Health
Why are more young people being diagnosed with cancer?
The recent announcement that Her Royal Highness Catherine “Kate” Middleton, Duchess of Cambridge, who will become Queen of the United Kingdom, is undergoing treatment for cancer came as a shock to many. Middleton, 42, has three young children, George (10), Charlotte (8) and Louis (5). Her diagnosis comes at a time when the British royal family has been rocked by the recent deaths of Prince Philip (2021) and Queen Elizabeth II (2022), scandalous revelations about Prince Andrew, and a bitter feud between future King William and his younger brother Prince Harry. It was the latest blow to the country. And King Charles' other recent diagnosis of an undisclosed type of cancer.
Mr Middleton's diagnosis unfortunately reflects a global trend of rising cancer rates among people under the age of 50.
In the United States, this trend is primarily reflected through the increasing incidence of gastrointestinal (GI) malignancies. Actor Chadwick Boseman's death in 2020 at the age of 43 from metastatic colorectal cancer, the most common gastrointestinal malignancy, came as a shock to many. Still, Bozeman's diagnosis reflects a trend that the medical community has noticed for more than a decade, one that is spreading to other gastrointestinal cancers, particularly stomach, pancreatic, esophageal, and bile duct cancers. , the incidence of appendiceal cancer, etc. is increasing. .
The global impact of cancer on human health is clear. Cancer is the second leading cause of death overall Since 2007, cancer rates among adults age 50 and older in the United States have declined. Advances in both early detection and treatment have also improved cancer survival in that population.
However, over the same period, the incidence of malignant tumors in young people has steadily increased. A 2023 study using the National Cancer Institute's SEER database between 2010 and 2019 found that the overall increase in young cancers (<50 years) during the study period was 0.74%; It was shown that cancer incidence among people over 50 years of age decreased by 0.87%. In the younger cohort, gastrointestinal cancers increased the most at 14.8%, followed by endocrine cancers (8.69%) and breast cancers (7.7%).
of The most dramatic increase in cancer incidence It occurs in people between the ages of 30 and 40.
Similar findings are being seen around the world.a British Medical Journal survey A study of young-onset cancers (under 50 years of age) around the world from 1990 to 2019 showed a shocking 79.1% increase since 1990. cancer mortality rate During this period, cancer rates increased by only 27.7%, mainly due to improved treatments (5-year survival rates for all cancers increased from 49% in the 1970s to approximately 69% in 2019). did).
Again, early-onset breast cancer was the most common malignancy in this age group, but the largest increase was seen in gastrointestinal malignancies, a finding that is similar in North America, Europe, Australia, and Asia. was.a Recent research from Canada individual showed Born after 1980 They were 2 to 2.5 times more likely to be diagnosed with colon cancer than previous generations of the same age.Recent systematic review Early-onset colorectal cancer findings from 40 studies across 5 continents and 12 countries show a 30% increase in early-onset colorectal cancer worldwide over the past 20 years . This kind of discovery U.S. Preventive Health Services Task Force It is recommended that the target age for regular colorectal cancer screening be lowered from 50 to 45 in 2021.
Similar to Kate Middleton's experience, the burden of early-onset cancers is borne more by young women than by men, but this is partly due to breast cancer, endometrial cancer, and ovarian cancer in the female population. The prevalence of invasive cancer is slightly higher in men (41.6%) than in women (39.6%), despite the increasing incidence of invasive cancer and the higher lifetime diagnosis probability.
Cancer is always a startling diagnosis. It can be even more frightening when a cancer diagnosis is made to a young, working person. My wife, Daphne, is a young-onset cancer survivor who was diagnosed with lymphoma at age 28 and breast cancer at age 42. In clinical practice, usually healthy girlfriends, including myself at age 32, diagnose early-onset gastrointestinal malignancies. I was diagnosed with stomach cancer earlier this year.
So why is this happening?
It is clear that environmental concerns are at play. Diet is certainly a factor.quoted earlier british medical journal The article states that “Dietary risk factors (such as a diet high in red meat, low in fruit, high in sodium, and low in milk), alcohol intake, and smoking are the main risk factors underlying early-onset cancer. It concludes that “there is” (). A 2022 review paper examining the impact of diet on the incidence of early-stage cancer found that a Western diet (low in fiber, high in fat, high in processed foods, sugar, and red meat) was associated with a higher incidence of early-stage cancer. It has been suggested that it is a pro-inflammatory effect that may lead to an increase in the . Chemicals present in our environment It can also cause cancer. More than 87,000 chemicals have been approved for human use, but fewer than 1,000 have been tested as carcinogens. Formaldehyde, perfluorinated chemicals (PFCs) used in nonstick surfaces, and certain components of polyvinyl chloride (PVC) have been shown to be carcinogenic. (This is just the tip of the chemical iceberg.)
Other studies have linked consumption of sugary drinks, obesity, and consumption of microplastics (abbreviated as MP) as possible causes. Most of these are intestinal microbiota, it is recognized that it has a profound and increasingly important impact on individual human health. Dysbiosis is a change in the gut microbiota in response to environmental or host-related changes associated with disease manifestation, detection, or treatment.
Dysbiosis affects a variety of conditions, including inflammatory bowel disease (IBD), neurodegenerative diseases (such as Parkinson's disease and Alzheimer's disease), diabetes, autoimmune diseases such as lupus and rheumatoid arthritis, and cancer. is increasingly recognized. Changes in intestinal flora It increases the risk of gastrointestinal malignancies by inducing chronic inflammation, producing mutagenic metabolites, altering stem cell dynamics, and stimulating cell proliferation. Chronic inflammation due to H. pylori has been associated with the development of both gastric adenocarcinoma and gastric lymphoma, with very specific changes in the gut microbiota composition (i.e., increased numbers of oral bacterial species such as Fusobacteria). ) is associated with the development of gastroenteritis. Colorectal cancer.
The idea that microplastics contribute to early cancer development is particularly interesting. Plastic products have been used around the world since the early 1900s, but became even more popular after 1945. Plastics in the environment are broken down into microparticles (MPs) that humans ingest throughout their lives and interact with the lining of the gastrointestinal tract.It has been shown that Ingestion of MP can destroy the protective mucus layer of the gastrointestinal tractIt affects the composition of the protective gut flora, especially in the colon and rectum, and can lead to increased exposure to carcinogens in the digestive system. Although a direct causal relationship has not been established, the temporal correlation between the emergence of microplastic exposure and increased early cancer development certainly raises concerns.
The increased incidence of early-onset cancer is clearly a product of environmental influences. This is likely the result of several different variables. This is due to the typical Western diet of ultra-processed foods with a relatively high content of animal fat and a low proportion of fruits, vegetables, and whole grains. Ingested toxins and food additives, changes in the gut flora due to these and other effects, and growth of ingested microplastics are also part of the equation. To reduce cancer risk for generations to come, scientists will need to focus their research efforts on all of these potential causative agents.
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