-related death among young people.
- Experts say it is still unclear why infections are increasing among people under 50.
- Gabby Zappia shares her journey through diagnosis and treatment after her initial symptoms were misdiagnosed as pregnancy-related.
In 2024, Gabby Zappia was 36 years old and pregnant with her third child when she noticed blood in her stool.
“When I mentioned this to my OB, she said it was most likely related to the pregnancy.” hemorrhoids. The explanation made sense and I wanted it to make sense, so I trusted it,” she told Healthline.
After her son was born, her symptoms continued and she continued to seek answers.
“a colonoscopy My life changed overnight. Instead of finding hemorrhoids, they found a large mass in my colon,” Zappia said.
In December 2024, Zappia was diagnosed with stage IV colon cancer that had spread to his liver.
“I was a full-time mom, managing every aspect of my child’s schedule, and I also had a small part-time job,” she said. “After receiving my diagnosis, I had to stop working to focus on my medical appointments and recovery. My husband took over most of the day-to-day tasks that I was handling, so I had to take a major step back from my role as a mother.”
Zappia immediately underwent a colectomy and began chemotherapy after recovering. immunotherapy at City of Hope in January 2025.
In April 2025, she stopped chemotherapy and underwent liver resection surgery and HAI pump implantation. After recovering, he resumed chemotherapy.
“After 15 rounds of chemotherapy, I was told there was no evidence of disease and rang the survivor bell in September 2025. A few months later, a ctDNA test showed cancer and a PET scan confirmed liver activity,” Zappia said.
She underwent another liver surgery in January 2026. Her ctDNA is still detectable, so we are currently considering clinical trials.
“Colon cancer is no longer just a disease of the elderly and is on the rise. You know your body better than anyone. If you notice something unusual, ask questions and request additional tests. Seek answers. Request a colonoscopy,” Dr. Zappia said.
She emphasized seeking a second opinion if you’re not being listened to.
“We need to be more aware. We need to listen to young patients. I’m just one of the many young people affected by colon cancer. If sharing my story can help one person catch cancer earlier, then it’s worth sharing this journey,” Zappia said.
Colorectal cancer, once considered a disease of the elderly, is now a disease of the elderly. Main cause Proportion of cancer-related deaths among adults under 50 years.
According to information from January 2026 JAMA researchColorectal cancer is the leading cause of cancer-related death among U.S. adults under age 50, surpassing breast and lung cancer.
Doctors at City of Hope, where Zappia was treated, said they are now treating dozens of patients in their 20s, 30s and 40s each week, mirroring what is happening across the country.
pashtun kashi, M.D., medical director of gastrointestinal oncology at Orange County’s Hope City, who treated Gabby, said three out of four people under the age of 50 are diagnosed with advanced disease.
“There are no screening guidelines for people under 45. It is important to reiterate that the screening age has moved from 50 to 45. [but] “We often see patients in their 20s, 30s, and 40s, and they often have advanced or metastatic disease because there is no screening test at the time of diagnosis,” Kasi said.
Although genetics may be a factor in a small proportion of early-onset colorectal cancers, Dr. Kasi said: rise Colorectal cancer in young people often occurs in people who have no risk factors.
Researchers are looking at possible factors such as antibiotic use, microbiome, and diet.
Kasi said paying attention to your body and your symptoms is your strongest defense right now.
“Of course, many of our individuals youngSo we’ve seen this cancer diagnosed during or after pregnancy, often classified as nothing to worry about, like hemorrhoids, but in hindsight, perhaps we should have been on the lookout for it sooner,” he said.
Symptoms such as rectal bleeding researcher This is a strong indicator of early-onset colorectal cancer in adults under 50 years of age. Changes in bowel habitsunexplained pain, and unintentional weight loss should be taken seriously.
“[The] In fact, at least for now, there are no guideline-approved screening tests for these young people, but these symptoms warrant more attention,” Kasi said.
City of Hope doctors say researchers are working on ways to improve treatment, focusing on improving responses to immunotherapy and conducting clinical trials for rectal cancer that combine targeted therapies, chemotherapy, immunotherapy and radiosensitizers.
Exploration of cell and CAR-T therapies for highly refractory cases is also ongoing.
Ajay Goel He is a professor and chair of the Department of Molecular Diagnostics and Experimental Therapeutics at City of Hope, where he works on blood-based tests to detect colorectal cancer in young patients.
“For the past 10 years or so, [we] They have now developed a blood-based test that can find evidence of early-onset colon cancer with fairly high accuracy. That means there is a test out there somewhere that is 90% accurate for finding people with early-onset colon cancer. So it was very exciting,” he said.
Although the test has not yet been published, Goel said it is promising. He envisions the test starting with patients as young as 18 as part of their annual exams performed by their primary care physician.
“We continue this work and hope that once we can validate it in a larger patient population, we can one day bring this test into the clinic,” he said.