The Growing Incidence of Cancer in Young People: Causes, Risks, and Prevention Strategies

2023-05-30 18:55:49

The growing number of people under 50 with tumors is becoming alarming. This incidence is of particular concern for colorectal cancer. Scientists suspect certain aspects of modern life, such as diet and exposure to pollution, as the main factors behind this increase.

Age is considered to be one of the main risk factors for cancer, the leading cause of death worldwide in people aged 60 to 79. The vast majority of cases (9 out of 10) concern people over 50 years old. Aging is in fact accompanied by generalized tissue remodeling, during which many biomolecular anomalies have a strong tendency to appear and accumulate. These alterations can be epigenetic, or result from somatic mutations due to genome instability and mitochondrial dysfunction.

However, precisely how aging increases the risk of developing cancer in different organs is unclear. According to the consortium of Cancer Grand Challenges«
no single cellular process associated with an aging soma sufficiently explains cancer risk in all tissues “. In addition, the number of people under 50 with cancer has steadily increased over the past three decades, globally.

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An emerging global epidemic

For the majority of cancer types, the increase in cases among people under 50 is relatively modest, with a rate of 22% between 1993 and 2018 in the UK. However, this increase is consistent for many forms of cancer, not to mention that it affects high-income countries as well as low- and middle-income countries. In view of this trend, experts believe it could be an emerging global epidemic. ” I think the trend won’t stop anytime soon and it could accelerate », affirms Shuji Ogino of the Harvard Medical School, author principal d’une study epidemiology conducted with the World Health Organization (WHO).

The largest increase is seen for early-onset colorectal cancer (EOCRC), according to a new study recently published in the journal Science and conducted by a team from Harvard Medical School. The incidence of this form of cancer is increasing rapidly worldwide (2-4% per year) and is on track to become the leading cause of cancer death in the United States among 20-49 year olds by 2030 In 20 European countries, this growth is 2% per year among 40-somethings, 5% among 30-somethings and 8% among young adults (in their 20s).

In addition, certain forms of cancer (bowel, breast and prostate) seem to be more aggressive in people under 50 years old. This aggressiveness is probably due to the fact that the tumors can present unusual genetic mutations in young people, and are therefore more difficult to treat. Surprisingly and at the same time, an overall reduction in colorectal cancer cases is observed in the elderly. This decrease would be associated with the improvement of screening and prevention strategies.

A multifactorial increase

Since the incidence of cancer is generally linked to age, scientists believe that its increase in young people is linked to environmental factors. One of them would be our diet, the biggest increase being observed for cancers of the digestive tract. In addition, certain dietary habits are commonly associated with serious disease risks, such as excessive consumption of processed foods. The increase in the occurrence of certain diseases such as obesity and diabetes could also be to blame. Exposure from childhood to certain substances such as antibiotics and environmental pollution could also increase the risk of cancer.

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However, diet, obesity, pollution and lack of physical activity would only partially explain this increase. Other factors must therefore be considered, such as gaps in screening and prevention. Indeed, in many countries, cancer screening is only offered from the age of 50, depending on the type of tumour. Young people who may be suffering from cancer thus have a much lower chance of being diagnosed, not to mention their tendency to minimize the symptoms. According to Harvard researchers, patients under the age of 50 take 40% longer to receive a diagnosis than those older. Thus, it would not be excluded that the apparent aggressiveness of cancer in young people could partly result from a late diagnosis.

Social disparities, in particular unequal access to care, could also influence the incidence of cancer. Alaska Natives, for example, have the highest rates of colorectal cancer in the world. This increase would be even more obvious in African-American communities, with a cancer mortality rate 44% higher than that observed in Caucasian communities. This rate would be associated with the lack of access to certain food needs and mutual health insurance.

This high incidence is even higher in low-income countries, where the demographic index is generally very young. ” If you compare a map of poverty with a map of colorectal cancer mortality by region, you will find that they are surprisingly similar », declared Rebecca Siegel, lead author of a study on the same topic and director of research at the American cancer society. It is important to consider that in many countries the cost of a checkup or colonoscopy is very high, compared to the average per capita income.