No. 1 cancer killer for people under 50 has gotten worse since 1990 — here’s your ‘best tool’ for beating it
Cancer deaths are falling among young Americans — except for one terrifying outlier.
Over the past 30 years, it has surged to become the top cancer killer of people under 50, overtaking breast, lung and brain cancers, as well as leukemia, a new analysis found.
“It is clear that this can no longer be called an old person’s disease,” Dr. Ahmedin Jemal, a senior author of the study and a top official at the American Cancer Society, said in a statement.
In the study, researchers analyzed more than 1.2 million deaths and found that overall cancer mortality in Americans under 50 dropped 44% between 1990 and 2023.
The decline was driven by sharp drops in four of the five leading cancer killers, which fell by as much as 6% annually.
Only one increased: colorectal cancer, which rose 1.1% each year over the past three decades, climbing from the fifth most common cancer death to first place.
“The steady rise in colorectal deaths under 50 is even more alarming compared to the dramatic declines for lung and breast, even as breast cancer incidence is climbing,” said Rebecca Siegel, senior scientific director of surveillance research at the American Cancer Society and lead author of the report.
The findings come as overall colorectal cancer rates in young Americans continue to climb, even as cases in older adults — the group historically most affected — have been falling for years.
“While we await answers for why colorectal cancer rates are up, lives can be saved now through symptom awareness and destigmatization and more screening uptake, as 3 in 4 people under 50 are diagnosed with advanced disease,” Siegel said.
Colonoscopies are considered the gold standard screening method for colorectal cancer, letting doctors detect disease and remove precancerous growths in one procedure.
While average-risk Americans were traditionally advised to start screening at 50, the American Cancer Society lowered its recommended starting age to 45 in 2018 amid the surge in cases among young people. Other major health bodies followed suit in subsequent years.
Now, doctors are urging young people to talk with relatives about their colonoscopy results.
“There are no risk factors that have been definitively concluded for early onset of colorectal cancer,” said Dr. Christine Molmenti, cancer epidemiologist and co-director of the Northwell Health Early-Onset Cancer Program, who was not involved in the study.
While research has suggested potential links between the disease and lifestyle factors such as ultra-processed food, obesity, smoking, alcohol and sugary drinks, many young colorectal cancer patients don’t fit that profile, she explained.
“They say they’re healthy. They say they eat well, and that they are generally fit and active,” Molmenti said. “Without a real firm risk factor, the best tool we have and the best strategy for early onset colorectal cancer prevention is family history.”
Scientists estimate that 16% of early-onset colorectal cancer cases are due to a genetic or inherited condition that increases a person’s risk.
“That’s 16% of the pie,” Molmenti said. “Then, 14% are due to the family history of colorectal cancer by a first-degree relative in their family.”
The remaining 70% is considered sporadic, but Molmenti noted that recent investigations have found an 18% rate of advanced polyps in first-degree relatives of early-onset cancer patients.
“That means if someone knows what their family’s colonoscopy results are — not for cancer, but for polyps — it could be lifesaving,” Molmenti said. “They could be diagnosed earlier or the cancer could be detected earlier because the guidelines for screening for colorectal cancer or advanced polyps is the same.”
People with a close family history of colon cancer or other risk factors, such as advanced polyps, are often advised to start screening by age 35 — or 10 years earlier than the youngest affected relative was diagnosed.
“There are almost more than 19,000,000 colonoscopies [performed annually] in the US today, and 2 to 10% of those [find] advanced polyps,” Molmenti said. “So those patients diagnosed with advanced polyps, especially if you’re 45, should be telling your brothers and sisters if you have them to get screened at 35.”
In 2026 alone, the American Cancer Society projects 108,860 new colon cancer cases and 49,990 new rectal cancer cases will be diagnosed in the US.
An estimated 55,230 Americans will die from the two diseases combined.
