Stephen Estrada should be an outlier.

At 31 years old, he’s a stage four colon cancer survivor. He’s had surgery and chemotherapy, and he participated in a clinical trial that eradicated his tumors. Presently, he’s NDE—survivor language for “no evidence of disease.” Happily, he has found a love for himself and a life that did not exist before cancer.

Many people know doctors recommend colonoscopies—the medical procedure that searches for cancerous tumors inside the rectum and colon using a small camera—for people starting at 50 years old. But Estrada was just 28, on the beach in Jamaica, when an unbearable pain in his gut shattered his vacation and upended his life.

The increase in young-onset colorectal cancer

 "I never imagined I would be diagnosed with stage four colorectal cancer in my twenties,” Estrada said. “The doctors I saw all told me colorectal cancer was for older men, even after I told them about my family history."

Estrada should be an outlier, but he’s not. For reasons unknown, incidences of colorectal cancer among people ages 20 to 49 have increased 51 percent since 1994, according to data from the National Cancer Institute.

The trend, which researchers predict could continue, is consistent across other studies, too. That’s why national nonprofit Colorectal Cancer Alliance has been advocating for research and educational advances related to young-onset colorectal cancer since 2012.

The rise in misdiagnosing

“The doctors I saw all told me colorectal cancer was for older men, even after I told them about my family history."

A forthcoming report from the Alliance, which tallied responses from nearly 1,000 young-onset colorectal cancer survivors, shows startling statistics. While 82 percent of respondents were initially misdiagnosed, 20 percent waited more than 12 months after symptoms started to see a doctor. 57 percent of respondents were diagnosed with stage three or stage four cancer, and 44 percent felt their diagnosis was delayed because of their age.

"The emergency room I visited twice misdiagnosed me as constipated,” Estrada said. “They kept asking me how often I took opioids, which I hadn't. It became clear they didn't believe I was in pain. They thought I was looking for drugs."

Today, Estrada works with national nonprofit Colorectal Cancer Alliance as a certified patient and family support navigator, helping people through the tumult of a diagnosis and recovery based on his own experiences and training.