Cancer Rates Are Rising in Young People. Here’s What You Need to Know

Cancer Rates Are Rising in Young People. Here’s What You Need to Know

By Karen E. Knudsen & Othman Laraki

Today a woman in her 30s faces higher odds of a cancer diagnosis than her grandmother did at her age two generations ago. Cancer incidence and mortality are rising in millennials and even younger populations, according to American Cancer Society (ACS) data, while rates among older Americans are declining. In July, a study found that both members of Generation X and Millennials face a higher risk than older generations of 17 types of cancer.

Cancer spares no one. Not a month goes by without the news of a celebrity, an acquaintance, a friend or a family member learning what each of us dreads to hear from a doctor: “You have cancer.” Just this March global attention was captured by the news of 42-year-old Catherine, Princess of Wales, who is married to the heir to the British throne, sharing the news of her cancer diagnosis.

In January the annual ACS cancer statistics report showed that people in the under-50 group were the only ones in the U.S. to experience an overall increase in cancer incidence from 1995 through 2020. Take colorectal cancer: incidence rates have increased by 1 percent to 2 percent per year since the mid-1990s in those younger than 55 years of age and decreased among those 65 and older. Meanwhile, in people younger than 50, colorectal cancer has jumped four spots to become the leading cause of cancer death for men and the second-leading cause for women.

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As the rate of cancer diagnoses among younger Americans continues to rise, we can no longer think of cancer as a disease of the elderly. What is going on?

Although we haven’t found a single reason for the increase, one thing is certain: we have a generational problem. Facts are stubborn things, and these alarming statistics demand answers. The 50-and-older population has benefitted from efforts to reduce cancer deaths. What new strategies can do the same for younger people?

Let’s start with what we know. The evidence shows that we can save lives by detecting cancer early, when treatment is more effective, less intensive and far less expensive. Regular, guideline-based screenings for the most common cancers, such as breast, colorectal and lung cancers, give the best chance for early detection. Screenings for cervical and colorectal cancers can also detect warning signs before cancer develops, which aids in disease prevention. In developing screening guidelines, organizations such as the U.S. Preventive Services Task Force (USPSTF) and ACS conduct an extensive scientific evidence review and consider the benefits, limitations and harms of each test. Cancer screening can have downsides, including the fact that some patients will be recalled for further evaluation based on an abnormal sign that will prove not to be cancer or will be diagnosed with a cancer that may not ever become life-threatening. The benefits of recommended cancer screening substantially exceed these harms, however. So it’s critical that young people pay attention to whether they have risk factors that mean they should get screened.

Continuing to raise awareness and discussing personal risk factors, such as unhealthy habits, environmental hazards and especially a family history of cancer, can significantly improve outcomes by guiding screening and treatment recommendations. But that formula and the system that activates it haven’t reached everyone under 50. For colorectal cancer, only 20 percent of eligible people aged 45 to 49 (ACS guidelines recommend this screening begin at age 45) reported being up-to-date with screenings in 2021 versus 80 percent of people aged 65 to 74.

The benefits of following these guidelines go far beyond a screening appointment. An accurate diagnosis and thoughtful decision on the appropriate course of treatment are two sides of the same coin–especially if cancer is caught early. A diagnosis may not mean radical surgery or expensive medications. If a patient has a slow-progressing prostate cancer, the best care is watching and waiting, known medically as “active surveillance.” Francis Collins, who led the sequencing of the human genome and was formerly director of the National Institutes of Health, recently shared his journey closely tracking a slow-progressing case of prostate cancer, which ultimately progressed but appears to have been caught in time to save his life. That can’t happen without a screening in the first place.

If you are under 50, you need to realize that you are not too young to develop cancer. Too often people with symptoms of cancer below the recommended screening age are reassured that they are too young to have cancer and that their symptoms must be linked to something less troublesome. And too often this delay in diagnosis has tragic outcomes. Screening guidelines are written for people at an average risk. A relatively small but meaningful percentage of adults instead have a family history and risk profile that warrants earlier screening. Almost one in three individuals who develop colorectal cancer when they are younger than 50 have a genetic mutation or relevant family history. Those who learn that they have hereditary risk factors through genetic testing should also start screening earlier.

Low adherence to screening guidelines isn’t young people’s fault. Guidance around cancer screenings hasn’t adapted to reach younger audiences. Information should find you in places that are relevant to your life–such as the websites and apps you use most often. As with media, it’s become clear that younger people consume health care differently. Adults under 50 are less likely to have a primary care physician who can understand risk factors that inform where to begin screening and what tests to use. As a younger adult, you may experience more barriers to accessing health care. You may be more likely to make trade-offs when seeking care, weighing health care co-pays against payments for rent, student loans or other financial priorities. And with the gig economy reshaping the workforce, the traditional medical practice’s hours are inconvenient for many workers. We need doctors and their services to be designed around your needs and convenience. Employer-based programs can also act as an additional touchpoint to engage with workers early and often to close screening gaps.

Nearly half of newly diagnosed cancers in the U.S.—42 percent, according to ACS researchers—are avoidable with a combination of prevention measures, such as eating a healthy diet and maintaining a healthy body weight. More than four million lives have been saved in the U.S. over the last 30 years because of a combination of cancer prevention–such as reduction in cigarette smoking–and improvements in early detection and treatments. With the right information about cancer risk, knowledge of screening and prevention options, as well as a path forward to receive the care they need, millennials can substantially reduce their risk of cancer. With two million cancer diagnoses in any age group expected in 2024—a record high—reaching younger Americans is more important than ever.