David Cox’s story is about a subject that should be of interest to most of us: “There are rising cases of breast, colorectal and other cancers in people in their 20s, 30s and 40s…
The investigation’s early findings, presented by an international team at the Union for International Cancer Control (UICC) congress in Geneva in September 2024, were as eye-catching as they are concerning.
The researchers, from the American Cancer Society (ACS) and the World Health Organization’s (WHO’s) International Agency for Research on Cancer, surveyed data from 50 countries to understand the trend. In 14 of these countries, the rising trend was only seen in younger adults, with older adult rates remaining stable.
The results are the latest in a host of studies detailing a similar rise of a range of different cancers in the young.
Breast cancer is one form of cancer where the trend is apparent. A new report from the ACS found that while deaths from breast cancer in women have dropped by around 10% in the past decade, incidence rates are rising by 1% per year overall – and 1.4% per year for women under the age of 50.
Based on epidemiological investigations, it seems that this trend first began in the 1990s. One study found that the global incidence of early-onset cancer had increased by 79% between 1990 and 2019, with the number of cancer-related deaths in younger people rising by 29%. Another report in The Lancet Public Health described how cancer incidence rates in the US have steadily risen between the generations across 17 different cancers, particularly in Generation Xers and Millennials.”
So what is going on? Why is the incidence of cancer going up amongst young people even as it is going down amongst older people?
One driver it seems is excess body weight: “A recent study found that accumulating excess body weight between the ages of 18 and 40 is associated with a greater risk of up to 18 different cancers, while the Lancet report found that 10 of the 17 cancers which are growing in prevalence among the young in the US are obesity-related malignancies such as kidney, ovarian, liver, pancreatic and gallbladder cancers as well as myeloma…
We know that eating too much sugar and processed food, having consistently high blood glucose and becoming insulin resistant not only raises your risk of diabetes but also cancer.””
Secondly, changes in sleep patterns may be to blame: “…
Ogino feels that a heavily overlooked connection is the marked change in sleep patterns around the world which has occurred in 50-100 years. One study found that the average sleep duration of children and adolescents declined by 60 minutes per night between 1905 and 2008, while shift work has become increasingly prevalent in recent decades in Australia, China, Japan, Europe and North and South America. A 2021 study using data from the English Longitudinal Study of Ageing, a database which contains information from more than 10,000 people over the age of 50, found an association between poor sleep quality and greater risk of cancer.”
A third culprit could be artificial light: “…our near permanent exposure to artificial light, either through streetlights or mobile phones and tablets, represents a novel carcinogen through triggering disruptions in the body’s biological clock, something that has been linked to breast, colon, ovarian and prostate cancer. Studies have even suggested that continued light exposure during nighttime hours through shift work may facilitate cancer growth through lowering levels of the hormone melatonin.
“We are exposed a lot to artificial light at night, even from when we are babies,” says Ogino. “And in Japan, for instance, a substantial fraction of the population stay up to midnight every night. Shift work has become more common with things like 24-hour convenience stores.””
A fourth aspect which is causing alarm is microplastics: “In June 2023, Frank Frizelle, a colorectal surgeon at Christchurch Hospital, New Zealand, issued something of a call-to-arms for colorectal cancer specialists around the world, calling for greater investigation of the potential link between ingesting high amounts of microplastics and developing premature bowel cancer.
His provocatively titled paper, “Could microplastics be a driver for early-onset colorectal cancer?”, argued that the emergence of colorectal cancer as an increasingly problematic disease in the under 50s matches the timeframe over which microplastics have become exponentially more present in the environment. His suggestion is that the presence of these tiny plastic particles may disrupt the colonic mucus layer, which protects the lining of the bowel from various pathogens and toxins from our food.”
And lastly our growing consumption of antibiotics could be the culprit here: “Given the ability of antibiotics to wipe out large swathes of bacterial species and thus drastically reshape the gut microbiome in potentially harmful ways, greater antibiotic exposure has previously been linked to lung cancer, lymphomas, pancreatic cancer, renal cell carcinoma and multiple myeloma.
“The bacteria that live in the gut have been selected by some sort of Darwinian process and they’re part of the immune surveillance which allows our immune system to recognise abnormal cells, foreign particles, and prevent the genesis of malignancies in the first place,” says O’Reilly. “It’s still not known, but the idea is that greater antibiotic exposure could mean that immune surveillance is not working as effectively as it should.””
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