Colorectal Cancer Is Affecting Younger People and More Women:

What Is the Most Effective Prevention Strategy Starting at Age 45?

2026-02-12 ｜ Written by Chun-Chen Chen ｜ Edited by Kuei-Fen Deng ｜ Source: Web Only

In recent years, governments around the world have observed a rapid increase in colorectal cancer cases among people under the age of 50, elevating the issue into a global public health concern. Taiwan is no exception. As incidence rates continue to rise, no one can be certain they will not become the next victim of a disease that is often discovered too late.

Traditionally, most countries—including Taiwan in the past—recommended beginning colorectal cancer screening at age 50. With the expansion of Taiwan’s national screening program, colorectal cancer incidence among middle-aged and older adults aged 55–74 has declined. However, changing environmental exposures and dietary habits continue to influence the future trend of colorectal cancer development.

A research team from the Health Management Center of National Taiwan University Hospital analyzed 27,805 individuals undergoing their first colonoscopy examination at NTUH. The study tracked the risk of advanced neoplasms across different age groups and was published in the authoritative journal Clinical Gastroenterology and Hepatology in 2025.

“Advanced neoplasm” refers to larger tumors (greater than 1 cm in diameter), including high-risk adenomas with pathological changes as well as confirmed malignant cancer lesions.

Alarmingly, the report revealed that the incidence of advanced neoplasms among Taiwanese individuals aged 50–54 continues to rise. Researchers suggest that this trend may be linked to the increasing prevalence of precancerous lesions in people aged 40–49. In other words, younger populations are facing growing colorectal cancer risks.

The significantly increasing prevalence of advanced neoplasms in the 45–49 age group suggests that colorectal cancer screening should no longer wait until age 50. Age 45 has become a new milestone for colorectal cancer prevention. Accordingly, Taiwan lowered the starting age for government-funded screening in 2025, allowing adults aged 45 and above to receive a free fecal immunochemical test (FIT) every two years.

According to long-term health examination data provided by the NTUH Health Management Center, another concerning trend has emerged.

Historically, men were believed to have a higher risk of colorectal cancer than women. However, detection trends over the past decade suggest that women may no longer benefit from the previously assumed “physiological gender protection,” serving as an important warning signal.

Researchers also found that individuals born more recently appear to have a higher risk of developing colorectal cancer. For example, people born between 1969 and 1974 have a 2.74-fold higher risk of advanced neoplasms compared to those born between 1954 and 1958. This may be associated with earlier exposure to Westernized diets, increased refined sugar intake, and worsening environmental pollution.

Although colorectal cancer is often called a “silent disease,” warning signs may still appear. People experiencing the following symptoms should seek medical attention promptly:

In addition to genetics, lifestyle factors play a major role in colorectal cancer risk.
Research suggests the following conditions may increase risk:

• Age – While younger-onset cases are increasing, risk still rises significantly after age 50.
• Obesity – Visceral fat accumulation may trigger chronic inflammation and increase the likelihood of polyp malignancy.
• Dietary Habits – High-fat, low-fiber diets and frequent consumption of grilled, fried, or processed meats such as sausages and bacon.
• Smoking and Excessive Alcohol Consumption – Long-term tobacco and alcohol exposure are established cancer risk factors.
• Family History – Having parents, siblings, or children with colorectal cancer significantly increases risk.
• Lack of Exercise – Sedentary lifestyles are associated with higher colorectal cancer risk.

Fecal Immunochemical Test (FIT)

FIT is a convenient, noninvasive screening method that does not require dietary restrictions. Because colon polyps may bleed microscopically, FIT can detect small amounts of hidden blood in stool samples.

Adults aged 45–74 are eligible for a free FIT every two years in Taiwan. Individuals aged 40–44 with a family history of colorectal cancer may also qualify for government-funded screening.
If a FIT result is positive, a follow-up colonoscopy is strongly recommended.

Colonoscopy

Colonoscopy remains the gold standard for detecting advanced neoplasms because it allows direct visualization of the intestinal lining. If polyps or tumors are discovered, physicians can perform biopsies or remove lesions during the same procedure.

People over age 45 are encouraged to undergo at least one colonoscopy. Individuals at higher risk may consider discussing earlier screening with their physician.

Improve Dietary Habits

Consume sufficient vegetables, fruits, and whole grains daily. Dietary fiber helps maintain a healthy gut microbiome, promotes bowel movements, and reduces the time carcinogens remain in the intestines.

Reduce intake of processed meats such as sausages, bacon, and ham, as well as fried foods, sugary drinks, and high-calorie snacks.
A simple principle for colon health:
Less red meat, less processed food, less high-calorie intake, and more fiber.

Exercise Regularly

Moderate exercise for at least 30 minutes, 3–5 times per week, can improve intestinal motility and metabolic health.

Quit Smoking and Limit Alcohol

Smoking and excessive alcohol consumption are major risk factors for multiple cancers.

Maintain Healthy Weight and Waist Circumference

Visceral fat, chronic inflammation, and insulin resistance are closely associated with colorectal tumor development.

Schedule Regular Screening

There is no need to panic about colorectal cancer, but relying on luck is not a strategy. Precancerous lesions often remain silent for years before progressing. Detecting and removing them early through screening remains the most effective prevention approach.

Especially given the rising trend among younger adults, eligible individuals should undergo regular FIT screening. Those with family history or warning symptoms should discuss colonoscopy evaluation with their physician.

Expert Consultant:
Dr. Wei-Yuan Chang, Department of Internal Medicine and Health Management Center, National Taiwan University Hospital
Specialties: Digestive medicine, gastrointestinal endoscopy, advanced endoscopic diagnosis and treatment of colorectal tumors.

This article was adapted from Common Health Magazine, published on February 12, 2026.