Cancer rates are rising among young people. What steps should they take to reduce their risk?

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As part of a worrying global trend, new cases of cancer among young people have risen sharply.

Early-onset cancers, defined as cases of cancer diagnosed in people under the age of 50, have increased globally by a staggering 79%.

In the United States, the American Cancer Society has reported that the demographics of cancer patients are increasingly shifting from elderly to middle-aged. While adults over 50 experienced a decline in overall cancer incidence between 1995 and 2020, there was a notable increase in people under 50.

Why do young people get cancer more often? Does this mean people should start screening for cancer at a younger age? Who should be most concerned? And what preventative measures should young people consider?

To answer these questions, I spoke with CNN wellness expert Dr. Leana Wen. Wen is an emergency physician and adjunct associate professor at George Washington University. She previously served as Baltimore’s health commissioner.

CNN: What are the deadliest cancers in young people?

Dr. Leana Wen: The types of early-onset cancers that cause the greatest number of deaths and the greatest burden globally are breast cancer; cancer of the trachea, bronchi and lung; and stomach and colorectal cancers, according to a 2023 study published in the journal BMJ Oncology.

These are similar statistics for older populations. In the United States, lung cancer, colorectal cancer, pancreatic cancer, and breast cancer are the four leading causes of cancer death. A report from the American Cancer Society notably highlighted colorectal cancer, which is now the leading cause of cancer death in men under 50 and the second in women under 50.

CNN: Why are cancer cases increasing among people under 50?

Magnifying glass: There are a number of hypotheses. Some researchers point to increasing obesity rates in recent decades, which are associated with the risk of early cancer. Along the same lines, changing dietary habits, particularly increased consumption of ultra-processed foods, and sedentary lifestyles are also associated with higher cancer rates. Others believe environmental factors could be at play, such as carcinogens released into the air, water and food supplies.

CNN: Should people start cancer screening at a younger age?

Magnifying glass: This is a complex question that I think is best answered by looking at recommendations aimed at the population rather than the individual.

Guidelines from major medical organizations and federal decision-making bodies are based on what is recommended for people at average risk. Most people should follow these guidelines.

For example, in the United States, the US Preventive Services Task Force recommends that people begin colon cancer screenings at age 45. The task force also released a draft recommendation that women should start mammograms at age 40. Both revisions represent changes to the guidelines. Before 2021, people were advised to start colon cancer screening at age 50. The mammogram change was only proposed last year and has not been finalized. Before this recommendation, most women were advised to start mammograms at age 50.

These guidelines will continue to be revised. Researchers will take into account factors such as changing demographics and the effectiveness of screening tools.

People at average risk should follow existing guidelines. This is one reason why they should be sure to have an annual exam with their doctor or other primary care provider. This is the time to review all the tests they need to do, including cancer screenings.

This is also the time to ask yourself if their personal medical situation puts them at higher than average risk. This is a very important part of the visit because these factors will determine whether they should start screenings at an earlier age than the general guidelines say.

For example, if a woman has a sister, mother, or other first-degree relative with breast cancer, she herself has double the average risk of breast cancer. A person who has two first-degree relatives has a five-fold increase in the incidence of breast cancer compared to average. It’s essential for people to know their family history because their provider might recommend other additional steps, such as genetic testing. They may also need to start mammograms or other screening tests at an earlier age.

Likewise, a person whose first-degree relative has a history of colon cancer should also discuss with their doctor the possibility of starting colon cancer screenings earlier than the generally recommended age. Other people who might need a colonoscopy sooner are those with inflammatory bowel disease such as Crohn’s disease or certain inherited genetic conditions.

CNN: Should everyone talk to their doctor every year about cancer screening?

Magnifying glass: Yes, and they must make sure to take the recommended exams.

According to the American Cancer Society, one in three people eligible for colon cancer screening have never had a screening exam. And up to 59% of women forgo their annual mammogram, according to some surveys.

People may skip these tests for several reasons. They might be busy with work and caregiving responsibilities. Although the Affordable Care Act is supposed to cover preventative care, including cancer screenings, they may not have a primary care provider or face other barriers to access taking care. And they may think they don’t need these tests because they’re young, healthy and feeling great.

But the startling statistics about the rise in cancer among young people should be a call to action. Many cancers are asymptomatic in their early stages. This is why screening is necessary: ​​to detect these cancers before they spread. Treatment can be curative if cancers are detected early.

CNN: What else would you recommend to young people?

Magnifying glass: It is essential that people know their risks. Specifically, they need to know their family history and whether they have other health conditions or lifestyle factors that increase their risk of early cancer.

Everyone should try to find out their family history of cancer. Are there any first-degree relatives who have had cancer? Know their own medical history and ask their doctor if a certain condition may increase their risk of cancer. Also be sure to mention any lifestyle factors, including smoking, alcohol consumption, dietary habits, and physical activity.

CNN: Are there steps young people can take to reduce their risk of cancer?

Magnifying glass: Yes. Smoking and excessive alcohol consumption are major risk factors. Quitting smoking and reducing alcohol consumption are important steps. One or two minutes of vigorous exercise a day can reduce cancer risk, as can cutting down on ultra-processed foods. It is also important to note that these lifestyle changes not only reduce the risk of cancer, but are also ones that decrease the risk of heart disease and premature death.