Cancer in the under 50s is rising, globally – why?

This analysis of cancer trends examines how these elements may be affecting cancers with early start. What we are exposed to as children can alter our chance of developing cancer later in life.

We are aware of the steps we need to take to lower our risk of developing cancer, right? Wear SPF, give up smoking, stay fit, eat less processed food, get enough sleep, and avoid processed foods.

But what if a significant portion of what causes cancer has occurred in our formative years, or worse yet, before we were even born.

It may be the case, according to a recent study from Brigham and Women's Hospital and Harvard University, especially in cases of cancer that develop before the age of 50. (early-onset cancers).

I assume we are aware of the actions we must take to reduce our risk of contracting cancer. Wear sunscreen, quit smoking, maintain a healthy weight, consume less processed food, get adequate sleep, and stay active.

But what if a sizable fraction of the factors that contribute to cancer were present during our formative years, or even worse, existed before we were even born?

A recent study from Brigham and Women's Hospital and Harvard University suggests that this may be the case, particularly for cancer cases that manifest before the age of 50. (Cancers with early onset).

Naturally, better screening programmes and earlier diagnoses help find some of these early-onset malignancies, which helps explain why there are more new cancer cases reported each year globally. However, that is not the entire tale.

Early-onset malignancies are more likely to spread than cancers discovered later in life and have different genetic signatures from late-onset cancers. As a result, those malignancies can require various forms of treatment and a more individualised strategy that is based on the patient's age at the time the disease first appeared.

Gut bacteria

The Brigham study looked at 14 cancers and found that the genetic makeup of the cancer and the aggression and growth of the cancer was different in patients who developed it before the age of 50 compared with those who developed the same cancer after the age of 50.

This seemed to be more prominent in several types of gut cancers (colorectal, pancreatic, stomach). One possible reason for this relates to our diet and microbiome. Gut bacteria are altered by high-sugar diets, antibiotics and breastfeeding. And as patterns of these things change in society over time, so do the bacteria in our gut.

This might support the implementation of sugar taxes as recommended by the World Health Organisation.

If our healthy cells are programmed in the womb, then so might the cells that go on to cause cancer. Maternal diet, obesity and environmental exposures, such as air pollution and pesticides, are known to increase the risk of chronic diseases and cancers.

Conversely, severe restrictions on food intake in pregnancy, as seen in famine, increase the risk of breast cancer in offspring. Both of these findings would have different implications for societal approaches to reducing cancer risk.

As a haematologist, I take care of patients with multiple myeloma, which is an incurable blood cancer that usually affects patients over the age of 70. In recent years, there has been an increased number of younger people diagnosed with this cancer worldwide, which is only partly explained by better screening. This study flags obesity as an important risk factor for early-onset disease, but clearly, there are other risk factors yet to be uncovered.

How to reduce your cancer risk

When asked how people reduce their cancer risk in light of these findings, Dr. Ugai recommended the following lifestyle changes:

• Avoiding western-style diets rich in highly processed foods, animal fat, desserts, and excessive red meat
• Avoiding sugar
• Exercising regularly
• Avoiding smoke/smoking
• Avoiding alcohol
• Consuming well-balanced nutritious foods and drinks
• Trying to get good sleep with a regular schedule and avoiding bright light at night
• Decreasing night shift jobs as much as possible
• Getting vaccinated against cancer-causing microorganisms such as HPV and HBV