A new study published in BJS by Oxford University Press has revealed a sharp global rise in early-onset gastrointestinal (GI) cancers, particularly among people under age 50. While overall colorectal cancer rates have declined in countries like the United States, early-onset cases, especially among those born after 1990, have surged significantly. In fact, people born in 1990 face twice the risk of developing colon cancer and four times the risk of rectal cancer compared to those born in 1950.
This trend is not limited to the U.S. A multi-country European study showed rising colorectal cancer rates among young adults and a 333% increase in teens aged 15-19. Today, early-onset colorectal cancer is the leading cause of cancer-related deaths for men under 50 and the second leading for women in the same age group in the U.S., with ethnic minorities, such as Black, Hispanic, Indigenous, and Asian communities, disproportionately affected.
Many early-onset patients are diagnosed at later stages due to delayed suspicion from both doctors and patients. Despite having similar clinical guidelines to older patients, younger adults often receive more aggressive treatment without clear survival benefits.
The emotional and financial burden is also heavier for them, as they are typically in their peak working years and may be managing family responsibilities or planning for children.
Compounding these challenges, many younger patients report inadequate support in dealing with fertility issues, despite clinical guidelines urging doctors to address this.
Additionally, survivors often face long-term quality-of-life struggles, such as anxiety, body image issues, sexual dysfunction, and depression, particularly among men.
Experts believe rising obesity rates, especially among youth, along with Western-style diets, alcohol, smoking, and liver disease, are key contributors to this surge. One study showed that women with a BMI over 30 nearly doubled their risk of early-onset colorectal cancer compared to those with healthier BMIs.
The paper concludes by emphasizing the urgent need for more research into the biology of early-onset GI cancers to guide improved prevention, screening, and treatment methods tailored for younger populations.
