Why are more people being diagnosed with cancer at younger ages?

BARCELONA, Spain — Between 1990 and 2019, the global incidence of early-onset cancer (EOC) increased by 79.1% increaseIrit Ben Aharon, MD, of the Rambam Healthcare Campus in Haifa, Israel, presented these startling figures during her talk. Keynote Speech in European Society for Medical Oncology (ESMO) Annual Congress 2024The session featured Dr. Shuji Ogino, MD and PhD, from Harvard Medical School and Brigham and Women's Hospital in Boston.

Available data suggest that the international oncology community is facing a true epidemic that can no longer be ignored.

A generation at risk

Ogino emphasized that the incidence of EOC, defined as cancer diagnosed in people under the age of 50, has been rising sharply for decades. This increase is just the tip of the iceberg, and as these younger patients age, there will also be an increase in chronic diseases and cancers in the elderly. In particular, many of these cancers affect the digestive tract, obesityHe emphasized the importance of the microbiome and diet.

“Focusing only on the present is not enough to fully understand why cancer is increasing among younger people,” Ogino said. Recent editorials The paper, which he co-authored, emphasizes the importance of assessing risk factor exposure starting early in life and continuing regular screening even for people who do not have cancer.

Epidemiological data show, for example, Colorectal cancer While the incidence of colorectal cancer in all age groups has been increasing since the 1950s, early-onset colorectal cancer only began to increase in the 1990s. How can we explain this 40-year gap? The postwar period could have been a turning point. Many lifestyle and environmental factors changed during this period, and the figures show a birth cohort effect. In other words, children born after the mid-20th century were exposed to known risk factors such as unhealthy diet, overweight, and lack of physical activity from an early age.

“In recent years, there have been various reports in the international literature about an increase in cancer among young people. Some of these publications have also attracted considerable attention in the media,” explained Massimo Di Maio, MD, President-elect of the Italian Society of Oncology. Univadis ItalyMedscape Network Platform. Di Maio said these publications confirm the perception, frequently reported by oncologists, that in recent years there has been an increase in cases of various cancers among young people. He stressed that EOC can only be understood by looking at the past of these generations and looking towards their future health.

“Paying attention to risk factors and lifestyle habits starting from an early age is very important,” Di Maio explained. “The more damage your body's cells undergo, the more likely it is that you'll develop cancer sooner, even at the same age.”

Change your perspective

Ogino stressed that research should be designed to collect data and samples from the early stages of a person's life and store that information over the long term.

This is easier said than done: “Collaboration between adult and pediatric researchers is not very active. Moreover, it is difficult to obtain funding to pursue such research, and researchers may be reluctant to see the results of their work decades after it began,” Ogino explained.

One possible approach is to use data already available from childhood cohorts. These data, which often include biological samples and genetic information, have been collected from populations of children who are now adults and can therefore help understand exposure to risk factors in early life and link it to outcomes in adulthood. A prime example is the UK Birth Cohort Study. National Health and Development SurveyIt began in 1946.

“Pediatric databases are currently not used to study subjects' adulthood diseases,” Ogino said, explaining that valuable data is being lost as a result. Returning to the question of whether these cancers are environmental or genetic, he stressed that genes also play a role, and that it is important to link these two aspects for more targeted prevention.

To curb this epidemic in an era of tumor testing and anti-obesity drugs, Ogino suggested rethinking prevention strategies, such as initiating testing earlier and considering pharmacological prevention.

But Di Maio believes this approach is premature. “Screening programs are based on demonstrated efficacy, which will be established over many years. In my opinion, it is not reasonable at this time to consider changing the screening pathway, including lowering the starting age, because such changes are not sufficiently supported by evidence of benefit,” he said. Di Maio also believes it is premature to commit to using anti-obesity drugs for prevention, beyond their approved indications to date. “The fight against overweight and obesity is not just a pharmacological issue,” he said, emphasizing the importance of lifestyle.

Ben Aharon declared financial interests with AstraZeneca, MSD, and Merck (invited speaker), and Bristol-Myers Squibb and Astellas (advisory board member). Ogino and Di Maio, who did not participate in the session, declared that they have no conflicts of interest.

Cristina Ferrario is a molecular biologist and former researcher in molecular oncology at three Milan Institutes. She holds a Master's in Communication and Health from the University of Milan (Milan) and a Master's in Cancer Genetics from the University of Pavia (Italy). She has worked as a science journalist for more than 20 years.

This story is Univadis Italy As part of our process, we use multiple editing tools, including AI, and a human editor reviewed this content before publishing.