Incidence of Early-Onset Cancer Is Rising. What Should You Do?

Cancer, always a threat to broad categories of people, is now striking young adults more than ever. You’ve undoubtedly seen evidence of it in the news: High-profile cases include the 2020 death of actor Chadwick Boseman from colon cancer at age 43. This past March, Kate Middleton, Princess of Wales, announced that she is being treated for cancer. The Princess was 42 at the time of her announcement.

These are just well-publicized examples of a phenomenon that is being observed around the globe: The incidence of cancer in people under age 50 – known as early-onset cancer – is increasing.

Statistics show that rates of more than a dozen cancers are increasing in adults under 50. Models predict that the number of early-onset cancers will have increased by about 30% over 2019 numbers by the year 2030. A study published in 2023 showed that early-onset incidence of 29 cancers increased by more than 79% globally between 1990 and 2019. The number of deaths from early-onset cancers increased by nearly 28% in that same time.

A report on the subject from the American Cancer Society (ACS) highlighted colorectal cancer, which has grown to become the leading cause of cancer death in U.S. men under 50. Colorectal cancer in the past has typically struck men 60 and older. It’s also now the second leading cause of cancer death in women under 50.

Often early-onset cancers affect the digestive system, and some of the steepest increases have been seen in colorectal, pancreatic and stomach cancers. But many others, including breast and prostate cancers, are also on the rise.

Researchers are not sure why cancer is rising in young adults, but several factors seem to be at work.

“Some of those most often mentioned include rising rates of obesity, increased consumption of ultra-processed food, and sedentary lifestyles,” says hematologist oncologist Ranju Gupta, MD, with LVPG Hematology Oncology and Lehigh Valley Topper Cancer Institute. “There might also be environmental factors at work, including cancer-causing substances in our air, water and food.”

Other factors that have long been recognized to increase the risk for cancer include:

• Diets high in saturated fats, red meat, processed meat and sugar
• Diets low in fruits, vegetables, whole grains and fiber
• Excessive use of alcohol
• Smoking, including exposure to secondhand smoke
• Inadequate sleep
• Night shift work
• Reduced reliance on breastfeeding
• Changes in women’s health, including reduced age of first menstruation, reduced number of births, increased age at first and last birth, and increased use of oral contraceptives

The ACS has noted that almost half of all cancers are linked to these lifestyle factors:

• Obesity
• Sedentary lifestyle
• Smoking
• Alcohol
• Lack of exercise
• Stress

In addition to addressing risk factors like those above, everyone should know their family history of cancer.

“Are there close relatives who have had cancer? What kind of cancer? What were the details of their experience? This information is important to understanding your own risk,” says Dr. Gupta.

As the age of cancer onset has decreased, some authorities have suggested that people get screened for cancer earlier. For example, in 2018, the ACS urged people to be screened for colorectal cancer starting at 45, rather than the previously recommended age of 50. The U.S. Preventive Services Task Force has issued a draft recommendation that women now start mammograms at age 40. That recommendation was also for age 50 in the past.

Guidelines like these will continue to be reviewed, and probably altered. But note that they are aimed at people of average risk. You should talk with your doctor about your level of risk and what it means for your approach to screening.

“If you as a woman have a sister, mother or other first-degree relative with breast cancer, you have twice the average risk for breast cancer. This is why it’s critical for people to know their family history,” Dr. Gupta says. “Everyone should talk to their physician every year about cancer screenings. And they should make sure to get the screenings that are recommended.”

Always keep in mind the fact that appearances can be deceiving and feeling good is no excuse for ignoring checkups and preventive care. Too often, clinicians find cancer in young people who are fit and seemingly healthy. One poignant example is the 30-year-old who was training for a marathon. Despite her appearing to be in excellent health, it was eventually revealed that half her liver had been consumed by a tumor.

If you’ve neglected your preventive care or are behind on recommended screenings, whatever your age, take steps to remedy that immediately.

“Many cancers offer no symptoms in the early stages. That’s why screening is so important,” Dr. Gupta says. “Treatment can lead to a cure if cancers are detected early and before they spread.”