The incidence of early-onset cancer (EOC), that is, cancer that occurs in adults under the age of 50, has increased by nearly 80 percent since the 1990s. This increase has has been accompanied by a notable 27.7 percent increase in cancer deaths within this population group. In this sense, during the European Society for Medical Oncology Congress 2024 (ESMO) this problem was addressed and analyzed.
Various studies have addressed this situation, obtaining various answers to the reason for this increase. For example, in certain types of cancer, such as prostate and thyroid, greater acceptance of early detection could be one of the reasons leading to more diagnoses. However, there are other recognized factors including changes in diet, lifestyle and environmental environment since the middle of the 20th century. These changes have led to greater adoption of Western-style diets, increased alcohol consumption, decreased physical activity, altered sleep patterns, and increased exposure to chemicals.
Special attention to CCR and breast cancer
In the specific case of colorectal cancer (CRC), although differences are observed in the distribution of characteristics between younger and older patients, such as tumor location and the presence of hereditary risk factors, analyzes of incidence trends show a common pattern. A high body mass index (BMI) is emerging as a significant risk factor for the development of CRC in all age groups. However, in younger populations, the relationship between high BMI, high fasting plasma glucose levels, and the development of CRC is even more marked, suggesting that metabolic factors play a critical role in the increasing incidence of cancer in this age group. cluster.
The upward trend in the incidence of early-onset colorectal cancer varies by geographic region. Worldwide, the incidence of this type of cancer increased by 64.3 percent between 1990 and 2019. During this period, the largest percentage increases in the incidence of early-onset CRC were recorded in regions such as Australasia, Latin America, Central, Eastern and Western Europe, the Caribbean, South, East and South-East Asia, North Africa and the Middle East, Asia Pacific, high-income North America, Western Sub-Saharan Africa and in areas of Oceania.
In 2019, of the 29 types of early-onset cancer analyzed, breast cancer was the one that showed the highest global incidencewith 13.7 cases per 100,000 inhabitants, reflecting an estimated annual percentage increase of 1.01 percent since 1990. Although countries with a high sociodemographic index (SDI) presented the highest age-standardized incidence of cancer in 2019 early-onset breast cancer, with 21.1 cases per 100,000 inhabitants, the most significant increase since 1990 was observed in countries with a medium sociodemographic index, where the incidence rose from 7.3 to 12.3 per 100,000 inhabitants.
Trends in the incidence of certain types of ovarian cancer and other invasive cancers suggest a steeper increase in younger cohorts. In a study carried out in Spain with more than 24,500 patients diagnosed with invasive cancer between 1998 and 2021, it was observed that the Average annual percentage increase in the incidence of some cancers was significantly greater in patients younger than 40 years compared to those 40 years or older. Among the types of cancer that showed this trend, head and neck cancer, colon cancer, non-Hodgkin lymphoma, melanoma, ovarian cancer and sarcoma stand out.
More research
To address the growing trend of early-onset cancers, a transdisciplinary research approach is essential. Future directions in this field include the analysis of trends in incidence and mortality in different geographic regions, which would allow better understand global patterns and anticipate needs of the population in the long term. Although experts agree that prospectively studying the relationship between early life factors and EOC is challenging, a promising option would be to use existing childhood cohorts, which would require close collaboration between EOC researchers and experts in pediatrics.
It is also necessary biospecimen collectionsuch as tumor tissues, to obtain key information about the pathogenesis of these cancers. The use of pathological molecular epidemiology approaches would allow linking tissue biomarkers with potential risk factors, providing a deeper etiological understanding. This knowledge could be the basis for developing more effective primary prevention, early detection and treatment strategies.
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