Progress in medical science has indeed helped improve life expectancy by enabling early detection of disease as well as cure. However, lifestyle changes have also increased incidence of the deadly disease of cancer, which is also manifesting early in people’s lives: “Breast cancer mainly affects middle-aged and older women – the median age of someone diagnosed with the disease is 62. But its prevalence, like that of many other cancers, is increasing in young people. Globally, the incidence of early-onset cancers – typically defined as ones that appear in people younger than 50 – rose by 79% between 1990 and 2019, with breast cancer accounting for the largest number of cases. Between 2012 and 2021, the diagnosis of breast cancer in women under 50 increased by almost 1.5% each year. Although breast-cancer survival rates are high – in America, 86% of women are alive ten years later, compared with 62% of women for all cancers generally – outcomes tend to be worse for young women, whose cancers are typically more aggressive.”
The early onset has its own ramifications on people’s lives: “ A diagnosis of breast cancer is devastating at any age, but in young people it can precipitate a unique set of crises. Treatment can induce early menopause and ravage fertility. Mastectomies can trigger body dysmorphia, which can be particularly harmful for young women, who often already suffer from insecurity about their appearance (especially if they are dating or looking for a partner). Many young patients are mothers, who somehow have to balance the needs of their children with the demands of their own care. And survivors have to live for decades with the side effects of treatment – which can include pain from nerve damage, extreme swelling and reduced lung capacity – and the fear of recurrence.
The uptick in breast-cancer cases among young women has also had unexpected social consequences. Young patients’ partners have become their carers decades sooner than they might have imagined; parents are taking in their adult children; and a new infrastructure of medical and mental-health care has developed to support this growing patient group.”
But why is this happening: “Shuji Ogino, a molecular epidemiologist at Brigham and Women’s Hospital in Boston and a professor at Harvard University, believes that the uptick is caused by changes to what researchers call our exposome – the environmental factors that influence human health. People are, on the whole, more obese and more sedentary than their ancestors; they are also more likely to drink alcohol and smoke too much, to eat ultra-processed foods, and to get too little sleep. All these trends are linked to an increased risk of cancer. From the time people are very young they are also more exposed than previous generations were to pollutants, carcinogens and microplastics, which can cause genetic mutations and even accelerate the growth of tumours.
In a study published in Nature in 2022, Ogino and his colleagues observed that the global rise in early-onset-cancer cases kicked off in the 1990s, with patients in their 30s and 40s. That would seem to indicate that human lifestyles profoundly shifted during the 1950s and 1960s, just as those people were born. It’s not difficult for doctors or even casual students of history to guess what changed: in the mid-century, many people gained greater access to cars and pre-packaged foods, and increasing numbers gravitated towards office jobs that kept them desk-bound all day. “We don’t know the whole picture yet,” Ogino cautioned. But one thing seems clear: our bodies are growing up in different environments from those of previous generations.”
The article goes on to share heart wrenching stories of the lives of young people being detected and battling out to deal with the after-effects.
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