Over the last few months there have been a number of headlines in the media about an increase in cancer in young people:
- ‘Cancer surging among under-50s worldwide but experts aren’t sure why’ – The Straits Times (Singapore)
- ‘Colon Cancer Is Rising Among Younger Adults. Here’s What to Know’ – The New York Times (USA)
- ‘What is causing the global rise in cancer among the young?’ – The Sunday Times (UK)
All these articles flag that cancer cases in the under 50s has increased significantly in the last 30 years and are predicted to increase further.
Quite alarming at first read…..
Yes, but we have to remember that cancer under 50 is still uncommon. Despite the increases, 90% of cancer cases still occur in the over 50s with the majority of those cases being in the over 75s.
So, no need to worry then?
Well, panic no, but early onset cancer (EOC, defined as cancer diagnosed in the 15-50 age bracket) is still a cause for concern. Whilst it is uncommon, some of the highest percentage increase in cancer cases over the last 30 years have occurred in this age bracket.
Is that not just because we are better at picking up cancer these days?
That may be part of it in some countries but not all, as not many countries routinely screen for cancer in the under 50s and the rate of EOC is increasing globally. In addition, not all cancers can be screened for, but certainly for some cancers such as breast and cervical, early diagnosis through screening may have a part to play. For other cancers such as colorectal and lung, which aren’t screened for traditionally in this age group, this can’t be the reason for the rises.
But are deaths from these early cancers also rising or are these young people more likely to survive despite being diagnosed?
That seems to depend on where in the world you live. Globally, the death rates for people with early onset cancer have also gone up but if you look at different regions in the world, you get a slightly different picture. In the USA for example, rates of EOC have gone up (actually at the highest rate in the world overall) and so have the number of people dying from EOC. Whereas in Asia Pacific, death rates have gone down, meaning that although more young people are being diagnosed with cancer, less are dying from it, reflecting better medical technology, treatments and access to healthcare over the last 3 decades.
But I don’t think we should find solace in that. Being diagnosed with cancer is a devastating and traumatic event with far reaching physical, psychological, and social implications for the survivor and their families: we definitely want to stop people getting it in the first place as much as we can.
So how do we do that?
We don’t fully know why more young people are getting cancer but the findings in this study pointed to correlations with our diet, lifestyle and also mentioned emerging evidence on environmental pollutants as contributing factors.
We all know that smoking causes cancer, but I think less people are aware of the other lifestyle factors that were shown in this study to be important:
- Alcohol intake
- Diet e.g, In this study high red meat intake was a risk factor in breast cancer, low fruit intake for lung cancer, low fibre/calcium/wholegrains in colorectal cancer, and high sodium in stomach cancer.
- Physical inactivity
- Having a raised fasting glucose (as found in diabetics and those with pre-diabetes)
With regard to diet, we have to remember that these findings were taken from an epidemiological study which gives correlations between a risk factor and an outcome not proof of cause. But in any case, it points to a westernised diet and lifestyle being implicated in the rise of EOC.
If you want to come in for a chat about implementing lifestyle changes to reduce your risk, please do. And of course, please don’t miss your routine screening and health checks. Screening gives us a golden opportunity to diagnose serious conditions early and the more we know about you and your family’s history, the more we are able to personalise the screening to make it most relevant to you.
Dr Natalie Hutchins is a UK family GP based in the Osler Health Star Vista clinic. If you would like to discuss your child health please make an appointment here.
Zhao J, Xu L, Sun J, et al. Global trends in incidence, death, burden and risk factors of early-onset cancer from 1990 to 2019. BMJ Oncology 2023;2:e000049. doi: 10.1136/bmjonc-2023-000049