The alarming rise of cancer in young adults and steps that could lower the risk

Cancer diagnoses are significantly increasing among young adults (20-50 years old), with colorectal cancer becoming the leading cause of cancer death for those under 50. This trend extends to over ten different cancer types, including breast, kidney, and uterine cancers, with the sharpest rise observed in people in their 20s.

William Brangham notes Chadwick Boseman (43) and James Van Der Beek (48) died of colon cancer. Dr. Veda Giri states 15% of Yale Cancer Center patients are diagnosed at age 45 or under. Dr. Shanthi Sivendran confirms colorectal cancer is the leading killer under 50 and 40% of cancers occur under 65.

The rise in early-onset cancers is attributed to a complex interplay of factors, including environmental changes, shifts in dietary patterns (e.g., increased consumption of ultra-processed foods), more sedentary lifestyles, and rising rates of obesity. These factors can collectively influence biological mechanisms, such as altering the gut microbiome, which plays a role in immune defense against cancer.

Dr. Giri explains 'birth cohort effects' where Gen X and later generations show higher rates. She cites ultra-processed foods, sedentary lifestyles, rising obesity, and their influence on the gut microbiome as potential contributors.

Family cancer history is a critical tool for determining individualized cancer screening schedules. If a first-degree relative was diagnosed with cancer at a young age, screening for that cancer type should typically begin 10 years prior to that relative's diagnosis age. Genetic testing can further refine these recommendations, with identified mutations (e.g., BRCA, Lynch syndrome) prompting screening to start as early as a person's 20s.

Dr. Giri details that if a mother had colon cancer at 45, a child should start colonoscopies at 35. She also explains how BRCA and Lynch syndrome mutations lead to screening in the 20s for breast and colorectal cancers, respectively.

Many early cancer symptoms, especially for colorectal cancer, are easily dismissed or attributed to less serious conditions (e.g., hemorrhoids, fatigue). Overcoming denial and stigma associated with discussing bodily functions is crucial. Persistent, unexplained symptoms like blood in stool, abdominal pain, changes in bowel habits, unexplained anemia, fatigue, or weight loss warrant immediate and persistent medical evaluation.

Laura Behnke's story highlights dismissing blood in stool as hemorrhoids during pregnancy. Dr. Giri lists specific colorectal cancer symptoms. Dr. Sivendran emphasizes the ease of explaining away symptoms and the need to 'look at your poop' and not ignore lumps.

When cancers like colorectal or breast cancer are detected at early stages, the cure rates are exceptionally high. The primary challenge in younger populations is the delay in diagnosis due to lack of awareness about age-appropriate screening or dismissal of symptoms, which can lead to diagnosis at later, tougher-to-treat stages.

Dr. Giri states that for early-stage colorectal or breast cancer, 'the cure rates are incredibly high... they are curable.' She warns that later-stage detection makes treatment tougher and increases spread.