Fewer Americans are dying from cancer, part of a decades-long trend that began in the 1990s as more people quit smoking and doctors became more likely to screen for certain cancers.
However, the American Cancer Society warned that these gains are threatened by a increase in cancer among people under the age of 55, especially cervical and colorectal cancer, and by persistent disparities between white Americans and people of color.
“The continued sharp increase in colorectal cancer among younger Americans is alarming,” said Dr. Ahmedin Jemal, senior vice president for surveillance and health equity science at the American Cancer Society and senior author of the study published Wednesday in CA: A cancer journal for physicians. His comments came in a press release accompanying the findings.
Cancer is the second leading cause of death in the United States, after heart disease, with smoking being a major contributor to both causes of death. As more Americans have quit smoking, rates and deaths from smoking-related cancers have seen long-term declines.
Problematically, younger people have seen a steady increase in cancer diagnoses over the same period, with colorectal cancer being of particular interest to researchers. The number of people under the age of 55 diagnosed with colorectal cancer has increased by 1% to 2% annually since the 1990s and is now the first leading cause of cancer death for men and the second for women (after breast cancer).
“We need to halt and reverse this trend by increasing the uptake of screening, including awareness of non-invasive stool testing with follow-up care, among people aged 45-49 years (old),” said Jemal.
While cancer remains primarily a disease of the elderly, the increase in cancer rates among young people is part of a global medical mystery. The trend is especially pronounced in developed regions, such as North America, Australia and Western Europe.
“Overall, the better developed the country and region, the higher the incidence of early-onset cancer,” write the authors of a recent paper in BMJ Oncology said. While the increase can be partly attributed to earlier screening, there may also be links to ‘potential risk factors’, particularly for developed countries.
To write Naturea group of specialist physicians has summarized the risk factors that researchers are now investigating, including “a Western diet, obesity, physical inactivity and antibiotic use, especially during the early prenatal to adolescent stages of life,” that alter the gut microbiome.
In addition to the physical impact of a cancer diagnosis on younger people, researchers worried about how this group of diseases affects people in middle age, often seen in the prime of life.
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“People under the age of 65 are less likely to have health insurance and are more likely to have to combine a family and a career,” he says Dr. William Dahut, Chief Scientific Officer of the American Cancer Society, in a statement. “Additionally, men and women diagnosed younger have a longer life expectancy during which they may experience treatment-related side effects, such as second cancers.”
Another concern for doctors is the increasing racial disparity and the increase in deaths from uterine (endometrial) cancer. Black Americans are now twice as likely to die from uterine cancer (9.1 deaths per 100,000 people) than white Americans (4.6 deaths per 100,000 people), with the incidence steadily increasing at 2% per year.
Stomach and prostate cancer have also led to greater disparities between white and black Americans. Likewise, death rates for Native Americans are twice that of their white counterparts for liver, stomach and kidney cancer.