Young adults diagnosed with colorectal cancer often experience delays in treatment and unequal access to care, according to research led by Meng-Han Tsai, PhD, an assistant professor at the Georgia Prevention Institute at Augusta University. The findings were announced on Apr. 10 and highlight how factors such as race, sex, geography, and socioeconomic status can affect patient outcomes.
The rise in early-onset colorectal cancer has made it important to understand why some patients are more likely than others to receive timely care or survive the disease. Tsai said that social and structural factors play a major role in determining who is diagnosed early, who receives prompt treatment, and who survives. “Early-onset colorectal cancer is no longer rare,” Tsai said. “What we’re seeing is that social and structural factors play a major role in determining who is diagnosed early, who receives timely treatment and who ultimately survives.”
In national studies of patients under age 50, Tsai’s team found many waited over 90 days after diagnosis before starting treatment—a delay long enough for the disease to progress further. These delays were more common among young men as well as Hispanic, Asian/Pacific Islander, and Black patients. The researchers also found that living in urban areas did not guarantee faster care; insurance coverage issues and system-level barriers could still slow down access even near major medical centers.
Additional research showed survival rates varied significantly by demographic group: young men and Black patients had poorer survival overall regardless of when their treatment began. For Hispanic, American Indian/Alaska Native, and Asian/Pacific Islander patients specifically, delayed care increased their risk of death even further—demonstrating that health disparities compound over time.
Geography was another critical factor affecting outcomes for younger adults with colorectal cancer. In Georgia specifically, those living in rural or persistently poor communities faced higher risks of dying from the disease—especially among people aged 30 to 39 years old.
Tsai’s work also examined when younger adults are diagnosed with colorectal cancer: racial minority groups tended to be diagnosed both earlier (in their twenties) but also at later stages of disease compared to non-Hispanic White peers—and they were more likely to have aggressive tumor subtypes associated with worse prognoses.
Treatment differences emerged as well: young men were less likely than women to undergo surgery; Black and Hispanic urban residents less likely than others to start any form of therapy; American Indian/Alaska Native or Asian/Pacific Islander rural residents less likely than others to receive radiation therapy—all pointing toward persistent inequities throughout the course of illness.
“These are not small differences,” Tsai said. “Receiving the right treatment at the right time can be the difference between survival and poor outcomes.”
Tsai concluded that addressing these gaps will require systemic changes: “As early‑onset colorectal cancer continues to rise, we need systems that recognize symptoms sooner, reduce delays and ensure that care is delivered equitably,” she said. “Improving survival means addressing both the cancer and the conditions surrounding it.”
The research received support from a pilot grant provided by Augusta ROAR SCORE grant program’s Career Enhancement Core.
