Why is there more cancer in younger patients? A scientist explains

While there has been tremendous progress in improving cancer survival rates, some new data are alarming.

Specifically, an emerging trend is the increasing incidence of some cancers in individuals younger than 50.

Why is this important?

To give you the context, in Canada nine in 10 cancers are diagnosed in folks who are 50 years of age or older. 

Therefore, existing population-level cancer screening programs are often geared toward this age group — to detect tumours in individuals who are more likely to develop them. Screening programs help detect the cancers early or before cancer symptoms are noticeable. 

However, in the last few years, reports started to show an increase in the incidence of some cancers, such as colorectal cancer, in age groups younger than 50. 

Implications of new trend in cancer for all of us

Apparently, the notion that cancer is generally an old folks' disease is now seriously challenged. 

Dismissal of symptoms in young patients, which may be early signs of cancer, happens.

I personally know a few N.L. residents who were affected by such practices. Their experience is the reason that I pen this article.

Dismissal of symptoms in young age groups can result in late-stage cancer diagnoses or misdiagnoses. This is important to highlight, as late cancer diagnoses translate into worse outcomes in patients. 

This is the exact opposite of what health-care programs would like to achieve by early diagnosis.

What can we do here in Newfoundland and Labrador?

Reducing cancer incidence and limiting late diagnoses benefit all stakeholders.

We should look for local data to see whether our population is also experiencing increasing incidence of certain cancers in young residents.

Two of the cancer screening programs offered to the population in Newfoundland and Labrador are for breast and colon cancers. For these cancers, screening for average-risk residents starts at 50 years of age. This is unless patients have symptoms or is monitored for reasons, such as familial history of cancer, when they could be screened at any age. This is similar to other provinces, except Ontario, which recently reduced its breast cancer screening age to 40. 

I understand that the provinces often follow national guidelines. 

In the meantime, hearing local patient accounts of their concerns not being taken seriously, leading to advanced disease, is disheartening.

Screening programs are helpful to catch cancers early. But the absence of regular screening programs for young age group creates a gap in care for many. 

Science and medicine create new knowledge every day. They have the ability to show the way to improved health care. The new cancer trend in young individuals is an opportunity for our health-care system to re-evaluate its guidelines.

Studies show that dismissal of symptoms of young folks is one contributor of missed cancer diagnoses and misdiagnoses. We need to reconsider how beneficial this approach is. Also, Canada should carefully look into the current evidence and consider lowering the screening age for select cancers, similar to the U.S.

Cancer is the leading cause of death in Canada, but decades of scientific research and health-care services have reduced the incidence and or mortality rate for many cancers. That's why clinicians want to replicate this success in cancers that are increasingly affecting younger individuals. 

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