Although cancer incidence and mortality rates for all cancers combined are considerably lower in younger adults than older adults, a disturbing pattern is beginning to emerge in the development of early-onset cancers, typically diagnosed in older patients, occurring in younger adults. The rising rates of obesity in the United States may be a key contributing factor in this trend—the prevalence of obesity is about 19% among children and adolescents between the ages of 2 and 19; 40% among adults between the ages of 20 and 39; 45% among adults between the ages of 40 and 59; and 43% among adults aged 60 and older1 and going up in all adult age groups. New research has found that by 2030, nearly one in two adults will have obesity2.
According to a recent study by the American Cancer Society and the National Cancer Institute, from 1995 to 2014, the incidence significantly increased for 6 of 12 obesity-related cancers—multiple myeloma, colorectal, uterine corpus, gallbladder, kidney, and pancreatic—in young adults between the ages of 25 and 49, with steeper increases seen in progressively younger ages and in successively younger generations.3
“We suspect that obesity might be one of the contributing factors for the increase in these cancers,” said Hyuna Sung, PhD, principal scientist and cancer epidemiologist in the Surveillance and Health Services Research Program at the American Cancer Society and lead author of this study. “Considering the latency period from the timing of exposure to cancer development, the impact of the obesity epidemic among youth may not have been fully manifested in the current cancer trends. The future burden of obesity-related cancers will likely increase in the population overall, as the younger birth cohorts at increased risk for cancer age enter the older age group.”
Trends to Watch in Early-Onset Cancer Among Young Adults
Although the percentages are small, incidences are increasing in some of the deadliest cancers usually found in older adults— colorectal, lung, breast, pancreatic, and multiple myeloma.
By Jo Cavallo October 10, 2020
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Weighing Risk Factors for Early-Onset Cancers
However, obesity alone does not fully explain the rise in early-onset cancers, especially colorectal cancer, in younger people. Other risk factors, such as smoking, diet, the microbiome, and lack of access to high-quality health care and screening, are also contributing to the development of early-onset cancers in this population.
In addition to colorectal cancer, which has seen an uptick of 2.2% a year from 2011 to 2016 in people younger than age 50,4 other cancers usually diagnosed in older individuals, including lung, pancreatic, breast, and multiple myeloma, are also now being found in younger adults. Although the incidences of these cancers in younger adults remain small, they are worth investigating in greater detail.
We asked five experts in these cancers to offer their perspective on the rise in early-onset cancers and their impact on young adults: Judy C. Boughey, MD, Professor of Surgery and a surgical oncologist at Mayo Clinic, Rochester, Minnesota; Benjamin A. Weinberg, MD, Assistant Professor of Medicine, Division of Hematology and Oncology at the Lombardi Comprehensive Cancer Center at Georgetown University; Geoffrey R. Oxnard, MD, a thoracic oncologist at Dana-Farber Cancer Institute [Editor's Note: Since this interview was conducted, Dr. Oxnard has taken a position at Foundation Medicine as Vice President, Global Medical Lead, Liquid Franchise]; Caitlin Costello, MD, Associate Clinical Professor of Medicine at Moores Cancer Center at UC San Diego Health; and Brian M. Wolpin, MD, MPH, Director, Gastrointestinal Cancer Center and the Robert T. and Judith B. Hale Chair in Pancreatic Cancer at Dana-Farber Cancer Institute.