Cancer rates and deaths are increasing among younger adults ages 15 to 49 years old, marking a worrying trend, according to the latest report from the American Cancer Society (ACS). While overall cancer mortality rates continue to decline nationwide, largely thanks to improvements in detection and treatment, certain cancers are rising rapidly among younger demographics.
New Cancer Diagnoses Hit Record Highs
The American Cancer Society projects over 2 million new invasive cancer cases will be diagnosed in 2024, breaking the record high set in 2019 prior to the COVID-19 pandemic . While part of this uptick can be attributed to delayed screenings over the past few years, the troubling rise in early-onset cancers among young adults is alarming experts.
“The sobering news is that the acceleration in new cancer cases is the result of obesity, poor diet, physical inactivity, heavy alcohol consumption, tobacco product use, increased UV exposure, and other factors that are largely preventable,” said Dr. William Dahut, the American Cancer Society’s chief scientific officer .
Death Rates Decline But Early-Onset Cancers Rise
The ACS report did confirm an overall steady decline in U.S. cancer death rates. From it’s peak of about 215 cancer deaths per 100,000 people in 1991, the cancer death rate has plunged 32% to 146 deaths per 100,000 people as of 2019. This translates to nearly 3.8 million total cancer deaths averted between 1991 and 2019. 
Much of these gains can be attributed to lung cancer death rates plunging by 51% among men since the early 1990s, thanks anti-smoking campaigns. Other successes include new therapeutic advancements improving mortality for melanoma skin cancers and Hodgkin lymphoma. 
However, while the overall picture is positive, the report highlighted worrying increases in colorectal, pancreatic, and lung cancer rates among younger adults (ages 15 to 49 years old). Other cancers like breast, oral, thyroid, liver, and kidney cancers are also rising among early-onset groups. 
|Changes in Early-Onset Cancer Rates
Colorectal Cancer Striking Young Adults
Perhaps the most concerning trend emphasized in the report is the rapid 11% rise in early-onset colorectal cancer rates. Colorectal cancer, which includes colon and rectal cancers, has long been considered a disease of old age with screenings recommended to start at 45 years old.
However, new research shows colorectal cancer cases among younger groups (ages 15 to 49 years old) shot up by nearly 20% from 2012-2016. What’s worse, colorectal cancer deaths among this age bracket surged by 13% from 2014-2018. 
Several factors could be contributing to this disturbing trend, including poor diets, sedentary lifestyles, obesity, smoking, heavy alcohol use as well as environmental exposures. Hereditary factors could also play an increasing role.
Whatever the causes, the rapid emergence of colorectal cancer among younger populations has doctors alarmed. Many are urging updated screening guidelines to start checking for colorectal cancers earlier, as early detection and intervention remains key for positive outcomes. 
“We are seeing more patients in their 20s and 30s with colon cancer and even patients as young as their late teens developing this disease. It is imperative we understand why this is happening and catch it as early as possible,” said Dr. Kimmie Ng, director of Young-Onset Colorectal Cancer Center at Dana-Farber Cancer Institute. 
Pancreatic Cancer Also Worrisome
While less publicized than the colorectal cancer trends, the ACS report also highlighted a steady 2% annual rise in pancreatic cancer cases since 2014. Pancreatic cancer remains relatively rare but can be extremely aggressive and difficult to treat in later stages. Hence, early detection is critical but current screening methods remain prohibitively expensive for widespread adoption. 
The disease still mostly afflicts older adults but doctors warn rates among early-onset groups are ticking upwards slightly for unclear reasons. Genetics, smoking, obesity, and diabetes likely contribute but research is still ongoing. As with colorectal cancers, improved screening techniques and early intervention will be key to bending the pancreatic cancer curve downwards. 
Calls for Cancer Prevention and Updated Screenings
While praising the declines in overall cancer mortality nationwide, ACS officials warned emerging cancer threats required urgent action on prevention efforts and updated screening protocols.
“Swift implementation of cancer screening guidelines along with better access to preventive care could lead to the prevention of at least 200,000 new cases of cancer in the first five years alone,” said Karen Knudsen, MBA, Ph.D., American Cancer Society CEO. 
Many experts advised the following prevention guidelines:
- Maintain healthy body weight
- Exercise regularly
- Eliminate tobacco use
- Practice safe sun protection
- Limit alcohol intake
- Emphasize cancer screening
- Colorectal screenings should likely begin by 40 years old
- Pancreatic screenings can detect early biomarkers
Officials also called for addressing socioeconomic, racial and regional disparities contributing to uneven cancer impacts while expanding access to newer precision oncology treatments. 
Outlook Going Forward
While the long-term cancer death rate declines mark progress, emerging threats among younger groups remain extremely concerning. Doctors urge rapid actions to curb lifestyle risk factors while updating screening protocols to provide earlier detection and intervention options for these patients.
Research into newer treatment options also continues full steam ahead. Exciting immunotherapy advances are already bearing fruit while precision oncology insights could allow better targeting of customized cancer treatments in the future. 
However, preventing avoidable cancer risks must be part of a multi-pronged strategy.
“The greatest opportunity is in cancer prevention,” said William Gradishar, MD, chair of Hematology and Oncology at Northwestern University Feinberg School of Medicine. “We know that up to 50% of cancers are preventable if we can modify behaviors and implement existing cancer screening guidelines.”
With heightened vigilance and proactive steps taken today, the emerging cancer threats of tomorrow can hopefully be averted.
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