Early-Onset Cancer Cases Are Rising

In a review article published in Nature, scientists discuss the problem of the increasing burden of early-stage cancer [1].

Not just an old age disease

We tend to think of cancer as a disease of old age, and with good reason: cancer is indeed strongly correlated with age. However, in recent decades there has been a worrying rise in the incidence of cancer in people under the age of 50: early-stage cancer. The problem has become so prominent that the US National Cancer Institute has named it a research priority. His data suggest that cancer incidence in people aged 25 to 39 may increase by another 11 to 12% by 2030, and we can only speculate as to why. In this review, the authors have tried to summarize what we know about this phenomenon and provide some ideas as to why it happens and what can be done about it.

The usual suspects

Some possible reasons, like the obesity epidemic, come to mind immediately. Obesity is a risk factor for several cancers, including cancers with an increased incidence of early-stage cancer (in their review, the authors mention breast, colon, pancreas, oesophagus, endometrial, head and neck and kidney cancers, and multiple myeloma) . However, it must be noted that the relationship between obesity and breast cancer is more complicated: BMI is negatively associated with survival in early breast cancer but positive in late breast cancer [2].

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Another risk factor common to most of these cancers is a sedentary lifestyle, which can also promote obesity. Like obesity, a lack of physical activity among children and young adults is common, with three out of four American teenagers, particularly girls, not getting enough exercise [3].

Then there are unhealthy eating habits. The so-called Western diet, based on highly processed foods full of empty calories, significantly increases the risk of cancer, both by inducing obesity and by itself.

An unhealthy diet is a major and direct contributor to colon cancer risk [4]. In addition to obesity and type 2 diabetes, it also promotes inflammatory bowel disease, another risk factor for cancer [5]. Processed meats in particular have been linked to cancer, and there is some equivocal evidence for red meat as well. While growth in meat production in Europe and North America has almost ground to a halt, it is skyrocketing in Asia.

This is a good time to mention that the dynamics of early-stage cancer, as well as risk factors, differ significantly between countries and regions. For example, while the West is slowly weaning itself off its unhealthy diet, many developing countries seem to be accepting this due to the reduction in poverty.

Lesser Known Factors

Other factors may not be as obvious. For example, breast cancer has been shown to be positively correlated with earlier menarche (first menstrual period), use of oral contraceptives, nulliparity (not giving birth), older age at first birth, and never breastfeeding.

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Lack of sleep is another risk factor with a high prevalence among high school and university students [6]. While there is little robust data on whether sleep patterns have changed over the past few decades, a Stanford paper discusses the potential impact of smartphones and tablets.

But not everything is gloomy. First, early detection is definitely one of the factors behind the increase in cancer cases in people under 50; It captures slowly progressing cancers that previously could fly under the radar into old age. Second, smoking, a major risk factor for several types of cancer, is on the decline. The same applies to alcohol consumption, although not in all countries and regions.

paradigm shift needed

The authors advocate a paradigm shift that includes greater awareness of early-stage cancer. This corresponds to the current state of knowledge in the field of longevity. As geroscientists know today, damage to our cells and organs accumulates very early, probably even before birth, and even a young and vital organism cannot completely compensate for it. Regardless of when you quit smoking, for example, previous smoking remains a risk factor. Of course, it’s still a good idea to quit smoking.


This in-depth review raises awareness of the growing problem of early-stage cancer, catalogs possible causes and suggests ways to combat this growing trend. This reinforces the longevity realm’s position that the fight against aging should begin much earlier in life than previously thought.

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[1] Ugai T, Sasamoto N, Lee HY, Ando M, Song M, Tamimi RM, … & Ogino S (2022). Is early-stage cancer a looming global epidemic? Current evidence and future implications. Nature Reviews Clinical Oncology, 1-18.

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[2] Modi ND, Tan JQE, Rowland A, Koczwara B, Abuhelwa AY, Kichenadasse G, … & Hopkins AM (2021). The obesity paradox in early and advanced HER2-positive breast cancer: pooled analysis of clinical trial data. NPJ breast cancer, 7(1), 1-6.

[3] Rajbhandari‐Thapa, J., Metzger, I., Ingels, J., Thapa, K., & Chiang, K. (2022). School climate-related determinants of physical activity in high school students. Magazine for youth.

[4] Mehta RS, Song M, Nishihara R, Drew DA, Wu K, Qian ZR, … & Chan AT (2017). Dietary patterns and colorectal cancer risk: analysis by tumor site and molecular subtypes. Gastroenterology, 152(8), 1944-1953.

[5] Axelrad, JE, Lichtiger, S., & Yajnik, V. (2016). Inflammatory Bowel Disease and Cancer: The Role of Inflammation, Immunosuppression, and Cancer Treatment. World Journal of Gastroenterology, 22(20), 4794.

[6] Leger D, Beck F, Richard JB, & Godeau E (2012). Total sleep time decreases sharply during adolescence.

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