‘You’re too young’: Dangerous myth behind Australia’s explosion in bowel cancer cases

Bianca Evans was sitting in a chemo chair when a chance meeting changed her life. She had just been diagnosed with early onset bowel cancer when the nurse on duty thought it would be helpful if she had someone to talk to who understood what she was going through.

Then 32, Evans had only just relocated from Sydney to the Gold Coast with husband Martin and their newborn daughter Zoe when she was given the news she had stage three bowel cancer, also known as colorectal cancer.

Evans had dealt with a lifetime of bowel-related symptoms, including constipation, bloating and occasional diarrhoea, which were put down to irritable bowel syndrome (IBS), but when her grandfather succumbed to bowel cancer she decided to visit her GP.

“I didn’t know if that was genetic or not so I started requesting to have a colonoscopy, but I had GPs say to me, ‘You’re too young, don’t be ridiculous’,” she told nine.com.au.

“I had one particular GP say, ‘People your age don’t get bowel cancer’.”

Evans was still living in Sydney and excitedly awaiting the birth of her first child when routine pregnancy scans showed nodules on her liver.

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They continued to grow and were monitored throughout the pregnancy, but it was only after Zoe was safely delivered that further investigations found the nodules were harmless hepatic adenomas caused by fluctuating pregnancy hormones.

While they were unrelated to cancer, after she and her family moved to the Gold Coast in 2023, a doctor handling her follow-up care suggested Evans have a colonoscopy.

“I was in the waiting room afterwards, having a sandwich, and my husband was on his way to pick me up and the doctor came out … and said, ‘I am really sorry, we found something. You have cancer’.

“My stomach sunk. I burst into tears. 

“My husband came in shortly later and could see me crying, and we were both a mess. It came as a massive shock.”

The doctor had discovered a large tumour measuring 4cm by 3cm in Evans’ rectum, in the lower part of her bowel. Rushed pathology tests during the colonoscopy left no doubt it was cancer.

Evans was referred for more tests to ascertain if the cancer had spread.

“At that point, I had no idea if I would live or die, or if it was really early or advanced. I had to wait.”

After about 10 days, Evans was told she had stage three bowel cancer, and treatment needed to begin immediately.

“Stage three means it had gone into one lymph node,” she said. 

“It was, ‘You have got to stop breastfeeding, we need to get the port in you and we need to start [chemo] within a couple of weeks’.”

After recovering from a collapsed lung that occurred during the port procedure, Evans was undergoing her first cycle of chemotherapy when she met Elle Howard.

“On my first day of treatment I was introduced to Elle. I was an absolute wreck that day, really upset, really scared. Nothing prepares you for chemo,” she said.

“My cancer care nurse sat with me, as did my husband, and she said, ‘Look, I would like to introduce you to another woman who is similar age, she’s got young kids, she’s got bowel cancer as well. I think you’d get on really well [and] it would be really good support for each other’.

“My first impression of Elle was, ‘Oh my gosh, she’s so happy, so bubbly and laughing’, and she was having all this poison pumped into her, but she was just really positive and happy.

“We chatted and she gave me some really good advice: ‘You’ll get through it, you’ll be fine, we are in this together’.

“We exchanged numbers [and afterwards] she sent me a beautiful message that night to check in and see how I was doing, and just to remind me she was there if I wanted to vent or ask questions. We ended up talking almost every day after that.”

The pair became firm friends, meeting up regularly, including with their partners and kids.

Howard, a lawyer, and mother of two young children, had been diagnosed with stage four bowel cancer on her 32nd birthday, just months before Evans.

They bonded over their shared experiences with early onset bowel cancer − something doctors recently recognised as a separate disease following an explosion in cases.

Once considered an ‘old person’s disease’, rates of bowel cancer, also known as colorectal cancer, in people aged 18 to 45 have increased by 12 per cent.

According to Bowel Cancer Australia, it is now the deadliest cancer for Australians aged 25 to 44.

Howard supported Evans during the difficult days of treatment.

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“Chemo made me very, very sick. I had a lot of symptoms, muscle weakness, I lost a lot of weight, a lot of nausea, vomiting, peripheral neuropathy as well,” she said.

But by far, the worst was the impact it had on her life as a new mum – just like Kellie Finlayson, the wife of former AFL play Jeremy, who was diagnosed when her daughter was three months old.

“The chemotherapy that I was having, they suggest you keep your saliva off young babies. I couldn’t kiss her, I had to be careful of my body sweat, I was too weak to hold her,” Evans said.

“There were days I couldn’t move off the couch. It was a really, really tough time.

“It makes me sad because I missed so much of her life. I was there, but I was watching her from the sidelines, essentially. I couldn’t be hands-on.”

After six cycles of chemo, tests showed the tumour had shrunk enough for surgery. Four weeks later, Evans underwent surgery.

“I had an Ultra-Low Anterior Resection. It was about five hours of surgery and they removed 30 centimetres of bowel and 28 lymph nodes,” she said.

Evans was also fitted with an ileostomy bag to allow her bowel to heal without being exposed to bacteria that causes infection and other serious complications.

She then underwent six more rounds of chemotherapy and later underwent surgery to have her ileostomy bag removed.

Through it all, Elle was by her side.

“Typically, we were there on the same day for a lot of the [chemotherapy] cycles,” Evans said.

It was during those long treatments that the two noticed the lack of support for young women battling cancer.

Evans said young female cancer patients face obstacles other people might not while navigating treatment, such as fertility problems, raising young children, managing a career, or maintaining their relationship.

