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Cancer is increasingly happening in adults under 50 years of age.

That’s why medical oncologist, Jalal Baig, was not as shocked about Kate Middleton’s recent revelation of her cancer diagnosis at the age of 42 as the rest of the world.

Baig told CNN that early-onset cancer – defined as happening in adults under 50 years of age – is no anomaly but rather a part of a rising global trend in which newly diagnosed cancer patients are getting younger.

Cancer patients are “increasingly shifting from older to middle-aged individuals,” according to a report released in January by the American Cancer Society, per another CNN article, which is deflating the myth that cancer is reserved for senior citizens.

Even though the overall US population is aging, “we’re seeing a movement of cancer diagnosis into younger folks, despite the fact that there are more people that are in the older populations,” said Dr. William Dahut, chief scientific officer for the American Cancer Society.

“So cancer diagnoses are shifting earlier,” he said. “There’s something going on here.”

In just one week, Baig saw a 37-year-old with breast cancer that had already metastasised to her lymph nodes, bones, lung and liver. In the room next door, he said, was a 45-year-old with colon cancer that had spread so diffusely throughout the liver that it had become packed and enlarged with the tumours.

Both patients had stage IV cancers that can potentially be controlled for a finite time but are no longer curable.

The global incidence of early-onset cancer increased by 79.1% and early-onset cancer deaths rose by 27.7% from 1990 to 2019, a 2023 study in the journal BMJ Oncology found.

More granular data on this uptick published last year in the Journal of the American Medical Association showed that from 2010 to 2019 in the United States, breast cancer accounted for the highest number of cases in this younger population, while rates of gastrointestinal cancers were rising the fastest.

Dr. Kimmie Ng, a medical oncologist at Dana-Farber Cancer Institute, told The Boston Globe last year, that the jarring increase in gastrointestinal cancers is connected to the risks associated with a person’s birth year saying “People born in 1990 have over double the risk of getting colon cancer compared to those born in 1950. And quadruple the risk of getting rectal cancer.”

Part of the cause of this shift has to do with the changes to nutrition and lifestyle that took hold in the middle of the last century.

Culprits may include ultra processed foods, sugary drinks, red meat, smoking, alcohol, sleep alterations, obesity and physical inactivity. Alone and especially in concert, these factors can alter the internal processes of our bodies by upsetting metabolism and ratcheting up inflammation.

Because the population’s underlying genetic risks haven’t changed in the past several decades, it has bolstered the case that environment and lifestyle have a greater role in these cancers than our genes.

“But as I have seen regularly in my own cancer clinic, obesity and lifestyle alone cannot account for all the young patients being diagnosed,” noted Baig. “Many whom I am treating are healthy, eat judiciously and exercise regularly. And so causation for their diseases still remains beyond science’s grasp.”

Research is also examining whether changes in the gut microbiome, the trillions of microbes that reside inside our tummies, are increasing our bodies’ vulnerability to cancer. Poor diet, excessive antibiotic use and certain medicines can cause an upheaval in this microbiome, which could then play a role in facilitating cancer.

Alarmingly, there is reason to believe that a person diagnosed at a younger age may have been exposed to risk factors as a baby or in utero because cancer is ultimately a disease understood to develop over decades as changes in DNA accumulate and spawn tumours. Research is thus also focused on the risk of cesarean delivery in females and a synthetic form of progesterone used to prevent premature labour.

While researchers try to figure out the causes, primary care physicians need to be educated on the rising presence of cancer in those younger than 50 and why age should not be used to downplay a presenting patient’s symptoms.

One should also not neglect to check up on nagging symptoms and not be shy to advocate aggressively for themselves since it can take multiple appointments before a cancer diagnosis is made.

[source:cnn]