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Cancer cases are rising in young people

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For a long time now it has been clear that an ageing society brings with it an increase in diseases usually seen in older people, such as cancer.

So it was something of a shock this week for many people when they read the news that cancer diagnoses have also been rising among younger people. Cases of early-onset cancer, where diagnosis happens in adults between the ages of 18 and 49, have jumped by 24 per cent between the early 1990s and 2019, according to new analysis by Cancer Research. The charity said “urgent research” is needed to discover the reasons behind the rise so we can set about trying to reduce it.

No other age group was found to have had such a hike in cancer cases. By comparison, there was a 10 per cent rise in cases among people aged 75 and over.

Although cases remain “relatively uncommon”, with only a small portion of the population being diagnosed with cancer before the age of 50, experts said the trend is important – especially as the data show the number of younger women being diagnosed with cancer is significantly higher than younger men, a trend that flips in older age groups.

Soaring childhood obesity rates are believed to be one of the main causes behind the rise in cases, along with poor diets and physical inactivity.

“Obesity undoubtedly increases risks of developing cancer, more so in adulthood than childhood,” says Alastair Sutcliffe, professor of general paediatrics at University College London.

“Undoubtedly, the human microbiome is changing and has been for a long time (see the teeth of stone age man) due to dietary change. Overall our diet has steadily improved until the outbreak of the obesity epidemic and thus children rarely starve to death. For further improvements it is that epidemic of obese children that we need to reverse. Largely through diet, starting in the first few years.”

We have also become better at diagnosing cancer for several reasons, such as increased awareness of symptoms and surveillance, suggesting there may not be a “true rise” in incidence.

Professor Sutcliffe said: “Paediatric oncologists lead the world in treatment of childhood cancers. Such have been their advances by the development of CAR-T cell therapy [which use your body’s own immune system to help fight cancer] that these treatment methods are now being used in adult cancers as well.

“Cancer is overall causing fewer deaths from diagnosis due to advances in treatments across all cancers. Children are prone to germ cell tumours most of which can be cured. If a child is diagnosed with a common childhood cancer [such as leukaemia] cure rates are nearing 100 per cent, a near revolution.

“The second commonest childhood cancers, brain tumours, are diagnosed quicker nowadays due to the introduction of the HeadSmart guidelines [provides further details and guides decisions based on head circumference, growth and endocrine changes, and behavioural changes] which have been a huge success.”

However, many young adults are still turned away by medics when they present with symptoms their parents believe could be caused by cancer. Intense workforce pressures are thought to be one contributory factor with GPs now having up to 60 or more patient contacts in a single day. Many believe it is inevitable some patients, especially otherwise fit and healthy younger people, are misdiagnosed.

A 37-year-old father of four “fobbed off” by the NHS for 18 months was recently given weeks to live as his cancer was mistaken for indigestion. Joe Snape, from Leek, in Staffordshire, presented at his GP surgery with stomach pains only to be given the devastating news over a year later at the Royal Stoke University Hospital that he had oesophageal cancer.

Eric O’Neill, professor of cell and molecular biology and director of oncology education at the University of Oxford, says: “Young adults in particular often fall into a grey zone where they are perceived as ‘too young’ to have a particular illness, especially where there is not enough knowledge or evidence to support a diagnosis.

“Increasing strain on the NHS means that young people can be dismissed too quickly by doctors and clinicians that are under enormous pressure and do not have the time to investigate concerns, leaving vague symptoms or malaise easy to dismiss as ‘stress’ or ‘worry’ in adolescents and young adults.

“This is particularly pertinent for young women and girls whose symptoms can be even more readily dismissed as hormonal or psychiatric, evidence for this is clear in the delays for endometriosis diagnosis. You don’t have to dig too far to see the stories amongst today’s younger generation where serious physical illnesses, including cancer, have been badged as psychological.”

As cancer has in the main been perceived as a disease of old age, Professor O’Neill believes we now have a duty to react to this “worrying change” in trend by raising awareness amongst the public, research and medical communities.

“We must put in place frameworks to identify and support these diseases amongst a cohort for whom, unlike paediatrics and geriatrics, dedicated holistic approaches are lacking.”

The good news is that around four in 10 cancer cases are preventable, with health professionals and charities continuing to bang the drum for people to improve their diet, do so some exercise, quit smoking and reducing alcohol intake all making a big difference.

Political changes are taking place. In February, the Government brought together experts to drive forward progress in tackling cancer in children and young people. The Children and Young People Cancer Taskforce, to be chaired by Dame Caroline Dinenage, aims to improve how we detect, treat and care for children with cancer. It will also consider genomic treatments, new diagnosis tools, research and innovation.

New research is also under way, such as US scientists looking into the effects of sugary energy drinks on colorectal cancer patients, to investigate the trend. More than half a century ago, the Medical Research Council and the government acknowledged the causal link between smoking and lung cancer, but responses were very limited. If research shows a causal link between types of food and drink and certain cancers, many hope politicians will be quicker off the mark in the 21st century to take action and save lives.

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