“[Younger women] need a lot of support and we just saw there was a gap,” she said.

“While there are a lot of fantastic charities and organisations out there, for the specialised life stage that young women are at, there’s not really anything for them.

“Elle, especially, was someone who really wanted be be a buddy to other young women we saw coming in [for treatment]. So whenever we did see another young woman, we would go up and introduce ourselves and we would have coffee, and we started putting on little lunches or coffee catch-ups for these other young women with cancer.”

So the two hatched a plan.

“I remember being in hospital after my surgery and Elle came to visit me… and I said to her, ‘I think there is something here’, and told her my idea, and she said ‘Let’s do it’.”

They got to work on a business plan, with Elle working on the legal side while Evans drew on her marketing and sales background.

The result was Yellow Freesia Foundation.

“It took about 18 months to get off the ground. Sadly, Elle didn’t see it through,” Evans said.

Howard died in January 2025 after a 21-month battle with bowel cancer. She was 33.

Grief-stricken over the loss of her friend and the foundation’s co-founder, Evans thought about putting it on hold.

“When she passed, I wasn’t sure what to do at that point. But her family gave me their blessing and said, ‘Please, we would love to see this become something, we would really love you to do it’. So we went ahead.”

The foundation was registered in April 2025 and launched its services in November. It has since had 77 referrals from women across Australia.

“We support women aged 18 to 45 through cancer and beyond, and it’s any cancers,” Evans said.

“We say ‘beyond’ because when you finish treatment, for those who get through treatment and finish, yes it’s great that you’ve gotten through it, but it’s a really, really hard period trying to get back to your new normal.”

Evans, who has been in remission since February 2024, said young cancer sufferers or survivors often faced a myriad of specific problems, such as infertility, re-establishing their careers, or relationship breakdowns.

The non-profit foundation is funded by donations, and offers free psychologist-led support groups; mind and body workshops and a member resource hub.

“Elle is definitely a massive part in what we do. Elle was just very, very special and I miss her dearly. She definitely helped me get through my treatment,” Evans said.

“She was a role model, she was probably one of the best friends I ever had, and she knew me better than a lot of my other close friends knew me.

“I feel so blessed and fortunate to have met her, even though it was for a very short time, and I am just really happy that I can carry her legacy forward with this.”

Early onset bowel cancer

The rates of bowel cancer cases in people under the age of 50 now account for one in eight, or 12.6 per cent, of all new bowel cancers cases in Australia, according to Bowel Cancer Australia.

The explosion in cases, and distinct genetic profile of early onset bowel cancers, has even led to it recently being reclassified as a separate disease.

Australian researchers have found a specific genetic mutation, known as BRAFV600E, was more prevalent in young female patients with metastatic bowel cancer.

A link between early onset bowel cancer and the gut microbiome was also found recently.

Researchers are examining if changes in the gut microbiome, caused by early-life antibiotic use, ultra-processed diets, lack of fibre and even some gut bacteria that produce specific toxins could drive bowel cancer rates.

While tests eventually showed Evans’ cancer was not caused by a known genetic factor, her cancer started in her rectum, in the lower part of the bowel, which is where early onset cancers are more frequently found.

Bowel or colorectal cancer comes under the umbrella of gastrointestinal (GI) cancers.

Australian-based non-profit organisation, GI Cancer Trials, said bowel cancer rates among people aged 20 to 29 had more than doubled in recent years, while rates in people aged 30 to 39 had tripled.

It said early-onset bowel cancer deaths had increased by 35 per cent since 2000, far outpacing the bowel cancer death rate in older people, which sits at 5 per cent.

Australian researchers are now leading the charge when it comes to bowel cancer research and treatment.

Among them is Dr Julia Freckelton, a gastrointestinal oncologist and chief investigator in a GI Cancer Trials latest clinicial study addressing the rising rate of early onset bowel cancer.

“At the moment, Australia is leading the world in rates of early-onset bowel cancer. By 2030, we expect one in three patients diagnosed with GI cancer will be a younger adult,” Dr Julia Freckelton said.

“The statistics are telling us very clearly that younger people are being diagnosed, more families are being impacted, and the healthcare system needs to evolve to respond to that reality.

“Australian researchers have both an opportunity and a responsibility to lead the world in understanding why this increase in GI cancers is happening and how we can develop better, more effective treatment.”

Ebony Gaylor was diagnosed with stage three bowel cancer in 2022.

“I was 38, working a busy job, raising my son and living life to the fullest,” she said.

“I’d been having gut issues that wouldn’t go away, so my GP booked me in for a colonoscopy just to be safe. Not long after that, I found out I had bowel cancer.”

Gaylor said it became clear during her diagnosis and treatment that the system wasn’t built for a “38-year-old woman balancing parenting and work” with a cancer diagnosis.

Luckily for her, research from a previous clinical trial conducted by GI Cancer Trials allowed her treatment time to be reduced, without lowering effectiveness.

She completed treatment and had no evidence of disease since 2024.

She now supports funding for research to learn more about the causes of early-onset bowel cancer and find better treatments.

“There is still so much we don’t understand about why younger people are developing GI cancers, and there is so much more we can do to improve treatment and support,” she said.

“Thanks to clinical research, I only had to complete half the standard rounds of chemotherapy. That made an enormous difference to my life and my family.”

Dr Freckelton said it was critical cancer care was tailored to younger patients, who were often navigating complex life circumstances that made treatment more challenging.

She is currently leading the ORBIT trial, which aims to deepen understanding of early onset bowel cancer and ensure better quality of life for patients during treatment.