Iran’s ‘Friendly Nations’ List Gives Way to Shifting Access in Strait of Hormuz
Iran’s first move through the Strait of Hormuz looked hard, deliberate, and politically selective. After the late February strikes, Tehran signaled that some countries could still move through the waterway. Reuters reported on March 27 that Foreign Minister Abbas Araqchi named friendly nations, including China, Russia, India, Iraq, and Pakistan. That message suggested Iran was dividing passage by politics, pressure, and wartime interest. At that stage, the Strait of Hormuz looked less like an open trade route and more like a channel Iran would manage on its own terms.
Yet the policy did not remain that narrow for long. Within days, Iraq received an exemption, vessels carrying essential goods won access, and Malaysia-linked ships were cleared. Reuters also reported recent crossings by ships linked to Oman, France, and Japan, provided they had no U.S. or Israeli ties. Shipowners, insurers, and governments are now reading every Iranian signal for signs of a wider reopening or a harder squeeze. A handful of tankers have passed, but the route is still dangerous and commercially strained. What began as a short list has become a shifting system of exemptions, conditions, and calculated leverage across the Strait of Hormuz. This article traces the latest updates to that initial list, examines how Iran’s position has changed, and looks at where passage through the Strait of Hormuz stands now.
How the original list took shape
Iran’s early passage policy appeared to favor a small group of politically aligned countries, yet severe security risks quickly showed that access was never truly guaranteed. Image Credit: Pexels
The early version of the story had a clear internal logic. That is why the headline spread so fast. Iran had answered the late February strikes by restricting movement through the Strait of Hormuz. It then signalled that some countries could still pass. Reuters reported on March 27 that Foreign Minister Abbas Araqchi named friendly nations permitted through. The countries included China, Russia, India, Iraq, and Pakistan. That statement gave editors a usable frame. It suggested Iran was dividing shipping by politics. The idea also matched Tehran’s wider message. Iran had already told the International Maritime Organization that certain states lacked innocent passage rights. It named the United States, Israel and other participants in the attacks. Shipping, therefore, looked split into hostile and acceptable groups.
Reuters also reported that China was pressing Iran over crude and Qatari LNG cargoes. Ship-tracking data showed one vessel moving after marking itself “China-owner.” That detail strengthened the first impression. Tehran seemed to reward states it viewed as useful. It also seemed ready to punish states tied to the war effort. For a breaking headline, that looked tidy and convincing. Yet even the first reports showed strain below the surface. Reuters said two Chinese container ships halted their attempt to leave the Gulf despite Iran’s assurances. A named country, then, did not receive a guaranteed corridor. It received a chance. That distinction matters. The first list was real as a political signal. It was never stable enough to explain the whole situation. The operational backdrop made that weakness harder to ignore.
UKMTO’s Joint Maritime Information Center said on March 6 that no formal legal closure had been declared. It also said, “the operational environment continues to reflect active kinetic hazard conditions.” The advisory warned mariners to “continue to exercise extreme caution.” It said attacks against commercial shipping still posed a high risk. Traffic data in that note showed how badly the route had tightened. Historically, daily transit averaged about 138 vessels. Recent reviews found only 4 confirmed commercial transits in the previous 24 hours. JMIC called that a near-total temporary pause in routine traffic. Reuters added the commercial picture. Analysts at Kpler and Vortexa said about 300 oil tankers remained inside the Strait. They were waiting for clarity that never truly arrived.
Kpler analyst Rebecca Gerdes told Reuters that safe passage “could not be guaranteed.” That short quote says more than the original list did. A government could name a friendly state. Owners still had to judge missile risk, insurance cost, crew safety, and the chance of reversal. Energy and trade bodies show why this mattered so widely. The IEA says nearly 15 million barrels a day of crude passed through Hormuz in 2025. That was about 34% of the global crude oil trade. UNCTAD says the Strait carries around one quarter of global seaborne oil trade. It also carries major LNG and fertilizer flows. Set beside the early Reuters reporting, the first headline starts to look incomplete. It captured the first diplomatic sorting. It did not capture the severe conditions shaping each transit decision.
