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Why are more young people getting cancer? What to know as cases rise 

Provided by UChicago Medicine

It’s a mystery doctors and scientists have yet to solve: More younger adults are getting diagnosed with cancer.

The number of early onset cancer cases — those that occur in adults under age 50 — is rising by 1% to 2% annually, according to the American Cancer Society.

An analysis of global health data published in the journal BMJ Oncology predicts a 30% jump in early onset cancers between 2019 and 2030.

Meanwhile, celebrity cancer cases — including actor Chadwick Boseman’s death from colon cancer at age 43, or the cancer diagnosis at 42 of Catherine, Princess of Wales — have put a spotlight on young people facing the disease.

Oncologists at the University of Chicago Medicine Comprehensive Cancer Center say they’re seeing the increase firsthand, and that they are treating more patients in their 30s and 40s in many cancers, including breastcolorectal, and head and neck cancers.

What factors are causing cancer in young people?

Scientists and researchers are still searching for a specific culprit.

“We have yet to identify any singular reason, although it’s likely related to a multitude of factors — possibly including lifestyle or environmental ones,” said UChicago Medicine adult and pediatric oncologist Adam DuVall, MD, MPH.

Some possible reasons include:

  • Chronic inflammation: The body’s response to injuries and “invaders” can be caused by low physical activity, obesity, chronic stress, prolonged infections or chronic exposure to toxins.
  • Later-in-life birth and/or having fewer children: Reproductive factors can lead to a slightly higher breast, ovarian or endometrial cancer risk.
  • Gut microbiome changes: When this delicate network of bacteria is thrown off balance — possibly by processed foods, microplastics or other substances — it could be easier for tumors to grow.
  • Healthcare disparities: Inequities in care can limit access to healthy food and timely treatment.

Cancer prevention in young people: 6 simple strategies that can help

Young people diagnosed with cancer often fall below the minimum recommended age for screenings that can catch their disease early, said UChicago Medicine gynecologic oncologist Nita Karnik Lee, MD, MPH.

it’s more important than ever for young adults to add cancer prevention measures to their to-do lists.

Three key steps can help:

  • Know the screening, prevention and risk reduction options suitable for your age group
  • Learn about your family’s cancer history
  • Identify the health symptoms that should warrant an immediate visit to your doctor

Early detection offers the best chance for survival. While nothing fully protects against cancer, oncologists from the University of Chicago Medicine shared several ways for young adults to stay vigilant:

  1. See a primary care physician annually

An urgent care facility is fine for immediate care, but it’s also important to see a primary care physician. Go once a year for a physical, even if you’re not sick. Routine tests to measure blood pressure, heart rate and weight — as well as physical exams and blood tests — provide a wealth of data over time.

These visits also help build a personal connection.

“Talking to a doctor you’ve known for four, five years or longer about a new complaint is different than talking to somebody at a random urgent care who you just met,” DuVall said. “Your doctor knows you and won’t be quick to dismiss your concerns.”

  1. Learn your family’s medical history — and share it with your doctor

If possible, find out who in your family had cancer, what type and at what age. That information can be valuable — especially for gauging your risks of some of the more hereditary certain cancers, such as breast, ovarian, colon or prostate cancer. About 5% to 10% of all cancers are thought to involve genetics inherited from a parent, according to the National Cancer Institute.

“Your family history may modify what your screening regimens are,” Lee said. “Your doctor may say, ‘You know what? Your mom was 45 when she had colon cancer, so you need to start your colon cancer screening at a younger age or more frequently.’ If you don’t share that history, doctors may not know how to best tailor their recommendations for you.”

  1. Consider genetic testing

If you do have a strong family history of cancer, or if you want more information about your health, ask your doctor about genetic testing. This can involve a blood, saliva or cheek swab test. The results can help you understand your inherited cancer risks and if more regular screenings are necessary. A genetic counselor can help to construct a family tree and better assess risks or need to get testing done.

Over-the-counter genetic tests are not particularly reliable, Lee said. She recommends UChicago Medicine’s Comprehensive Cancer Risk and Prevention Clinic, which specializes in genetic testing and counseling.

“Not everybody who has a family history should automatically get a genetic test,” said Lee, who is also Associate Director for Community Outreach and Engagement at the UChicago Medicine Comprehensive Cancer Center. “There are a lot of nuances and medical and family history will be reviewed to decide if testing — and which test — would be best and whether a family member might want to undergo initial testing.”

There are disparities in genetic testing, Lee said.

“Minority patients are less likely to get appropriate testing based on family history alone, so we want to be sure young people ask and know about their cancer history on both sides of the family,” she said.

If genetic testing does uncover a mutation, that can put you at a higher-than-average risk for certain cancers. This may change recommendations for the age to start screening, or the type or frequency of a screening exam.

  1. Get age-appropriate cancer screenings and an HPV vaccine

Universal prevention starts early with a vaccination for human papillomavirus (HPV). The vaccine is recommended for boys and girls ages 9 to 26, and it can be given up until age 45. It has been shown to prevent several HPV-related cancers, including cervical, vulvar/vaginal, anal and oropharyngeal.

“The best thing is to get an HPV vaccine as soon as you’re eligible. You want it before you have exposure to HPV,” which is transmitted through sexual (genital skin to skin) contact, even if the infected person has no symptoms, said UChicago Medicine head and neck surgical oncologist Nishant Agrawal, MD.

For people who have an average risk of cancer, here are other screening milestones to know:

  • Starting at age 25: People with a cervix should get an HPV test every five years, even if they’ve been vaccinated for HPV.
  • At age 40: Begin receiving mammograms and talk to your doctor about the best screening plan.
  • At age 45: Start testing for colon cancer with a colonoscopy or stool testing.
  • At age 45: Men at high risk of prostate cancer (including Black men and those with close family members who had the disease before age 65) should talk to their doctors about screening.
  • At age 50: Receive annual low-dose CT scans for lung cancer if you have a smoking history of 20 pack years, currently smoke, or have quit within the last 15 years.
  1. Eat healthy foods, don’t smoke, and exercise regularly

There’s a reason every doctor recommends this. Poor eating, excessive alcohol use, smoking and an inactive lifestyle are proven to trigger — or worsen — almost every disease.

At least 18% of all cancers diagnosed in the U.S. are related to high body fat, physical inactivity, alcohol consumption and/or poor nutrition, according to the American Cancer Society.

  1. Pay attention to unusual symptoms that won’t go away

A new symptom might not indicate cancer, but it’s important to seek medical care to gain a better understanding of the situation. If you experience any of the following, call your doctor:

  • Blood in the stool or rectal bleeding
  • Changes in bowel or bladder habits
  • Changes in your breasts
  • Difficulty swallowing
  • Irregular vaginal bleeding
  • Lumps on the body
  • New abdominal pain or pelvic pain
  • New swollen glands
  • Persistent cough
  • Skin changes or irregular moles

“If there’s something different that’s happening, you should ask your doctor, ‘What tests can I do to help me figure out if this is something more serious?’ Be sure to advocate for yourself if something does not seem right to you,” Lee said.

For more information, visit https://uchicagomedicine.org/global

Adam DuVall, MD, MPH Assistant Professor of Medicine (Hematology & Oncology)
Nita Karnik Lee, MD, MPH Associate Professor of Obstetrics and Gynecology Associate Director, University of Chicago Comprehensive Cancer Center Community Outreach and Engagement
Nishant Agrawal, MD Professor of Surgery Chief, Section of Otolaryngology-Head and Neck Surgery

 

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