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In a disturbing worldwide trend, new cancer cases among young people have been increasing sharply.
Early-onset cancers, defined as cancer cases diagnosed in people under 50, increased globally by a staggering 79%.
In the United States, the American Cancer Society reported that the demographics of cancer patients are increasingly shifting from older individuals to middle-aged people. While adults older than 50 experienced a drop in overall cancer incidence from 1995 to 2020, there was a notable increase in people younger than 50.
Why are young people getting cancers at higher rates? Does this mean people should start screening for cancer at younger ages? Who should be most concerned? And what preventive measures should younger individuals consider?
To help with 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 was Baltimore’s health commissioner.
CNN: What are the deadliest cancers in younger people?
Dr. Leana Wen: The types of early-onset cancer that cause the highest death toll and burden globally are breast cancer; tracheal, bronchus and lung cancer; 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 top causes of cancer deaths. A report from the American Cancer Society especially highlighted colorectal cancer, which is now the leading cause of cancer death in men younger than 50 and the second in women under 50.
CNN: Why are cancer cases rising in people under 50?
Wen: There are a number of hypotheses. Some researchers point to the escalating rates of obesity over the last few decades, which is associated with the risk of early-onset cancer. On a related note, the change in dietary habits, specifically the increase in consumption of ultraprocessed food, and sedentary lifestyles also are associated with higher cancer rates. Others speculate that there may be environmental factors at play, such as carcinogens released into the air, water and food supplies.
CNN: Should people start screening for cancer at younger ages?
Wen: This is a complex question that I think is best answered by looking at recommendations for the population versus for the individual.
Guidelines from major medical organizations and federal policymaking bodies are based on what is recommended for people at average risk. Most people should follow these guidelines.
For instance, in the United States, the US Preventive Services Task Force recommends that people begin colon cancer screenings at age 45. The task force also issued a draft recommendation that women start mammograms at age 40. Both revisions represent changes to guidelines. Before 2021, people were advised to start colon cancer screenings at age 50. The mammogram change was only proposed last year and hasn’t been finalized. Before this recommendation, the guidance was for most women to begin mammograms at age 50.
Such guidelines will continue to be revised. Researchers will consider factors such as changing demographics and effectiveness of screening tools.
People who are at average risk should follow the existing guidelines. This is one reason they should make sure to have an annual checkup with their physician or other primary care provider. That is the time to review all the tests that they need to do, which includes cancer screenings.
That is also the time to discuss whether their personal medical situation puts them at higher risk compared to average. This is a very important component of the visit, as these factors will determine whether they need to begin screenings at an earlier age than the general guidelines.
For instance, if a woman has a sister, mother or other first-degree relative with breast cancer, they themselves have double the average risk of breast cancer. Someone who has two first-degree relatives has a fivefold increase in breast cancer incidence compared to average. It’s crucial for people to know their family history because their provider could recommend additional next steps, such as genetic testing. They may also need to start mammograms or other screening tests at an earlier age.
Similarly, someone who has a first-degree relative with a history of colon cancer should also speak with their physician about starting colon cancer screenings sooner than the general recommended age. Others who may need a colonoscopy earlier are those with inflammatory bowel disease such as Crohn’s disease or certain inherited genetic conditions.
CNN: Should everyone talk to their physician every year about cancer screenings?
Wen: Yes, and they should make sure to get the screenings that are recommended.
One in 3 people who are eligible for colon cancer screenings have never received any screening exams, according to the American Cancer Society. And as much as 59% of women forgo their annual mammogram, according to some surveys.
People may skip these tests for a number of reasons. They might be busy with work and caregiving responsibilities. Though the Affordable Care Act is supposed to cover preventive care, including cancer screenings, they may not have a primary care provider or face other barriers to accessing care. And they may think that they don’t need these tests because they are young, healthy and feeling just fine.
But the startling statistics about the rise in cancer in younger people should be a call to action. Many cancers are asymptomatic in early stages. That is why screening is needed: to detect these cancers before they spread. Treatment can be curative if cancers are detected early.
CNN: What else would you recommend that younger people do?
Wen: It’s essential that people know their risks. Specifically, they need to know what their family history is and whether they have other medical conditions or lifestyle factors that increase their risk of early-onset cancer.
Everyone should try to find out their family history of cancer. Are there first-degree relatives who have had cancers? Know their own medical history and ask their physician if a certain condition may increase their cancer risk. Also, be sure to mention all lifestyle factors, including smoking, drinking alcohol, dietary habits and physical activity.
CNN: Are there steps younger people can do to reduce their cancer risk?
Wen: Yes. Smoking and heavy alcohol intake are major risk factors. Quitting smoking and reducing alcohol intake are important steps. As little as one or two minutes of vigorous exercise a day can lower cancer risk, as can reducing ultraprocessed food. It’s also important to note that these lifestyle changes not only reduce the risk of cancer but also are the same ones that lower the likelihood of heart disease and premature death.