Why Is Cancer on the Rise in Young People?
Cancer cases in this group have jumped 30% over the last 40 years. Scary? Yes. But there's plenty you can do to reduce your risk.by Sarah Ellis Health Writer
We don’t typically think of cancer as a disease of the young. But the truth is that it can strike anyone, from young children to elderly adults. And if new research is any indication, there is one age group we should pay extra special attention to: adolescents and young adults.
A large December 2020 study in JAMA Open Network sheds light on some concerning statistics–the increase in cancer rates among people ages 15 to 39. Researchers found that between 1973 and 2015, cancer rates increased by 30%, with breast cancer and testicular cancer being the most common diagnoses. Every year since 2006, 70,000 or more people in this age group in the U.S. have been diagnosed with some form of cancer, a lower number than in older adults but a higher number than in children. The American Cancer Society notes that 5% of all cancers are diagnosed in people between 20 and 39 years old.
What’s causing this increase in cancer rates among young people? Experts say it’s a combination of environmental factors, lifestyle factors, and better screening practices. The good news: There are things you can do right now to lower your risk.
Why This Age Group Matters
“The reason we wanted to look at this population is because they’re somewhat excluded from other cancer populations,” says Nicholas Zaorsky, M.D., study author and radiation oncologist at Penn State Hershey Medical Center in Hershey, PA. He explains that when researchers study cancer, they often place patients into two main buckets: adults and children. But that leaves out a crucial segment of our population, one that can’t be put simply in one of those two categories.
“This is a cancer population that doesn’t normally undergo screening for cancer,” Dr. Zaorsky says, because they’re often considered to be a low-risk group. “They have a unique array of cancers that they might be susceptible to, because they’re older pediatric patients in some ways, but young for adult cancers.” They’re also under-represented in clinical trials.
Which Cancers Are Increasing and Why?
The most common cancers among the 15-39 age group include breast cancer, testicular cancer, thyroid cancer, non-Hodgkin lymphoma, and cervical cancer. But those aren’t necessarily the ones that concern doctors most. Instead, they’re worried about the cancers that are increasing among a notable portion of the young population. These include:
Colorectal cancer: 12% of colorectal cancer diagnoses, or 18,000 cases per year, occur in adults under 50 years old. “I do think the increasing rate of early-onset or young-onset colon cancer is very concerning and something we need to pay more attention to,” says Michael Roth, M.D., associate professor of pediatrics at The University of Texas MD Anderson Cancer Center in Houston. The death of “Black Panther” star Chadwick Boseman in August 2020 brought young-onset colorectal cancer to the forefront of public conversation. Family history and diet play a role in who gets it.
Lymphoma and leukemia: Experts still have a lot of questions about what causes these two forms of blood cancer, which is common among both older people and younger adults. The Leukemia & Lymphoma Society estimates that 7.2 per 100,000 people under 20 years old are diagnosed with one of these cancers–a number that is likely similar for people in their 20s, but lower as they enter their 30s. Risk factors include immune disorders, lifestyle, family history, and chemical exposure.
Melanoma: “The other one we saw was melanoma, and we think that’s because of UV exposure from tanning beds,” Dr. Zaorsky says. Family history, fair skin, and a history of sunburn or excessive sun exposure all contribute to your risk for this disease. It is one of the most common cancers in young adults and one of the most preventable.
Breast cancer: Despite its reputation as a cancer for older women, breast cancer can also occur in women in their 20s and 30s. According to the CDC, 11% of all breast cancer diagnoses are in women younger than 45. The danger here is that this group often isn’t getting regular mammograms, which aren’t generally recommended until age 40 and older. “As you get in your thirties, we start seeing a rise in breast cancer and colon cancer,” Dr. Roth says. “And unfortunately for these diagnoses, many of these patients have very poor prognoses.” Breast cancer in younger women is more likely to be aggressive or metastatic due to later diagnosis.