How the list widened and changed
The first big change came when exemptions spread beyond the states named in the initial reporting. On April 2, Reuters said Manila had received assurances on Philippine passage. The assurance covered Philippine ships and fuel supply through the Strait of Hormuz. The Philippines had not appeared in the early Reuters list tied to Araqchi’s statement. That alone showed the framework was expanding. Two days later, Reuters reported that Iran was allowing vessels carrying essential goods to Iranian ports through the waterway. Those ships had to coordinate with Iranian authorities and follow set procedures. Passage was no longer tied only to nationality. It also depended on cargo and Iran’s own domestic needs. Iraq then pushed the story further. Reuters reported on April 4 that Iran had exempted Iraq from restrictions on transit through the Strait.
On April 6, Reuters reported that Iraq’s state oil marketer SOMO told buyers to submit lifting schedules within 24 hours. SOMO said its loading terminals were fully operational and ready to execute contracts without limitation. That language matters because it showed confidence returning on paper, even if shipowners still hesitated in practice. The policy was becoming more elastic. Iran was no longer simply naming friends. It was deciding when to relax pressure, where to relax pressure and which trade flows served its interests best. That shift is central to the article’s update. It turns the story from a list into a moving policy. Actual vessel movements then made the shift impossible to dismiss. Reuters reported on April 5 that the tanker Ocean Thunder passed through Hormuz with Iraqi crude.
It carried about 1 million barrels of Basrah Heavy. The same Reuters report said the vessel was among 7 Malaysia-linked ships cleared by Iran. That detail changed the meaning of 7 in later coverage. It did not describe a final club of 7 friendly nations. It referred to Malaysia-linked vessels receiving clearance after diplomatic talks. Reuters said Malaysian Prime Minister Anwar Ibrahim confirmed that Iranian officials had agreed to let Malaysian vessels pass toll-free. Reuters also reported that ships linked to Oman, France, and Japan had crossed in recent days. Another Reuters dispatch said Iran would allow passage for vessels without U.S. or Israeli links. That is a broader and more fluid standard. It is still coercive because it excludes large parts of global shipping.
Yet it is no longer a fixed national whitelist. It is a conditional system shaped by diplomacy, cargo, ownership links, and Tehran’s immediate bargaining needs. UNCTAD’s March assessment helps explain why that flexibility matters beyond oil headlines. It warned that disruption in Hormuz affects crude, LNG, fertilizers, food costs, and vulnerable import-dependent economies. Once those wider trade effects are included, the old “7 friendly nations” angle becomes too narrow. Iran began with a politically useful list. It then moved into selective and evolving exemptions as pressure built. That is the cleaner frame now for any updated article or headline going forward this week. More exemptions may emerge as diplomacy and conflict continue colliding.
Where the Strait of Hormuz stands now
None of these crossings means the Strait is functioning normally. The latest official warnings still describe a dangerous operating picture. UKMTO’s Joint Maritime Information Center said the maritime security situation continued to reflect critical kinetic risk. It said attacks remained likely and conditions were still highly hazardous for commercial shipping. The advisory also said no formal legal closure had been declared. Yet it stressed that commercial operators still faced a restricted and highly sensitive transit environment. IMO has echoed that danger in humanitarian terms. It says around 20,000 seafarers, along with port workers and offshore crews, have been affected in the region. In a briefing published on April 2, the IMO Secretary-General issued a blunt warning. He said, “Fragmented responses are no longer sufficient.”
IMO also said it had confirmed 21 attacks on commercial ships since February 28. It reported 10 seafarer fatalities and several injuries. Those figures explain why limited crossings do not equal normal trade. A vessel may pass and still prove nothing about wider confidence. One successful transit does not rebuild schedules or reduce insurance costs. It also does not persuade every owner to send another ship into the Gulf. Reuters reflected that caution after Iraq’s exemption. Some market participants said it remained unclear whether shipowners would return while the war continued. That hesitation is one of the clearest markers of the present moment. Access exists, but confidence does not. The route is usable in fragments, not in a stable commercial sense.
