The professor: “Clear increase in incidence and we don’t know why”
“A disturbing fact: over the last 20 years there has been a clear increase in the incidence of some serious cancers among young people. And we still don’t know why.” This is the comment on a report from the ‘Wall Street Journal’ posted on social media by Roberto Burioniprofessor of Microbiology and Virology at the Vita-Salute San Raffaele University of Milan, who dedicated his latest book ‘Match point – How science is defeating cancer’ to oncology.
Cancer is affecting more and more young people in the United States and around the world, baffling doctors, we read in the WSJ. In the USA, according to federal data, diagnosis rates increased in 2019 to 107.8 cases per 100 thousand people under 50, up 12.8% compared to 95.6/100 thousand in 2000. A study also appeared on Last year in ‘BMJ Oncology’ – the newspaper recalls – it reported a strong global increase in tumors in people under 50, with the highest rates in North America, Australia and Western Europe. Doctors are trying to understand what makes them sick and how to identify young people at high risk. They suspect that lifestyle changes – less physical activity, more ultra-processed foods, new toxins – have increased the risk for younger generations.
“Patients are getting younger,” says Andrea Cercek who co-directs a program for patients with early-onset gastrointestinal cancer at Memorial Sloan Kettering Cancer Center in New York, where Meilin Keen, a 27-year-old whose story starts the WSJ article. Last June, Meilin was studying for the bar exam when she started vomiting blood, thus discovering that she had stomach cancer for which she underwent surgery. Cercek believes it is “probable” that at the basis of the cancer boom in the under 50s there is “some environmental change, something in our food, in our drugs or something that we have not yet identified“.
In 2020 – continues the WSJ – the death of actor Chadwick Boseman at the age of 43 from colon cancer turned the spotlight on the growing prevalence of this tumor in people under 50, a trend that had already alarmed oncologists in the previous decade. Experts soon realized that the phenomenon also affected other forms of cancer, from pancreatic cancer to appendix cancer, from stomach cancer to uterine cancer. “Colorectal cancer was the canary in the coal mine,” is the metaphor used by Timothy Rebbeck, a cancer epidemiologist at the Dana-Farber Cancer Institute in Boston.
The cancer death rate in the United States has dropped by a third since 1991 – the WSJ points out – thanks to the reduction of smoking, more effective treatments and screening for early diagnosis. However, the increase in early-onset cancers threatens to set back the progress made in the fight against cancer, even as cancers continue to affect older people much more often. In 2019, a fifth of new colorectal cancer patients were under the age of 55, a figure that had almost doubled compared to 1995. And younger patients are often diagnosed when the cancer is in an advanced stage, so much so that mortality rates for Colorectal cancer among the over 65s are decreasing, while increasing in the under 50s.
“We are seeing more and more young people contradicting the classical teaching that cancer is a disease of aging“, highlights Monique Gary, medical director of the oncology program, Grand View Health Pennsylvania. But when faced with an unusual symptom, having a tumor is not a boy’s first fear. Suffering from heartburn and reflux since he was in high school, and having taken antacids for months while preparing for the bar exam, Meilin herself initially believed she had drunk too much coffee when she lost her appetite and vomited blood. She only went to the emergency room when her vision darkened. seen and felt faint. In the hospital the doctors stabilized her and subjected her to investigations, and when one of them put forward the hypothesis of a carcinogenic bacterium, Meilin almost laughed. “I never thought about cancer until I had”, he confesses.