Cancer in younger patients alarming physicians

(Stat News) An array of cancers — colorectal chief among them — are striking people younger than 50 at higher rates than in previous decades, prompting new screening guidelines, new research, and growing concern.

Theories abound, although none has firm data behind it.

But experts believe that the rise in cancer among younger adults may be driven by changes in how many of us have lived our lives over the past half-century.

Dr. Kimmie Ng, the Young-Onset Colorectal Cancer Center director at the Dana-Farber Cancer Institute.

At age 35, someone born in 1990 will face quadruple the risk of rectal cancer and double the risk of colon cancer compared to the risk faced by a 35-year-old born in 1950.

Whether it’s sitting all day, consuming cured meats and sugar-sweetened drinks, taking antibiotics, or staying up late with the lights on, these practices — their effects probably interacting — seem to have had a profound impact on the internal workings of our bodies, disrupting metabolism and boosting inflammation.

Cancer remains about 20 times more common among older people than among the young. But doctors are concerned about the upward trend, as they increasingly diagnose malignancies once infrequently seen in anyone under 50.

An analysis of data from 44 countries, published last fall, showed that more than a dozen cancers have increased among people under 50. The most common cancer types trending upward were breast, colorectal, uterine, kidney, and thyroid cancers among women and colorectal, kidney, liver, prostate, and thyroid cancers among men (although increased screening may account for the last two).

Pancreatic cancer, an especially deadly disease with only a 10 percent survival rate, is also increasing among young people, said Dr. Brian M. Wolpin, director of the Gastrointestinal Cancer Center at Dana-Farber. According to National Cancer Institute data, pancreatic cancer among men younger than 50 increased by 6.5 percent yearly from 2017 to 2019; the yearly increase among women was 2.4 percent from 2000 to 2019. Pancreatic cancer is expected to strike 64,000 Americans this year, compared with 300,000 breast cancer cases and 153,000 colorectal cancers.

Obesity, as defined by BMI or body-mass index, remains the prime suspect in the search for the cause of early-onset cancers, especially colorectal cancer, for several reasons. One is circumstantial: The average BMI rose in parallel with early-onset colorectal cancer, increasing at the same rate over the same period.

The habits that cause weight gain — lack of exercise, poor diet, sweetened beverages — also boost cancer risk.

The research found that millennials with common chronic medical conditions and their children are “high utilizers” of the health care system compared to Generation X. This includes 106% more hospital admissions for millennials with diabetes and 55% more emergency room (ER) and urgent care (UC) visits for hypertension.

More research is needed to try and understand what’s going on but for now the rise in cancer among younger patients is concerning.

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