Cancer cases rising in younger population
You may think of cancer as mainly occurring in adults at older ages, but a new study is showing more and more cases among younger patients.
A study in the British Medical Journal Oncology reports that worldwide cancer cases in people under age 50 rose 79% between 1990 and 2019, with the number of cancer deaths rising by more than 27%. The American Cancer Society reports that people under age 50 in the United States were also the only age group to show a rising number of cancer cases between 1995 and 2020.
Another 2023 study in the JAMA Network Open shows that among cancer rates in Americans younger than 50, breast cancer was the most common type, with the biggest increase occurring in gastrointestinal cancer cases. Breast, colorectal and stomach cancer showed the highest mortality rates in younger adults.
Researchers are asking why these cases are on the rise in younger patients, and some point to environmental and lifestyle factors, including poor diet, lack of exercise, smoking and sun and pollution exposure.
A study presented at the American Association for Cancer Research Annual Meeting this year showed evidence of accelerated aging in people under 50, meaning their body’s condition didn’t match their chronological age. The researchers found younger people had signs of accelerated aging, which can be a factor in early-onset cancers.
“Yes, I am seeing more and more young patients with cancers across the board, especially gastrointestinal cancers,” said Dr. Nitin Kapoor, Hematology/Oncology, UPMC Hillman Cancer Washington. “While some cancers have been declining in older people, various reports and studies have shown that cancer is on the rise in younger adults.”
One of the most recent is Cancer Statistics, 2024, an American Cancer Society (ACS) annual report on cancer facts and trends. Published in January, the report revealed that while cancer deaths are falling, new cases are ticking upwards – from 1.9 million in 2022 to over 2 million in 2023.
“More of those new cases involve younger people,” Kapoor said. “The ACS report showed younger adults to be the only age group with an increase in overall cancer incidence between 1995 and 2020 – the rate has risen by 1 to 2 percent each year during that time period.”
The ACS report also showed increases in breast, prostate, endometrial, colorectal and cervical cancer in young adults. Colorectal cancer still overwhelmingly affects older adults but is now the leading cause of cancer death in men younger than 50 and second in women under 50. Those numbers have been rising steadily since the mid-1990s.
As to the reasons behind this increase, Kapoor looks to possible links between diet and lifestyle. “I think the rise in early onset cancers is related to lifestyle and diet with rise of the metabolic syndrome in the United States and Western countries,” he saId. “Some researchers point to the escalating rates of obesity over the last few decades, which is associated with the risk of early-onset cancer. On a related note, the change in dietary habits, specifically the increase in consumption of ultra-processed food, and sedentary lifestyles also are associated with higher cancer rates.
“Others speculate that there may be environmental factors at play, such as carcinogens released into the air, water and food supplies.”
Dietary factors likely play a huge role in this increase, and Kapoor thinks that increases the risk factor for early onset cancers.
“That as well as being a risk factor for multiple types of cancer including colon, rectal, pancreatic, stomach and esophageal cancer,” Kapoor said. “Processed meat has been identified as a carcinogen by the World Health Organization (WHO) and consumption of processed meat and foods is on the rise in the United States and around the world.”
What’s even more concerning about this scenario is that cancer cases in younger people often tend to be more aggressive.
“I think some of the molecular characteristics and pathways of how something becomes cancerous are different between the older and younger groups,” said Kapoor. “Younger adults tend to have a more aggressive-appearing cancer. They also tend to present at a more advanced stage that is not solely explained by a delay in diagnosis. I think the biology of the same cancer diagnosed between young and elderly is different.”
This trend may well lead to changes in screening guidelines in the future.
“Recently, the recommendation for colon cancer screening was dropped to age 45 from 50 due the rise in colorectal cancer,” Kapoor added. “Mammogram screening used to start at age 50 but now is at age 40. I don’t think the average risk patient will need to be screened earlier, but I think each patient needs to discuss with their primary care doctor what their risk is.”
He advises people who are at average risk to follow the existing guidelines and be sure to undergo an annual checkup with your physician or other primary care provider. That is the time to review all the tests that you need to be done, which includes cancer screenings.
“That is also the time to discuss whether their personal medical situation puts them at higher risk compared to average,” he said. “This is a very important component of the visit, as these factors will determine whether they need to begin screenings at an earlier age than the general guidelines.”
In the end, his advice to everyone remains the same.
“Pay attention to exercise and nutrition, don’t smoke or drink too much alcohol and be aware of family history and share it with a primary care physician.”