Rising Rates of Cancer in Young Adults — What You Need To Know

Age is a major risk factor for cancer and is most typically diagnosed in people ages 65 to 74. But early-onset cancer — or cancer found in people ages 18 to 49 — is rising at an alarming rate.

The American Cancer Society reports increases in 17 of 34 cancer types in the Gen X and Millennial populations. Death rates for some cancer types are increasing, too.

We asked colorectal surgeon David Liska, MD, to explain the rise of cancer in young adults.

Why is cancer increasing in younger adults?

There’s no definite answer to this question, but there are theories, says Dr. Liska.

Experts have identified what they call a “birth cohort effect,” showing that people born from the 1960s onward are seeing increased cancer rates. The effect is consistent across all industrialized countries, not just the United States.

“The assumption is that there must be an environmental exposure that started in those years and affected subsequent generations,” explains Dr. Liska. He adds that there’s likely more than one environmental factor at play.

Experts also draw a parallel between the obesity epidemic and the rise in early-onset cancer. Obesity and a sedentary (inactive) lifestyle are risk factors for many cancer types.

“That parallel is clear, but it’s important to note that there are plenty of young adults with cancer who are very active and at a healthy weight,” he clarifies. “Rising obesity rates aren’t the only factor.”

Which cancers are most common in young adults?

The most common cancer in adults under 50 is breast cancer. But rates are also high for other early-onset cancer types, including:

• Cervical cancer
• Colorectal cancer
• GI (gastrointestinal) cancer
• Lymphoma
• Melanoma

“Breast cancer is the most commonly diagnosed early-onset cancer,” Dr. Liska says. “But from a mortality standpoint, colon cancer in young adults has a more significant impact.” (Colorectal cancer is the leading cause of cancer deaths for adults under 50.)

Dr. Liska also notes that cancers such as appendiceal (appendix) cancer and prostate cancers are increasing in younger adults but are still considered very rare.

Is cancer diagnosed differently in young people?

There are recommendations for when people should begin cancer screenings, but early-onset cancer is often detected at a younger age than the recommended age for those suggested check-ups.

That means younger people typically aren’t getting diagnosed through screenings. Instead, they usually have symptoms that lead to a cancer diagnosis.

Symptoms of cancer can be specific to the type of cancer, but general signs of cancer in young adults include:

• Fatigue
• Unexplained weight loss or loss of appetite
• Weakness
• Pain

But research and surveys show that younger adults tend not to promptly bring those symptoms to the attention of a healthcare professional, says Dr. Liska. (Young adults tend to see medical providers less often.)

In addition, Dr. Liska says physicians are often less likely to test for cancer when young patients show those general symptoms.

Compared to cancer diagnosed in older adults, early-onset cancer is more likely to be:

• Aggressive or advanced stage. Dr. Liska says it’s not clear whether early-onset cancer tends to be inherently more aggressive or if it just gets caught at a later stage.
• Hereditary. Most early-onset cancers aren’t due to a hereditary condition, but the percentage of cancer cases due to an inherited genetic syndrome in younger populations is higher than in older age groups.

How can you avoid cancer as a younger adult?

There’s no surefire way to avoid cancer. But people can reduce their risk of early-onset cancer in several ways, including:

• Being proactive. Cancer vaccinations, such as the HPV vaccination, can be effective in preventing cervical cancer. And get screened for common cancers as soon as recommendations allow. For people of average risk, that means screening at age 40 for breast cancer, 25 for cervical cancer and 45 for colorectal cancer.
• Knowing your family history. A family history of cancer can determine your screening guidelines and whether or not prophylactic (preventive) surgery is an option.
• Living a healthy lifestyle. Get regular exercise and eat a whole-food diet. Avoiding deli and red meat can reduce your risk of colorectal cancer. Avoid excessive drinking and don’t smoke, as tobacco use is a well-established risk factor for many types of cancer.

Dr. Liska also stresses the importance of bringing any new symptoms to the attention of a healthcare provider right away to see if you need testing.

“The earlier you diagnose cancer at any age, the better the outcome,” he emphasizes. “In younger adults, recognizing symptoms and taking action is the best way to identify and treat cancer early.”