Fifteen months ago, a disturbing trend began to surface – a rise in early-onset cancer, impacting individuals at increasingly younger ages. For decades, researchers had observed this shift, noting its presence in medical journals likeNatureandThe Lancet. Initially, these cases were dismissed as isolated tragedies, medical anomalies reported in publications likeThe Wall Street JournalandThe New York Times.
Everything changed in 2017 with a landmark study from the American Cancer Society. The narrative shifted from “rare occurrence” to “emerging epidemic.” Then, in 2020, the world mourned the loss of Chadwick Boseman, a vibrant actor taken by colorectal cancer at just 43. His death resonated deeply, bringing the crisis into sharp focus – a focus that mirrored my own personal grief, as my son, Patrick, passed away at 32, just a month before Boseman.
The story expanded beyond initial reports, gaining traction in mainstream media, even appearing in widely-read magazines and tabloids. Investigations began to explore potential causes: ultra-processed diets, rising obesity rates, environmental factors, sedentary lifestyles, and even a specific gut bacterium and its potential to trigger genetic mutations.
The latest Cancer Statistics report reveals a stark duality. Overall cancer survival rates have dramatically improved, climbing from 50% to 70% since the 1970s – a remarkable achievement. Yet, beneath this encouraging statistic lies a troubling reality.
Colorectal cancer continues to climb among young adults, becoming the leading cause of cancer-related deaths in those under 50. Incidence rates are increasing nearly 3% annually, a significant acceleration from the previous decade. The data paints a clear picture: a surging tide that demands immediate attention.
A recent analysis inJAMAvividly illustrates this alarming trend. A graph charting colorectal cancer mortality from 1990 to 2023 shows a stark, unwavering red line steadily climbing upwards, while lines representing other cancers are in decline. It’s a visual representation of a crisis unfolding in real-time.
This isn’t just a statistical anomaly. Young patients are often diagnosed at later, more advanced stages, making treatment significantly more challenging. Awareness, however, is only the first step. The U.S. House recently passed a bill that could pave the way for Medicare coverage of multi-cancer early detection tests – a potentially life-saving advancement.
Despite this progress, debate continues. Some researchers advocate for rigorous clinical trials before widespread adoption of these new tests, fearing insufficient vetting. But the urgency of the situation demands a different approach. Years could be lost waiting for “gold-standard” trials, and historically, it takes nearly two decades for research to translate into routine clinical practice.
We simply don’t have that kind of time. These tests offer a crucial opportunity to reach those who avoid traditional screening methods like colonoscopies. They should be viewed as complementary tools, encouraging physicians to adopt more comprehensive lifestyle and environmental assessments. Utilizing polygenic risk scores, combined with standard evaluations, can help identify individuals at higher risk for early-onset colorectal cancer.
The projected toll is staggering: an estimated 2,800 to 3,200 deaths in those under 50 in 2026. While statistics can feel abstract, each number represents a life lost, a family shattered – and many of these deaths are preventable. The next Cancer Statistics report will likely show a continued rise in mortality rates for this age group, a grim prospect I desperately hope to see disproven.
The adage “insanity is doing the same thing over and over and expecting different results” rings painfully true. We cannot afford to remain complacent. Current blood-based tests, while sensitive, aren’t perfect in detecting early precursor lesions. A negative result shouldn’t instill false confidence, nor should a potential false positive cause paralyzing anxiety.
We must embrace progress, not demand perfection. Any test that encourages a reluctant patient to seek screening is a victory. Any conversation that prompts a physician to consider cancer in a young, seemingly healthy individual is a step forward. The future holds the promise of even more accurate blood or breath-based tests, offering a new era of early detection.
Preventing these avoidable deaths, and mitigating the devastating impact on families, is paramount. The day the Cancer Statistics report shows a decline in colorectal cancer mortality among young adults will be a day of profound hope – a hope fueled by innovation and a relentless commitment to change.