The wider energy picture shows why even partial disruption still matters. The IEA says nearly 15 million barrels a day of crude passed through Hormuz in 2025. That was about 34% of the global crude oil trade. It also says only Saudi Arabia and the UAE can reroute some crude away from the Strait. Even then, bypass capacity is limited. The EIA likewise describes Hormuz as one of the world’s most important oil chokepoints. UNCTAD says the Strait carries about one quarter of global seaborne oil trade. It also carries significant LNG and fertilizer flows. Those numbers explain the pressure building around governments, importers, and markets. Reuters reported on April 1 that IEA Executive Director Fatih Birol described losses above 12 million barrels.
He warned, “We are heading to a major, major disruption.” Reuters also reported that April losses could double March losses. On April 5, Reuters said Brent was near $110 a barrel while WTI was around $111. Those prices followed sharp weekly gains. Refiners had begun seeking alternatives from the United States and Britain, yet those shifts can only soften the blow. They do not reopen Hormuz. So the current position is best described as selective movement under severe stress. Some ships are crossing. Some states are receiving exemptions. Yet the lane remains strategically choked, commercially impaired, and dangerous enough that every transit still looks exceptional instead of routine. That is where the Strait of Hormuz stands right now in practical terms. Insurance fears and military risk still shadow every attempted transit.
What experts think may happen next
Experts expect Iran to keep using the Strait as leverage while any wider reopening depends on fragile diplomacy and security guarantees. Image Credit: Pexels
Most expert analysis now points away from a clean military fix. It points instead toward a long negotiation over access, deterrence, and postwar leverage. Reuters reported on April 3 that recent U.S. intelligence assessments suggested Iran was unlikely to ease its grip soon. The reason was strategic, not only tactical. The Strait gives Tehran rare leverage over Washington and over energy-dependent states far beyond the region. Ali Vaez of the International Crisis Group framed that leverage in stark language. He told Reuters, “The U.S. handed Iran a weapon of mass disruption.” That quote has travelled because it captures the scale of the shift. Iran is no longer threatening only through missiles and proxies. It is also threatened by trade disruption, freight risk, and oil market stress.
Reuters cited one source familiar with the intelligence assessment. The source said Iran had now tasted its power over the waterway. It was therefore unlikely to surrender that leverage soon. That view fits the traffic pattern seen so far. Tehran has allowed narrow movement at chosen moments. Yet it has not given up the broader power to frighten markets, pressure governments, and extract concessions. That means the next phase may turn on bargaining, not reopening alone. Any temporary passage deal could still leave Iran room to tighten access again. That risk grows if talks stall or fresh strikes occur. Diplomatic reporting points in the same direction. Reuters reported on April 2 that about 40 countries discussed ways to reopen the waterway. No concrete operational agreement emerged. President Emmanuel Macron called a military move to force the Strait open “unrealistic.”
He said ships would face Guard attacks and ballistic missiles. Reuters later reported that former CIA Director Bill Burns saw specific Iranian demands ahead. He said Tehran would seek “long-term deterrence and security guarantees” in any settlement. Burns also said Iran would want direct material benefits. On April 6, Reuters reported that UAE adviser Anwar Gargash said the use of Hormuz must be guaranteed. He said that a guarantee should form part of any U.S.-Iran deal. Reuters also reported today that the United States and Iran had received a peace proposal. Iran, however, rejected reopening the Strait as part of a temporary ceasefire. Taken together, those reports suggest three realistic paths. Iran could widen exemptions for countries or cargoes it sees as useful.
It could accept a negotiated reopening tied to sanctions, security guarantees, and wider settlement terms. Or it could tighten access again if diplomacy breaks down or force returns to the center of policy. The common thread is uncertainty. That is why the article should open with the original list, then move into the harder truth. The list mattered at the start. It no longer explains the current state of the Strait of Hormuz on its own. That is also why the next headline needs more room than the first one did this week, especially as exemptions keep shifting and diplomacy stays unsettled for now. Markets, diplomats, and shippers are bracing for further sudden shifts.
