Cancer Rates on the Rise in Young Adults

Earlier this year, a medical researcher at the Rambam Health Care Center in Haifa presented a startling statistic to a meeting of European cancer specialists. The incidence of cancer among younger adults had increased by almost 80 percent in the nearly 30 years between 1990 and 2019.

The new research by Dr. Irit Ben-Aharon pointed out that what are termed early-onset cancers have been increasing sharply in patients under 50. For example, it is predicted that by 2030, 25 percent of American patients diagnosed with colorectal cancers, one of the most common forms of the disease, will be 49 years or younger.

At Emory’s Winship Cancer Institute, Dr. Olatunji Alese, who is director of gastrointestinal oncology is seeing an increasing number of patients with the disease.

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“We’re seeing many patients who are not nearly as old as the historical median age at diagnosis for colon cancer, which for many decades, had been in the 70s. For example, in 1995 one in 10 patients developing colon cancer, or colorectal cancer, was younger than 55 years of age; that had increased to 20 percent by 2019. So, within 24 years, the proportion of patients newly diagnosed with colorectal cancer under the age of 55 has almost doubled.”

Dr. Olatunji Alese is seeing more young patients with colorectal cancers.

According to Dr. Alese, no one seems to know why the statistics have climbed sharply. But most researchers in the field believe it’s more environmental than biological. There has been some speculation regarding microplastics, others have pointed to the use of antibiotics in livestock breeding.

Others point to a less exotic explanation. There’s increased consumption of highly processed foods, which often contain relatively large doses of chemical additives or our tendency to spend too much time sitting at our desk or stretched out on the sofa. Or we may be overweight, which is said to affect almost 40 percent of adults under 40. For now, scientists are stumped.

And because diagnostic tests are geared toward older adults it may take longer to catch the cancers. Colonoscopy exams, for example, aren’t routinely given to those under 45. And even if they were, there is no guarantee that younger patients would seek out these expensive and usually uncomfortable tests.

“Often times you find younger patients,” Dr. Alese points out, “unfortunately ignoring the symptoms because they just don’t think it’s serious enough. Or even when they go to healthcare facilities, they don’t get the appropriate workup to detect the cancer early. And, again, younger patients tend to have worse survival outcomes in a lot of the instances.”

That’s also the case with breast cancer in women, which tends to be more aggressive in younger persons. Dr. Mariya Rozenblit, who studies breast cancer at Yale University Medical School, says there are other issues as well.

“Younger women diagnosed with breast cancer are also more likely to have a genetic mutation than older women. The good news is that once breast cancer is diagnosed, the prognosis is usually very good. The treatments can be long, but we still have very high cure rates.”

Still, a biennial report published at the beginning of last month by the American Cancer Society found that breast cancer rose by nearly 10 percent from 2012 to 2021, and the rise was even faster in women under 50. According to the National Cancer Institute, one woman in every 50 will develop breast cancer by that age.

Israeli medical researcher Irit Ben-Aharon told European cancer experts that disease rates are up sharply.

Earlier this year, the U.S. Preventative Services Task Force recommended that mammography screenings start for start women at age 40 rather age 50, and that annual exams start at age 45.

It’s expected that in 2024 there will be more than 300,000 new cases of invasive breast cancer diagnosed in U.S. women, including more than 13,000 in women under 40 and over 37,000 in women in their 40s.

Bringing down these numbers for colorectal and breast cancer, according to most experts, will depend on access to good health care, something that Georgia is trailing most of the rest of the nation in. The Commonwealth Fund ranked Georgia 45th out of the 50 states surveyed in overall quality of health care that is offered here.

And if there are attempts to curtail or cancel the Federal government’s Affordable Care Act, or cut Medicaid, the result, according to Dr. Alese, is likely to have a significant impact.

“One thing that the Affordable Care Act did was to remove the copayment for most cancer screening tests,“ he said. “So, patients aren’t left with a big medical bill for either a colonoscopy or mammogram or any other screening test. There has also been a lot of research showing that in those states, for example, who extended Medicaid, there has been improvement in cancer related survival.”