CNN
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Yiana Dos Reis Nunes was 43 years old when she told her husband.
An ultrasound scan found spots on my liver, blood tests and a colonoscopy were done.
“I had a fist-sized tumor, but I had no pain, no bowel problems,” recalls her husband, Brendan Higgins, who works as an artist in New York City.
By the time doctors discovered it, Dos Reis Nunes’ colon cancer had spread. That means it was stage 4 and had reached other parts of her body.
The family was blindsided.
“She had a baby 15 months before her diagnosis, so she had a million blood tests. There was not.”
When cancer strikes an adult under the age of 50, doctors call it an early onset case. These cancers at young ages are becoming more common.
new review 40% of cancer registries in 44 countries report a rapidly rising incidence of early-onset cancers in colorectal cancer and 13 other cancer types, many of which affect the gastrointestinal system. We found that this increase occurred in many middle- and high-income countries. .
The review authors say the increase in young adults is partly due to improved sensitivity of tests for some cancer types, such as thyroid cancer.But tests don’t fully explain trends, say co-authors Shuji Ogino, professor of pathology at the Harvard TH Chan School of Public Health.
Ogino said the surge was likely due to an unhealthy stew of risk factors working together, some of which are known and others which require investigation.
He linked many of these risks to cancers such as obesity, inactivity, diabetes, alcohol, smoking, environmental pollution, and a Western diet high in red meat and sugar, not to mention shift work and sleep deprivation. It is pointed out that it has established
“There are also many unknown risk factors, such as contaminants and food additives. No one knows,” he said.
Ogino said the fact that so many of these cancers (8 out of 14 studied) involve the digestive system suggests that diet and the large role of the bacteria that live in the gut, called the microbiome, play a role. I think it shows
Dr. Elizabeth Platts, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, said: Editing the journal Cancer Epidemiology, Biomarkers & Prevention, which was not involved in this review.
get fat. Once upon a time it was rare. Not only is it becoming more common to have a dangerously high BMI, but people are becoming obese at an early age, and even as children, so the risk of these cancers increases with previous generations. It was built decades earlier than
The surge in early-onset colorectal cancer (the cancer Dos Reis Nunes had) is particularly steep.
According to Ogino’s review, the average annual increase in colorectal cancer among young adults in the United States, Australia, Canada, France and Japan was approximately 2% during the study period. In the UK, almost 3% per annum in England, Scotland and Wales. In South Korea and Ecuador, it is about 5% per year.
“It doesn’t look big, but you can think about inflation. If it’s 2% every year, it’s going to be a big change in 10 or 20 years,” Ogino said. “It’s not trivial.”
Between 1988 and 2015, these annual increases pushed the incidence of early-stage colorectal cancer from about 8 per 100,000 to about 13 per 100,000, according to another investigator. and increased by 63%. recent reviews It was published in The New England Journal of Medicine.
Studies show that approximately 1 in 10 colorectal cancers in the United States are diagnosed between the ages of 20 and 50.
Ogino’s review found something called the cohort effect. This means that the risk of early-onset cancer increases with each successive group of people born later. For example, people born in the 1990s have a higher risk of developing cancer early in their lives than those born in the 1980s.
Other malignancies on the rise in young Americans include malignancies of the breast, endometrium, gallbladder, bile duct, kidney, pancreas, thyroid, stomach, blood plasma cells, and a cancer called myeloma. increase.
Dr. Karen Knudson, CEO of the American Cancer Society, calls the review “a call to arms.”
Cancer is a serious diagnosis at any age, but when it occurs in young adults, tumors are usually more aggressive, and regular cancer screening can help detect the most common types of cancer, including: is not recommended and often leads to long periods of undetection. Until the age of 50, as the breast and prostate.
“These early-onset cancers are not only more likely to be diagnosed when the tumor is at a more advanced stage, but are also associated with worse survival outcomes in the several reports compiled here. “We were doing it,” said Knudson.
Dos Reis Nunes started therapy in 2017 Sloan Kettering Cancer Center and Mount Sinai Cancer Center in New York.
Her husband remembers doctors explaining that she was one of a growing number of young patients.
“I remember having discussions at both hospitals that colon cancer patients were getting younger and younger, but they couldn’t explain it,” Higgins said.
Higgins says he spent a lot of time in online support groups looking for answers and solace.
“And there were a lot of young people in those groups,” he said. “There weren’t people in their 50s and 60s living there. It’s like they’re in their 30s, 40s, 50s. So I was very conscious that this was no longer an old man’s disease,” he said. Told.
In fact, regular screening with colonoscopies and tests to check for blood in the stool has led to fewer cases of colorectal cancer and lower mortality among older people.
Knudson says three things should happen after such a large and definitive review:
“One is a call for research to really understand some of the specific trends we’re seeing,” she says.
Second, she wants to develop a greater awareness of risk. The hope is that this will enable people to modify their behavior and control the risks they can.
Third, groups that advocate cancer screening should reassess when screening should begin, she says. Some may start at a young age.
In fact it has already happened.
Last year, the U.S. Preventive Services Task Force was launched in response to the rising incidence of colon cancer among young adults. reduce age Doctors recommend that people over the age of 45 start screening for colon cancer.
“If you’re 45, you should really think about this rather than waiting until you’re 50 or 55,” says Higgins.
Higgins said his wife’s first 12 months of cancer treatment were almost miraculous, “like an amazing response to chemotherapy.”
“And I’ve actually read about this, and it could unravel really quickly,” he said. rice field.”
His wife died in 2019, leaving behind daughters Maeve, aged 11 and 20, who are not yet four.
“We had a great love story,” he said. “I’m still hurt. I’m still angry.
“Life is okay. We’re all fine. But deep down, I’m afraid that’s what happened to her. She was a really nice person.”
