People in their 20s, 30s and 40s haven’t had to worry as much as older adults about being diagnosed with cancer. For them, the focus has been on the steps they may take to reduce their risks for developing cancer in the future.
However, for a growing number of adults under 50, a cancer diagnosis is becoming a fact of life. Skin cancer, breast cancer, thyroid cancer and colorectal cancer are among the most common in these age groups, and cancer researchers are trying to understand what is behind the rising numbers in recent years.
"It is our job as experts in this field to really interrogate each person and figure out what is driving this change, especially this type of really epidemic type change in our younger folks," said Edward Kim, MD, MBA, Physician-in-Chief at City of Hope® Orange County, in an interview with KABC-TV about early onset colorectal cancer.
"If it's something in the food, the plastics, the environment? Not sure," he said.
Dr. Kim’s observations are in line with a study released in December—by a national nonprofit organization dedicated to health care cost transparency—that reviewed billions of health care claims filed between 2016 and 2023.
The FAIR Health study, Cancer in Young Adults, found that while overall cancer treatment rates had declined during that time period, including for those younger than 50, the rates for younger adults bottomed out in 2020 and began ticking up again over the next three years.
Between 2020 and 2023, the claims-based research found:
- An 11.7 percent increase in cancer patients aged 18 to 29
- A 7.2 percent increase in cancer patients aged 30 to 39
- A 7.5 percent increase in cancer patients aged 40 to 49
While the 2020 rates may have been lower than normal due to people avoiding health care services during the COVID-19 outbreak, and the 2021 rates were affected by many people only seeking health care services for COVID, the report said that “even compared to 2019, the cancer treatment rate in patients aged 40 to 49 increased 3.5 percent.”
This article will examine:
- Cancer by age groups
- Troubling trends in younger adult cancer rates
- What cancers are impacting younger adults?
- Proactive steps you can take
If you or a loved one have been diagnosed with cancer and want to get a second opinion of the diagnosis or more information about treatment options call us or chat online with a member of our team.
Cancer by age groups
The vast majority of cancer cases involve adults over the age of 50 and new research on increasing rates in younger adults doesn’t change that.
As the body ages, it is more susceptible to cell mutations that may lead to cancer. Weaker immune systems, an increasing amount of chronic conditions and the development of age-related biochemical processes that impact genes may also play a role in cancer’s disproportionate impact on older adults.
The National Cancer Institute’s data as of March 2021 shows the median age for a cancer diagnosis is 66—and more than 80 percent of all cases are in people over the age of 55. The statistics hold true for individual cancers as well, with a median age of 67 for colorectal cancer, 71 for lung cancer, 62 for breast cancer and 66 for prostate cancer.
Some cancers are more common in the very young, the NCI says, with about a quarter of bone cancer cases being diagnosed in children and adolescents under age 20, as well as 12 percent of brain and other nervous system cancers. Overall, however, those under age 20 account for only 1 percent of all cancer cases.
Likewise, the cancer rates in younger adults, those between the ages of 20 and 50, are also very far from the levels in people who are 60 and older. Fewer than 20 percent of cancer cases are diagnosed in adults aged 20 to 55.
Troubling trends in younger adult cancer rates
So, why is there concern about cancer in younger adults when news on the cancer front has been so encouraging in recent decades, with overall cancer incidence and death rates declining?
Years of progress in treating cancer, improved screening to diagnose cancer sooner and greater awareness of factors that may increase or decrease someone’s risks for developing cancer have contributed to those improving statistics.
In addition, breakthrough treatments should help keep those rates in decline. In particular, the use of the Hepatitis B and HPV vaccines are having an increasing impact on reducing some cancers linked to those viruses as their use becomes more widespread.
In some ways, these positive developments are raising concerns about what is happening among younger adults because those individuals should, at least in theory, be benefiting from them.
A report in the August 2024 edition of The Lancet Public Health found increasing rates in younger adults in 17 of 34 cancers researchers examine—“including nine that previously had declining incidence in older birth cohorts.” The findings, the report said, showed the need to “identify and tackle underlying risk factors.”
A 2023 study in BMJ Oncology found divergent trends regarding early onset cancer between 1990 and 2019, with increasing global rates of younger adults being diagnosed with cancer over that time, but a decreasing rate of younger adults dying from the disease. The report, with lead authors from Zhejiang University School of Medicine in China and from Harvard University, said the early-onset cancer incidence rate had increased 79.1 percent over those 30 years, while the corresponding death rate had decreased 27.7 percent.
