Cancer in the young is increasing: should we be worried?

Updated: Feb 25

There have been a number of headlines on the same topic recently that caught my eye:

cancer cases in the under 50s have 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.

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 absolutely want to stop people getting it in the first place as

much as we can.

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 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.
Obesity
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 but is

not proof of cause. But in any case, it suggests that a westernised diet and sedentary

lifestyle are probable factors in the rise of EOC and importantly, ones that most of us have

the ability to change.

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