According to a new report, cancers of the gastrointestinal tract — including those of the colon, rectum, pancreas and bile duct — are being diagnosed more often and at a faster rate in younger adults than they were a decade ago.
The study, published earlier this month in JAMA Network is openThe researchers sought to compare cancer rates – or the number of new cases diagnosed – in people under the age of 50 between 2010 and 2019. Over a decade, early-stage cancer rates increased by 0.74%.
During that time period, early-onset gastrointestinal cancers not only had the largest increase in the number of new cases (from 6,431 cases in 2010 to 7,383 cases in 2019, or an increase of 14.8%), but they also had the fastest increase, rising by an average of 2.16%. annually
This new data, while not necessarily surprising, supports other recent research on higher rates of gastrointestinal cancers in younger populations, the researchers said. Jake Stein, MD, MPHassistant professor of oncology and health services researcher at the University of North Carolina College of Medicine.
“Many in the medical community have known about the increase in gastrointestinal and especially colorectal cancer in younger patients for some time,” said Stein, who was not involved in the new research. health in an email. “But this study provides clear data to show that these trends are real.”
And it’s not just early-onset gastrointestinal cancers that are on the rise, the new study also identified increases in cancer rates of the breast, urinary tract and reproductive system.
Here’s what you need to know about this increase in early cancers, and what you can do to reduce your risk.
In order to estimate the prevalence of early-onset cancer in the United States, the study authors used data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program, which includes information from about 26% of Americans.
Using this large dataset, the researchers screened reported cases of cancer in people under the age of 50 — technically known as early-onset cancer — and matched them to the individuals’ self-reported sex and ethnicity. They also collected data on the age group and type of cancer.
In all, the researchers found that 562,145 patients were diagnosed with cancer at first stage between 2010 and 2019. The majority of them ranged between 40 and 49 years old, and were women.
The study authors cataloged 56,051 new cases of early-onset cancer in 2010, and an additional 56,468 cases in 2019. These 417 additional cases in 2019 represented an increase of 0.74% over the decade.
In particular, rates of early gastrointestinal cancers increased the most between 2010 and 2019, followed by cancers of the urinary tract and cancers of the female reproductive tract, such as cancer of the cervix or ovary.
For early-onset gastrointestinal cancers, the most commonly reported cancers are colorectal, stomach, and pancreatic cancer. However, the rates of cancers of the appendix, intrahepatic bile duct, and pancreas increased faster over the decade.
Breast cancer also stood out for the researchers, as this type of cancer had the highest number of early new cases in 2019 specifically.
He explained that the study provides “a big picture, or a comprehensive view of what is happening.” Kala Visvanathan, MD, MHS, professor of epidemiology and oncology at the Johns Hopkins Bloomberg School of Public Health. However, there are still some missing pieces.
Visvanathan said the study did not look at mortality rates or the number of young people who died from cancer.
Nor does it include data on “individuals, what their risk factors are, including family history, diet or lifestyle,” she said. health.
This makes it difficult to determine why rates of early-stage cancer increased between 2010 and 2019. However, lifestyle and behavioral factors likely explain this rise at least in part.
The reasons for the increase are still not well understood. Dr. Matthew Colkeysaid chief of hematology and medical oncology at Boston Medical Center and Boston University health in an email. “Known risk factors such as obesity, diabetes and lack of exercise may play a role, although it is certainly possible that there are others that we have not yet identified.”
Stein added that diet — particularly higher consumption of alcohol, processed foods, and red meat — could also be behind the increase.
In addition to the different types of cancer the researchers saw, they also confirmed that the incidence of early-onset cancer changes dramatically depending on different demographic factors.
On top of the average 0.74% increase in early cancer cases, women saw a 4.35% increase in incidence over the course of the 2000s. The opposite was true for men, as cases of cancer at the onset of their appearance became less frequent, as they decreased by 4.91%.
The differences increased when the researchers stratified the results by race. People who were of Asian or Pacific Islander, or Hispanic descent experienced increases in rates of early-stage cancer by double digits (32.3% and 27.6%, respectively). Native Americans also saw an increase of 2.3%, while rates of early-stage cancer decreased for both black and white Americans.
Differences were also found between age groups. People between the ages of 30 and 39 saw the greatest increase in early-stage cancer rates, while cancer rates stagnated for the 40-49 age group and decreased for people over 50.
“If you look at age, what you see is that the increase is happening even in younger individuals, that 30 to 39-year-old group,” Visvanathan said. “For me, this is worrying.”
Again, it’s not entirely clear why early-onset cancer cases are divided by sex, race, or age differences. Visvanathan added that while it’s important to address these disparities, even the groups that saw a decline weren’t out of the way.
“Everyone is focusing on the ones that have changed, but they’re not looking at what the baseline is,” she said, adding that stagnant or slightly declining infection rates still paint a worrying picture.
It’s also important to remember that even as early-onset cancer cases are on the rise, they are still small compared to the rates of cancer associated with older age.
SEER data from 2013 to 2017 found that 350 out of 100,000 people ages 45 to 49 will develop cancer. This jumps to more than 1,000 per 100,000 people in age groups 60 and over.
More than anything else, studies like these are important so that healthcare professionals, policy makers, and even individuals can gain a better understanding of cancer risk.
Not everyone should start cancer screening at a young age, but it’s important that those who may be at increased risk because of family history, genetics, race or other factors, don’t delay that conversation with their doctor, Visvanathan said. .
Specifically for gastrointestinal and colorectal cancers, the U.S. Preventive Services Task Force lowered the recommended age for colorectal cancer screening from 50 to 45 in 2021, due to higher cases among younger adults. It is likely that in the coming years, other screening recommendations – perhaps for gastrointestinal or breast cancer – will be similarly modified.
“We’re not yet at the point of saying we should be doing screening tests like mammograms or colonoscopies for younger patients, but future studies can help explore this further,” Stein said.
If the guidelines are re-evaluated or updated, Kulkey added, it is critical that “members of underrepresented groups, who already face barriers to accessing health care, are aware of these screening guidelines and have access to cancer screening.”
In addition to the big picture recommendations, Visvanathan said, the study should also serve to raise awareness about the prevalence of early-stage cancer. In other words, people should remember that “cancer is not just a disease of the elderly,” Stein said.
This will be especially important when researchers consider the impact the coronavirus might have on cancer rates in the United States. The data used in this study ended in 2019, and it’s likely that in the years since, rates of early-onset cancer have grown even more.
Stein explained that many of the factors that can increase the risk of cancer, such as obesity, a sedentary lifestyle and alcohol use, have all been increasingly prevalent during the pandemic. It also made it difficult for some to access care.
“The pandemic has exacerbated many of the social determinants of health,” he said. “Many people have skipped preventive healthcare, including mammograms and colonoscopies, during the pandemic. We’ve seen an increase in advanced cancer cases as well, which is a clear and worrying trend.
In addition to simply recognizing the possibility of cancer early on, people should also do what they can to prevent it – this can include maintaining a healthy weight, avoiding smoking, and protecting the skin from the sun.
These strategies are not foolproof, of course. But being prepared and aware of the risk factors that lead to early onset of cancer – especially among certain population groups – is the first step to detecting it early.
“I’m still relatively young, so I say this with sympathy, but there is often a feeling among young people that I’ll worry about that when I’m older.” “This study reminds us that we should take care of our bodies in the here and now,” Stein said. “Eating healthy food, drinking less alcohol, losing weight, staying active – these are habits that can keep us healthy even in our 30s.”