The report’s sobering news for the future? It projected early-onset cancer cases would increase by 31 percent by 2030—and that the death rate would also go up by 21 percent.
“Dietary risk factors (diet high in red meat, low in fruits, high in sodium and low in milk, etc.), alcohol consumption and tobacco use are the main risk factors underlying early-onset cancers,” the study said. “Encouraging a healthy lifestyle could reduce early-onset cancer disease burden.”
What cancers are impacting younger adults?
Breast cancer had the highest incidence rate of early-onset cancer cases in the United States in 2019, while gastrointestinal cancers had the fastest-growing early-onset rates in the country between 2010 and 2019, according to an August 2023 report in JAMA Network Open from the Yong Loo Lin School of Medicine in Singapore. They were followed by urinary system cancers and cancers of the female reproductive system, which had the next fastest growth rates.
“Among gastrointestinal cancers in 2019, the most common types of incident early-onset cancers were in the colon and/or rectum, stomach, and pancreas,” the report said. “During the study period, the gastrointestinal early-onset cancers with the fastest-growing incidence rates were in the appendix, intrahepatic bile duct, and pancreas.”
In addition, the report found that the increases in early-onset cancer in the United States between 2010 and 2019 disproportionately impacted:
- Females
- American Indians and Alaska Natives
- Asians or Pacific Islanders
- Individuals aged 30 to 39
“There is a need to inform health care professionals about the increasing incidence of early-onset cancer, and investigations for possible tumors need to be considered when clinically appropriate, even in patients younger than 50 years,” the study said.
The American Cancer Society reports that younger women have a larger share of the cancer cases than men of the same age. They had an 82 percent higher cancer incidence rate than men in 2021, compared to a 51 percent higher rate in 2002. Increasing cases of breast cancer and thyroid cancer in women were a major reason behind the trend.
“The increase in cancers observed in younger women is concerning,” says Maurie Markman, MD, President of Medicine & Science at City of Hope® Cancer Centers in Atlanta, Chicago and Phoenix, who was not involved in the study. “Several hypotheses can be advanced to partially explain the data, including later childbearing, changes in tobacco and alcohol consumption among women, and the staggering increase in obesity within the population.”
Proactive steps you can take
Given the rising trend in cancer cases in younger adults, research shows people of all ages may lower their cancer risk—or help identify a potential risk—by taking the steps listed below.
Get vaccinated: The HPV vaccine is recommended for children starting at ages 11 and 12, up to age 26, to help prevent many cancers of the reproductive system—including cervical, vaginal, vulvar, anal and penile cancers—as well as some oral cavity cancers. The hepatitis B vaccine may help prevent liver cancer.
Know your family’s medical history: Since some cancers are passed through the genes and inherited, you should know what cancers may run in your family and put you at greater risk for developing those cancers.
Don’t rule out cancer: Younger people shouldn’t rule out cancer as a possibility for unexplained symptoms. If doctors are having a hard time diagnosing the cause of such symptoms, they should at least consider the possibility of cancer. A screening may be helpful, even if you’re younger than the recommended age for a screening.
You should also be aware of the basics when it comes to lowering your risk for developing cancer. These include those listed below.
Don’t smoke: There is a proven link between smoking and cancer. It’s also important to avoid secondhand smoke, since it also is a risk factor for cancer.
Eliminate or reduce your alcohol consumption: Studies show that drinking any amount of alcohol is a risk factor for developing cancer. Consider giving up drinking completely or at least reducing your intake as much as possible.
Maintain a healthy weight: Obesity is a risk factor for many different types of cancer.
Eat healthy: The foods you eat are just as important as the amount you eat. Avoid red meat, fried foods, highly processed meats and foods, and those with sugar. Instead, doctors recommend diets that are low in sodium and eating plenty of fruits, vegetables and whole grain foods.
Cover yourself outdoors: Wear protective clothing when out in the sun and use sunscreen on exposed skin to protect against skin cancer.
Exercise: A sedentary lifestyle is a risk factor for cancer, so make sure you’re getting enough physical activity. The American Cancer Society recommends 50-300 minutes of moderate-intensity exercise each week or 75-150 minutes of vigorous-intensity activity.
Be aware of potential dangers around you: Many environmental factors may increase your risk for developing cancer, such as from pollutants and exposure to chemicals and pesticides. Avoid contact with such substances or wear protective gear when necessary.
If you’ve been diagnosed with cancer and want to get a second opinion on your diagnosis or treatment options, call us or chat online with a member of our team.
