The rising incidence of cancer in younger adults is a growing concern for oncologists worldwide. While cancer is historically considered a disease of aging, an increasing number of individuals under the age of 50 are receiving diagnoses, challenging conventional understanding and prompting intensive research into the underlying causes.
Susan White, a 34-year-old woman from Ireland, experienced this shift firsthand. After months of experiencing gastrointestinal issues initially dismissed as appendicitis, she was ultimately diagnosed with stage three bowel cancer in . Her case highlights a disturbing trend: cancer diagnoses are occurring in younger individuals, often unexpectedly and at more advanced stages.
“It hadn’t been seen on anything, it was only when I was open on the table,” White recounted, describing the moment she received her diagnosis. “I was diagnosed on Valentine’s Day, lying by myself in a hospital bed on a morphine drip.” White’s experience underscores the often-delayed diagnosis faced by younger patients, as cancer is not typically suspected in this age group.
Historically, colorectal cancer was often referred to as an “old man’s disease.” White’s surprise reflects this long-held perception. “The only symptoms I had was a really bad pain. I never had so much as a loose stool or changes or anything. I couldn’t believe it,” she said.
Data from multiple sources confirm this trend. A study published in in Nature Reviews Clinical Oncology found that individuals born after are more likely to develop cancer before the age of 50 compared to those born in . The American Cancer Society reported in that while overall cancer deaths in Americans under 50 have nearly halved over the past three decades, colorectal cancer deaths have actually increased by a little over 1% annually, making it the leading cause of cancer death for both men and women in this age group.
The increase isn’t limited to colorectal cancer. Prof. Maeve Lowery, a consultant medical oncologist at Trinity St James’s Cancer Institute, notes a rise in lung, breast, and kidney cancers in younger patients. “More recently and very concerningly, there have been several studies that show now we have an increase in the incidence of gastrointestinal cancers – stomach, pancreas, oesophagus, bile ducts and appendix,” she said. “They’ve increased by 15 per cent from to . That’s in the US but that’s huge.”
The reasons behind this increase remain unclear, but researchers are actively investigating potential contributing factors. While genetic predisposition plays a role in some cases, many younger patients diagnosed with cancer have no known family history or genetic markers. Prof. Lowery emphasizes that younger patients often present with fewer traditional risk factors. “Young patients don’t have as many modifiable factors as our older patients do. Physically, they’re very active, they’re not obese, they’re following the healthy guidelines, they’re monitoring their alcohol and they’re not smoking.”
Current research is exploring the potential role of the gut microbiome, suggesting that early-life antibiotic use and dietary habits may influence the composition of gut bacteria and potentially increase cancer risk. “Things being investigated at the moment would be looking to see what kind of bacteria live in the gut which could be influenced by things like antibiotic use in childhood or diets exposed during childhood, which can affect the type of bacteria you can live healthily with in your gut,” Prof. Lowery explained. “If there’s an imbalance in those, that might predispose someone to cancer. Notice some early signals it might be a factor but it’s still under investigation.”
A cancer diagnosis at a younger age presents unique challenges beyond the medical aspects of treatment. Financial pressures, fertility concerns, and a lack of established support systems are common issues faced by young adults with cancer. White described the overwhelming burden of balancing treatment with childcare and financial responsibilities. “I got a medical card for six months, I was getting €100 a week, but you have a mortgage, or loans, and it just puts a huge strain on us,” she said.
Recognizing these specific needs, institutions like St James’s Hospital and the Irish Cancer Society have established young onset cancer programs. These programs provide specialized support services, including social work, advanced nursing care focused on survivorship and sexual health, and assistance navigating the financial and emotional complexities of a cancer diagnosis. Amy Nolan, director of clinical affairs at the Irish Cancer Society, noted that younger patients often experience delays in diagnosis. “Younger people, they tend to go to a doctor a number of times before it’s considered that this could be a cancer. And then when it is identified it can be at a later stage so it can be incurable, you’re looking at multi-modal treatment.”
The young onset cancer program at St James’s Hospital also addresses often-overlooked issues such as the impact of cancer treatment on sexual health and fertility. Louise Kelly, an advanced nurse practitioner within the program, emphasized the importance of addressing these concerns. “There are some physical side effects [to cancer] such as how the body works or looks – low libido, painful intercourse, erectile dysfunction, low testosterone. It can be early menopause, pelvic floor dysfunction,” Kelly said. “There can be changes to how a body looks and works which has an effect on confidence, intimate relationships, and also navigating fertility concerns.”
Rahul Gomes, diagnosed with acute lymphoblastic leukemia at age 19, highlights the importance of addressing the mental and emotional toll of cancer. He emphasized the need to focus on mental resilience alongside physical treatment. He also proactively addressed potential fertility impacts by freezing his sperm prior to chemotherapy and radiation. “Mentally it was very tough. I was told if I could manage the mental thing, then I could manage the physical side much easier,” he said.
For Susan White, the journey continues. After initial positive responses to treatment, she recently received news that the cancer has spread. “I was absolutely devastated, to be honest. I’m not taking it well at all. This has hit me harder than my original diagnosis. We’ll start chemo and an immunotherapy drug my oncologist is hoping to get. Then there will be surgery at some stage again. We’re not out of options yet.” Her story serves as a poignant reminder of the increasing prevalence of cancer in younger adults and the urgent need for continued research, early detection, and comprehensive support for those affected.
