Cancer Before 50: Gastrointestinal Cancer is Skyrocketing Around the World

Rates of early-onset gastrointestinal cancers are rising sharply across the globe, with early-onset colorectal cancer now becoming a major public health concern. According to a new paper in the British Journal of Surgery, published by Oxford University Press, the global incidence of these cancers among adults under 50 is accelerating, particularly in high-income countries (1^✔ ✔Trusted Source
Early-onset gastrointestinal cancers: comprehensive review and future directions

Go to source). In the United States, while the overall age-standardized colorectal cancer rate dropped from 66.2 cases per 100,000 in 1985 to 35.7 in 2018, the incidence in younger populations has steadily increased.

Since the mid-1990s, cases among adults under 50 have risen significantly, with age-adjusted incidence rates increasing from 5.9 per 100,000 in 2000 to 8.4 per 100,000 in 2017. Adults born in 1990 face double the risk of colon cancer and four times the risk of rectal cancer compared to those born in 1950.

Colorectal Cancer Now Leading Cause of Cancer Death in Young Men

This cancer has now become the leading cause of cancer-related death among men under 50 and the second-leading cause among women under 50 in the United States. Disparities are particularly striking across racial and ethnic lines.

A National Cancer Institute analysis spanning from 1973 to 2009 revealed that 16.5% of American Indian and Alaska Native, 15.4% of Hispanic, 12% of Asian and Pacific Islander, and 11.9% of Black patients were diagnosed with colorectal cancer before age 50—compared to just 6.7% of non-Hispanic White patients.

A Centers for Disease Control and Prevention analysis further highlighted the sharp rise in early-onset cases, showing a 185% increase among people aged 20 to 24 and an astonishing 333% rise in those aged 15 to 19.

Delayed Diagnoses and Advanced Stage Detection Common in Young Patients

Younger adults often face delays in diagnosis, as symptoms are not typically associated with cancer by either patients or physicians. As a result, many are diagnosed only after the disease has progressed to more advanced stages, limiting treatment options and worsening outcomes.

Despite having the same official screening guidelines as those with average-onset cases, younger individuals are frequently subjected to more aggressive treatments. However, these treatments do not necessarily lead to better survival outcomes and can often lead to significant side effects and long-term complications.

Emotional, Financial and Social Toll on Young Adults

Younger patients with gastrointestinal cancers often experience unique challenges. Many are in their peak earning years, and the financial strain of cancer care can be overwhelming. For those with young families or plans to start one, the diagnosis can be particularly devastating.

Concerns about fertility are often overlooked. Despite recommendations from the American Society of Clinical Oncology to discuss fertility preservation, about 50% of patients of reproductive age report that their physicians did not address how treatment could impact their ability to have children.

Mental Health and Quality of Life More Severely Affected in Young Survivors

Survivors of early-onset colorectal cancer are more likely to face issues such as anxiety, sexual dysfunction, body image concerns, and reduced quality of life compared to those diagnosed later in life. Young male patients, in particular, are more susceptible to depression following diagnosis and treatment.

Social functioning and physical well-being also tend to be worse among these patients, making survivorship more challenging and less well supported within the current healthcare systems.

Obesity and Lifestyle Factors Key Contributors to Rising Rates

Several risk factors have been linked to this rising trend, including obesity, sedentary lifestyles, smoking, alcohol use, non-alcoholic fatty liver disease, and diets high in processed foods. Childhood and adolescent obesity, which continue to rise in the United States, is a major contributor.

In a 2019 analysis involving over 85,000 women, those with a body mass index over 30 had nearly twice the likelihood of developing early-onset colorectal cancer compared to women with lower body mass indexes.

Call for Deeper Understanding to Improve Outcomes

Lead author Sara Char emphasized the importance of advancing biological understanding of early-onset gastrointestinal cancers. She stated that ongoing research is essential for refining screening, prevention, and treatment approaches. As incidence rates continue to rise, targeted public health responses will be necessary to reduce disparities and improve patient outcomes.

In conclusion, the research reveals an urgent global trend: the sharp increase in early-onset gastrointestinal cancers, especially colorectal cancer, among young adults. Disproportionately affecting marginalized groups and driven by lifestyle-related factors, this alarming rise calls for earlier screenings, better physician awareness, and more supportive, individualized care for younger patients.

Reference:

1. Early-onset gastrointestinal cancers: comprehensive review and future directions - (https://academic.oup.com/bjs/article/112/7/znaf102/8191209)

Source-Medindia