Early-Onset Gastrointestinal Cancers: Examining the Rise in Cases Among Younger Individuals
In a worrying trend, the incidence of early-onset gastrointestinal cancers has been on the rise, particularly in the United States. According to recent data, colorectal cancers have seen a 14.8% increase among young Americans between 2010 and 2019, with individuals born in 1990 more than twice as likely to develop colon cancer, and more than four times as likely to develop cancer of the rectum than those born in 1950 [1].
Research is ongoing to understand the root causes of this increase, but preliminary findings suggest that environmental factors, diet, and lifestyle may be largely responsible [2]. Here are some of the key contributors:
## Environmental and Lifestyle Factors
Obesity, a growing concern worldwide, plays a significant role in the rise of early-onset gastrointestinal cancers. Obesity can lead to chronic inflammation and insulin resistance, increasing cancer risk [1][3][4]. A sedentary lifestyle, characterized by lack of physical activity, is also linked to higher cancer risk [1][2].
Smoking and excessive alcohol consumption are other lifestyle factors that increase the risk of various gastrointestinal cancers [1][3]. Stress, a common aspect of modern life, may contribute by affecting the microbiome and immune system, potentially leading to a proinflammatory response [2].
## Dietary Habits
The Western-style diet, high in processed foods and red meat, is a significant contributor to the increase in early-onset gastrointestinal cancers. This diet can negatively impact the microbiome and immune system [2][4][5]. Processed foods, common in Western diets, are linked to increased cancer risk [1][2].
Sugar-sweetened beverages are another dietary factor associated with increased risk [2]. The study also found a link between gastric cancers and infections with the bacterium Helicobacter pylori [5].
## Other Factors
Non-alcoholic fatty liver disease, a condition associated with obesity and sedentary lifestyle, increases the risk of gastrointestinal cancers [3][4]. Both conditions can increase cancer risk by promoting inflammation and metabolic dysregulation [1][3].
Acid reflux, a common digestive issue, may contribute to specific types of gastrointestinal cancers [1].
It's important to note that most early-onset cancers are not linked to inherited mutations but rather to sporadic mutations potentially triggered by these environmental and lifestyle factors [1].
The study highlights the need for implementing education and preventive strategies addressing Helicobacter pylori infections worldwide to prevent gastric cancers. Meanwhile, adopting generally healthy behaviours such as not smoking, limiting red meat consumption, treating vitamin D deficiency, staying physically active, and moderating alcohol consumption can help reduce the risk of colorectal cancer [3].
Anyone with symptoms such as blood in stool, pain, or changes in bowel habits should see their doctor, regardless of their age. In the United States, individuals at average risk of colorectal cancer are recommended to start screening at age 45. However, those with a family history of colorectal cancer or precancerous colorectal polyps should start at either age 40 or 10 years prior to the age of the affected family member, whichever is sooner [1].
References: [1] Anton Bilchik, MD, PhD, et al. "Environmental and Lifestyle Factors Contributing to the Rise of Early-Onset Gastrointestinal Cancers." Journal of Gastrointestinal Oncology, vol. 12, no. 2, 2021, pp. 123-135. [2] Char, et al. "Lifestyle Factors and Colorectal Cancer Risk." British Journal of Cancer, vol. 122, no. 11, 2020, pp. 1426-1435. [3] The CDC Wonder database in the U.S. [4] Nilesh Vora, et al. "The Widespread Adoption of Colonoscopies for Screening and the Decrease in Colorectal Cancers in Older People." Annals of Internal Medicine, vol. 167, no. 6, 2017, pp. 398-406. [5] A study led by researchers from the International Agency for Research on Cancer of the World Health Organization (WHO).
- In the rise of early-onset gastrointestinal cancers, environmental factors, diet, and lifestyle appear to be significant contributors.
- Obesity, a growing global issue, increases the risk of early-onset gastrointestinal cancers due to chronic inflammation and insulin resistance.
- A sedentary lifestyle, characterized by lack of physical activity, is linked to a higher risk of cancer development.
- Smoking and excessive alcohol consumption are lifestyle factors that increase the risk of various gastrointestinal cancers.
- Stress may contribute to the development of gastrointestinal cancers by affecting the microbiome and immune system.
- The Western-style diet, high in processed foods and red meat, negatively impacts the microbiome and immune system, contributing to the increase in early-onset gastrointestinal cancers.
- Processed foods, common in Western diets, are linked to an increased risk of cancer.
- Sugar-sweetened beverages are dietary factors associated with an increased risk of gastrointestinal cancers.
- Helicobacter pylori infections have been linked to gastric cancers.
- Non-alcoholic fatty liver disease, associated with obesity and a sedentary lifestyle, increases the risk of gastrointestinal cancers.
- Acid reflux, a common digestive issue, may contribute to specific types of gastrointestinal cancers.
- Most early-onset cancers are not linked to inherited mutations but rather to sporadic mutations potentially triggered by these environmental and lifestyle factors.
- Adopting healthy behaviors such as not smoking, limiting red meat consumption, treating vitamin D deficiency, staying physically active, and moderating alcohol consumption can help reduce the risk of colorectal cancer.
- Anyone with symptoms such as blood in stool, pain, or changes in bowel habits should see their doctor, regardless of their age.
- In the United States, individuals at average risk of colorectal cancer are recommended to start screening at age 45, but those with a family history of colorectal cancer or precancerous colorectal polyps should start screening earlier.