One other reason for the rise in cancer rates? Screening methods have improved drastically over the years. “Our diagnostic tools are better, and we are detecting some cancers that might be more indolent,” Dr. Roth says–meaning slow-growing, asymptomatic cancers that require no intervention (doctors will simply want to monitor them over time). He also worries about patients who were diagnosed with cancer as children, then exposed to radiation treatments that put them at greater risk of a second cancer diagnosis. “It’s possible that we are detecting more cancers in these patients because they have had more toxic exposures to help manage other diagnoses earlier in life,” he says.
What Can We Do About It?
“The good news is that the absolute rates are still relatively low,” Dr. Roth says. “One shouldn’t expect to be diagnosed with a cancer during this age.” But don’t write off your risk, either. “It is incredibly important that young people go to the doctor every year and get a general health check-up, make sure they’re talking with their doctors about their risks, exercise, and nutrition,” he suggests. “What you do now really does matter when you get older.”
Dr. Zaorsky agrees that a healthy diet and regular exercise are the best defenses in your control. “The standard [diet] in the U.S., for many people, isn’t ideal,” he says. Focus on eating whole foods, limiting processed foods, sugar, and alcohol, and sourcing fresh ingredients whenever you can.
Other than that, pay attention to your family history. If someone in your immediate family had cancer–especially if they had it young–you may need to start regular screenings earlier. Talk to your doctor about your risks and concerns. “This is a challenging time in our country, given everything that is going on with the pandemic,” Dr. Roth says. “Unfortunately, during these challenging times, many folks have abandoned or not paid as much attention to their health and well-being.” Don’t skip your appointments in an effort to stay safe. You won’t ultimately be doing your health any favors.
For those who do receive a cancer diagnosis, Dr. Zaorsky suggests getting involved in clinical trials. “We think that all cancer patients should go on a trial,” he says. It’s a great way to get access to cutting-edge treatments, often at low to no cost to you. Plus, you’ll be helping support the research needed to better understand these cancers moving forward, and ultimately to figure out a cure.
Cancer Rates Rising: JAMA Open Network. (2020.) “Trends in Cancer Incidence in US Adolescents and Young Adults, 1973-2015.” jamanetwork.com/journals/jamanetworkopen/fullarticle/2773343
Cancer in Young Adults: American Cancer Society. (n.d.) “Types of Cancers That Develop in Young Adults.” cancer.org/cancer/cancer-in-young-adults/cancers-in-young-adults.html
Cancer Stats: American Cancer Society. (n.d.) “Key Statistics for Cancers in Young Adults.” cancer.org/cancer/cancer-in-young-adults/key-statistics.html
Colon Cancer Rates: American Cancer Society. (n.d.) “Colorectal Cancer Rates Rise in Younger Adults.” cancer.org/latest-news/colorectal-cancer-rates-rise-in-younger-adults.html
Leukemia & Lymphoma: Leukemia & Lymphoma Society. (n.d.) “Childhood Blood Cancer Facts and Statistics.” lls.org/facts-and-statistics/overview/childhood-blood-cancer-facts-and-statistics
Mammogram Recommendations: American Cancer Society. (n.d.) “American Cancer Society Guidelines for the Early Detection of Cancer.” cancer.org/healthy/find-cancer-early/cancer-screening-guidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html
Breast Cancer in Young Women: BreastCancer.org. (n.d.) “Do Young Women Have Worse Breast Cancer Outcomes? It Seems to Depend on the Cancer’s Characteristics.” breastcancer.org/research-news/do-young-women-have-worse-outcomes
Breast Cancer Rates Young Women: Centers for Disease Control and Prevention. (n.d.) “Breast Cancer in Young Women.” cdc.gov/cancer/breast/young_women/index.htm
Second Cancers: American Cancer Society. (n.d.) “Second Cancers Related to Treatment.” cancer.org/treatment/treatments-and-side-effects/physical-side-effects/second-cancers-in-adults/treatment-risks.html