The statistics are alarming. According to Cancer Australia, between 2000 and 2024, the rates of at least 10 different cancers have risen significantly in people under 50, especially those in their thirties. In that age group for example, pancreatic cancer has gone up by 500%, prostate cancer 200%, bowel cancer 173%, liver cancer (hepatocellular carcinoma) 150% and kidney cancer by 85%. 20% of breast cancers are now diagnosed in women under 50. And although not included in the 10, it’s likely that lung cancer in young women who’ve never smoked is also rising.
With some of these cancers like pancreatic, the actual numbers are still low. In others like thyroid, the reason, could be that changes in testing are over diagnosing. But that still leaves most unexplained, and when you look at US data, the range of what are called early onset cancers is even wider.
What’s even more troubling is that there seems to be a generational change affecting Gen X and Millennials (It’s too early to say whether Gen Z are affected). It’s called a cohort effect and if true, it means that these higher cancer rates will follow them through life and while the numbers may be low now, they won’t stay that way. People in these generations could end up with double the lifetime risk of cancer compared to their parents.
This is happening in people who have young families; they are still on their career ladder; money is tight, and they have everything to look forward to. In addition, the cancers are often diagnosed late which can mean extended and complex treatment and poorer outcomes.
When you talk to people with early onset cancer, as I did for a recent Four Corners story, they are confused and often blame themselves. Was it eating too much red meat from the BBQ? Should I have done more exercise? Did I allow myself to become too stressed?
When you’re looking for the causes of cancer there are two places to go: genes and the environment. With genes, the fact is that most of the people experiencing these cancers do not have a family history, nor do they have one of the recognised cancer genes. So that leaves the environment. They have been exposed to something or some things which have triggered their cancer. But it wasn’t a BBQ five years ago. The development of cancer is a process which can take 20 or 30 years. That’s one reason why cancer is still largely a disease of ageing because it takes time to develop. So, if you’re diagnosed with cancer in your 30s, the cause is likely to have been in an exposure in childhood or maybe even to your mother. hat makes finding the cause even harder since you have to go back in time.
Lots of things were changing 20 or 30 years ago. Caesarean section rates were soaring and when a baby is delivered by section, it takes time for them to acquire a normal microbiome. The global food industry was really getting going with manufactured, synthetic, high calorie foods which also affect the microbiome and cause weight gain and obesity, well known to increase cancer risk. We were also exposed to more and more plastic products and the ‘forever’ chemicals they can contain. And in Australia, we were still being exposed to chemicals that were known to be carcinogenic.
Australian research into early onset bowel cancer is suggesting that changes to children’s microbiomes might have exposed them to germs which produce cancer causing toxins.
What can we do?
A lot of this is up to government to be more proactive when it comes to regulation of chemicals. The current approach is to assume they’re safe until a problem arises. They should be making sure they’re safe first. We should try to reduce our consumption of ultra processed foods which can be hard for families where both parents have full time jobs and it’s hard to cook fresh meals all the time. The evidence though is strong for a diet high in vegetables, low in red meat and cooked at a moderate heat. And then there are changes with no evidence to support them but it’s what I’ve done. Plastic containers have been chucked out and replaced with glass. All non-stick cookware also thrown out and replaced with stainless steel or cast iron. It’s not cheap.
But even more importantly, new symptoms in a previously well person should never be assumed by that person or their health professionals that it can’t be cancer because you’re “too young”. They need to be taken seriously.
