Rising bowel cancer rates in younger patients and the risks of delayed diagnosis
Trainee Kerrina Gray and senior associate Amy Anderson highlight the growing concern over rising bowel cancer rates in younger patients and the potentially serious consequences of delayed diagnosis.
While bowel cancer continues to be diagnosed more frequently in older adults, there is increasing concern about a sustained rise in cases among younger people. In the UK, bowel cancer rates in those under 50 have risen steadily over recent decades, with the sharpest increase seen in the youngest age groups. In the UK, rates among under-24s have increased by approximately 75% since the early 1990s, and the reasons for this trend are not yet fully understood.
This shift is particularly troubling because bowel cancer is often perceived as a disease affecting those in older age. As a result, symptoms in younger patients may be more easily attributed to other conditions, such as irritable bowel syndrome (IBS), haemorrhoids or dietary issues. Where this results in a failure to appropriately investigate symptoms, there is a risk of delayed diagnosis and avoidable harm.
Current screening and referral pathways
Routine bowel cancer screening in England is offered every two years to people aged 50 to 74, using the Faecal Immunochemical Test (FIT). Patients aged 75 and over may continue to access screening upon request. NICE guidelines also recommend the use of FIT for adults who present with certain bowel symptoms, regardless of age, to help guide referral decisions.
Where FIT results or symptoms raise concerns, patients should be referred urgently under the ‘two-week wait’ pathway. This fast-track system is intended to ensure that people with suspected cancer receive specialist assessment within 14 days, allowing prompt diagnosis and treatment where cancer is identified.
In practice, however, bowel cancer symptoms can be non-specific and overlap with much more common conditions. This creates a risk that younger patients, who fall outside routine screening programmes, may not be referred promptly or at all if presenting with symptoms raising suspicion of cancer.
Delays in diagnosis and emergency presentations
The importance of referral and timely investigation is reinforced by findings from the National Bowel Cancer Audit, published in October 2025. The Report revealed that 19% of bowel cancer diagnoses were made in an emergency setting. Cancers diagnosed in this way are often at a more advanced stage, with fewer treatment options and poorer outcomes.
The Audit also highlighted that 8% of new bowel cancer cases occur in people under the age of 50. This gives rise to concern considering that patients under 50 years of age are not routinely invited for screening.
These findings echo wider concerns about delays in diagnosing younger cancer patients more generally. A 2024 report from the Nuffield Trust and the Health Foundation found that half of all 16-24-year-olds with cancer had three or more interactions with their GP practice before receiving a diagnosis, with one in five of those patients requiring five or more contacts with their doctor before being diagnosed.
Learning from missed opportunities
Initiatives such as Jess’s Rule aim to address these kinds of delays. Now being advertised on posters in GP practices across England, Jess’s Rule encourages clinicians to ‘reflect, review and rethink’ if a patient has attended three times with the same or worsening symptoms without a clear diagnosis. Whilst not a change in the law, it formalises good practice and reinforces the need to keep an open mind, regardless of a patient’s age.
In the context of rising bowel cancer rates in younger people, these lessons are particularly important. Where symptoms persist, worsen or cannot be otherwise explained, further investigation or referral may be crucial. Delays in diagnosis can have serious consequences, and improving access to timely investigation may be key to reversing the trend of late-stage diagnoses and improving outcomes for patients of all ages.
Not every delayed diagnosis will amount to clinical negligence. Each case must be assessed on its individual facts. However, if you are concerned, one of our specialist clinical negligence solicitors can advise on whether a delayed or missed diagnosis of bowel cancer may give rise to a claim for compensation.
About Amy and Kerrina
Amy Anderson is a senior associate in the personal injury and medical negligence team. She regularly handles claims against hospital trusts, GPs, private clinicians and other healthcare providers and has a special interest in birth injury and maternal damage claims.
Kerrina Gray is currently a third-seat trainee in the personal injury and medical negligence team.
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