Why Is Cancer Happening To Young People?

Oncologists like Cathy Eng at Vanderbilt University Medical Center in Nashville, Tennessee and George Barreto, a surgeon from Mumbai, now at Flinders University in Adelaide, Australia are noticing a health trend, which has alarmed them and many other health experts. The trend in notice is about the types of cancers which are typically seen in older adults, but are now affecting younger people under 50.

Eng recalls a case of a 16-year-old with advanced gastrointestinal cancer, who flew from China to Texas but was too late by then. For Barreto, it was an observation among his friends and family that highlighted the rising incidence of early-onset cancers worldwide. He had promised that he would get to the bottom of this.

Statistics show that early-onset cancers, particularly colorectal, pancreatic, and stomach cancers, are increasing globally. The model suggests a 30% rise in cases by 2030.

While there is a decline in cancer deaths in some countries due to improved screening and treatment, early-onset cancers have now become more common. In the US, colorectal cancer is taking the lead as the cause of death in men under 50. There is a noticeable rise among women, Hispanic individuals, and American Indian and Alaska Native populations. Health disparities, including limited access to healthcare and systemic racism, also have become a catalyst in this trend, especially in marginalized communities.

There are multiple factors that could have led to the rise of early-onset cancer. Obesity, processed diets, alcohol consumption, and microbiome disruption are some of the most common ones.

For instance, changes in gut microbiota caused by diet or antibiotics can lead to inflammation and increase cancer risks. However, studies also show young, and seemingly healthy individuals developing aggressive cancers, this could indicate a more complex underlying reason.

Scientists are also looking at the genetic differences in early-onset tumors. Some aggressive tumors suppress immune responses more effectively than others. However, a conclusive finding is yet to come. Prenatal exposure to synthetic hormones is also being investigated. Some studies also aim to uncover environmental and lifestyle factors native to specific regions which could lead to such a condition. For instance, while Japan and South Korea are located near one another and have a similar topography and economy, the rate at which early-onset cancer is increasing in South Korea is must faster than in Japan.

The first and foremost thing to focus on would now be to increase screening and awareness. Advocacy campaigns are also targeting younger audiences and screening guidelines are being revised.

For instance, in the US, colorectal cancer screening now begins at 45, and Alaska Native health programmes have also recommended starting at 40.

The need for patient-centred care for young adults is of utmost importance. Cancer in younger patients can present unique challenges. Younger patients are also the ones who would want to prioritise fertility and long-term cognitive impact over treatment side effects. Many also face economic struggles, for instance, Candace Henley, who was diagnosed with colorectal cancer at 35 was raising five children. The aggressive surgery did not help her and left her unable to continue her job as a bus driver. She was left homeless. Physicians and the healthcare system must therefore understand the factors that can lead to more holistic care.

Researchers are suggesting a global biobank, where projects are kept to collect comprehensive data on prenatal and early-life exposures.

While unanswered questions still remain, progress is being made. Through advocacy and awareness campaigns, many patients are now seeking a second option, that is too, timely. Early detection and increased awareness are also helping many address the alarming rise in the rate of early-onset cancer, in the hope of solving the puzzle and getting more answers.