WHY ARE CANCER RATES RISING IN ADULTS UNDER 50?

One of the most common risk factors for cancer is something we can’t do anything about—age. Our cancer risk increases as we get older, with the average age at diagnosis hovering around 68.

But a new study in Nature Reviews Clinical Oncology says that over the last few decades, doctors have been seeing dramatic increases in cancer in adults younger than 50. The disturbing trend has scientists searching for:

• Reasons behind the sharp increase in early-onset cancer

• How best to screen for or detect cancers in young adults

• Whether the cancers are different types of common cancers in older adults

• Which treatments show promise for younger people

Cancers in the under-50 age group may foreshadow an “emerging pandemic,” says the study’s researchers at Brigham and Women’s Hospital in Boston. Cancer patients under 50 are at a different point in their lives than the typical, older patient: They may be students, parents of young children, family breadwinners or caregivers to aging parents. Their cancer treatments may mean a different financial burden, one that hits during their prime incomeearning years. They may also face higher risks of other health issues, including infertility, heart disease and secondary cancers.

“Young adults often have a more challenging landscape than older adults diagnosed with cancer,” says Toufic Kachaamy, MD, Interventional Program Specialist and Chief of Medicine at Cancer Treatment Centers of America® (CTCA), Phoenix (he was not involved in the study). “When you’re 40 and get cancer, there’s a good chance that you’ve never been sick before. One day, you’re out to dinner or a party, the next thing you know, you’re on chemotherapy.”

While increased screening may partially explain the rising number of early-onset diagnoses, researchers say that doesn’t tell the whole story.

“Evidence suggests that the earliest phase of carcinogenesis might start in early life or young adulthood, followed by intervals of up to several decades between initial cellular damage and clinical cancer detection,” the study’s authors wrote.

Since the mid-20th century, many unhealthy changes have affected diet, lifestyle, obesity, the environment and our microbiomes. Those changes may now be occurring earlier in life and may be making humans more susceptible to cancer at a younger age. Studies also suggest the increase in early-onset cancers may be part of the growing trend in chronic diseases affecting younger adults.

If you’re a parent or thinking about becoming one, your concern about early-onset cancer should extend to your children. The study says that a woman’s smoking, diet, alcohol consumption and obesity during pregnancy may play roles in her child’s future cancer risk. Providing your children with healthy meals, limiting processed and sugary foods in their diets, encouraging them to exercise, watching their weight and avoiding their exposure to second-hand smoke may help reduce their future cancer risk at a time when they’re too young to make good choices for themselves.

“We found that this risk is increasing with each generation,” says Shuji Ogino, MD, PhD, a professor and physician-scientist in the Department of Pathology at Brigham who was involved with the study. “For instance, people born in 1960 experienced higher cancer risk before they turn 50 than people born in 1950, and we predict that this risk level will continue to climb in successive generations.”

HOW CAN PEOPLE UNDER 50 REDUCE THEIR CANCER RISK?

The Brigham researchers say preventing early-onset cancer may have to include promoting healthy diets and lifestyles in childhood and adolescence, discouraging smoking and alcohol consumption in those age groups, and encouraging physical exercise.

The authors say reforming food production may also help, so consumers have more choices than ultra-processed foods and drinks. They also say government actions, such as taxing sugar-sweetened beverages, may have an impact in discouraging unhealthy behaviors.

“I am personally optimistic that with essential education of the public worldwide, beginning with school-age children, and with concerted efforts to impact governmental policy, we will be able to have a major positive impact on controllable factors that increase cancer risk,” says Maurie Markman, MD, President of Medicine & Science at CTCA® (he was not part of the study).

To make a difference:

Exercise: Staying physically active helps to avoid a sedentary lifestyle. Even a modest amount of exercise each week, including brisk walks, may have an impact.

Eat healthy: A plant-based or Mediterranean diet reduces many cancer-related risk factors. These diets are high in fiber and lean protein and include fruits and vegetables that may help promote healthy gut bacteria in the microbiome, along with beans, whole grains and nuts, while limiting the amount of red meat and processed foods.

Maintain a healthy weight: Being obese or overweight increases the risk of cancer, so avoid a BMI higher than 30.

Don’t smoke: The carcinogens in tobacco smoke not only affect the lungs, but they also travel through the bloodstream and may increase the risk of digestive tract cancers and other cancers as well.

Drink in moderation: No amount of drinking is safe because of the damage alcohol may do to your cells. Health professionals recommend no more than one alcoholic drink per day for women and no more than two a day for men. Get vaccinated: Vaccines are available against cancer-causing viruses such as the human papilloma virus (HPV) and the hepatitis-B virus (HBV).