Since 2023, colorectal cancer (CRC) has been the leading cause of death among people under 50. Yet funding for CRC research is dwarfed by spending on other cancers.
More than 155,000 Americans will be diagnosed with colorectal cancer this year, and more than 55,000 will die from it. The fastest growing demographic is Americans in their 20s and 30s. According to the American Cancer Society, CRC diagnoses in people under 55 increased by 50 percent from 1995 to 2019. It is now the leading cause of cancer death for men and women under 50.
I know this because I am part of the statistics. I was diagnosed a little over two years ago, weeks before my wedding and long before the recommended screening age. Statistics told me I had 13 months to live. That’s about one month for every year I had spent raising my daughter, and about half as long as I had known the fiancé who completes our family.
The costs of inaction to this growing crisis are significant.
The young people most affected by this epidemic are economic earners, soldiers, teachers, and the young parents and entrepreneurs our nation has historically relied on. Perhaps more alarming, young people are being diagnosed at advanced stages of the disease when options are limited.
The cost isn’t just measured in the lives of young Americans. CRC has the second highest treatment cost of any cancer – an estimated $24.3 billion annually – a number that does not account for lost productivity and the greater economic impact.
Our lack of investment in CRC research and its cures also is born out in patient outcomes.
Despite CRC being the second leading cause of cancer-related deaths and the third most common cancer diagnosed annually, CRC accounts for less than 1/20th of federal cancer funding at the National Cancer Institute. This underfunding demonstrates that the scale of the crisis isn’t being met with proportional resources.
CRC lacks truly effective, precision medicine approaches that are becoming common with other diseases. Too often, young people are left cycling through chemotherapy regimens that only buy a little more time, rather than advanced science that offers a true shot at survival. The current five-year survival rate for Stage IV colon cancer is 13 percent. I am three times more likely to die of my Stage IV cancer than my fellow Americans with other cancers.
Leadership on this issue begins with a simple commitment to fairness. If the National Cancer Institute (NCI) dedicated resources to finding treatments and cures for CRC commensurate with its impact as measured in diagnoses and deaths, funding would more than quadruple.
In addition, the NCI must dedicate more resources for research, clinical trials, biomarker studies, and innovative treatment strategies. There hasn’t been a new frontline CRC treatment for most patients approved in two decades. That’s unacceptable. For complex cancers like CRC where pharmaceutical industry investments are lacking due to low profitability, it is imperative that the government step in.
As has always been true in America, our greatest challenges can be overcome by our collective genius, commitment to innovation, and willingness to invest in solutions for a future we can’t quite see. When the federal government has invested in battling other cancers at scale—look to breast and prostate cancers as examples—survival has increased dramatically. The battle against CRC requires the same.
I have endured procedures that sent me to the ER with uncontrollable pain. Every two weeks I travel far from my family for IV infusions, and every day I swallow more pills than I can count. Like so many others living with CRC, I endure the literal poisoning of my own body with the hope that the growth of science will outpace the growth of my disease.
That cannot happen without the help of my government, and that means we need leaders in Congress.
The numbers say there’s no hope for me, but in America there is always hope. I’m proud of the kid I raised, the way I’ve loved, and all I have contributed in a career combating human trafficking. I am not done wife-ing. I am not done mom-ing. I am not done fighting.
I am begging you not to abandon the ever-growing number of Americans just like me.
For more information on how you can help, please contact the Colorectal Cancer Alliance, the nation’s leading nonprofit organization dedicated to the prevention, treatment and acceleration of research to end colorectal cancer in our lifetimes.
Alison Kiehl Friedman (1979–2025) was a devoted mom and lifelong public servant who served as Deputy Ambassador to Monitor and Combat Trafficking in Persons. She wrote this commentary shortly before she passed away from Stage IV colon cancer.
