In 2019, 28-year-old Krystle Harris's life took a dramatic turn when she received a stage three breast cancer diagnosis. She was in graduate school, working full-time, and had just been a bridesmaid in her best friend's wedding. "I felt like everything was taken away from me at that point," she said.
Harris had to return home to begin six months of chemotherapy, a lumpectomy, and radiation. In 4/2020, she was declared cancer-free. However, four years later, doctors discovered she had metastatic thyroid cancer—all before her 33rd birthday.
Since 1990, the rate of early-onset cancers (cancers diagnosed in people under 50) has increased globally by almost 80%. This number is projected to rise by another 31% by 2030, according to research published in BMJ Oncology. The American Cancer Society's most recent report shows women under 50 have an 82% higher incidence rate than men of the same age, up from 51% in 2002.
For every 100,000 people under 50, approximately 103 are diagnosed with cancer. The disease tends to be more aggressive in younger individuals, often due to later-stage diagnoses. Colorectal cancer leads with the fastest-growing rate, followed by uterine, blood, kidney, and breast cancers.
Previously, age was considered one of the biggest risk factors for cancer. Now, youth no longer offers the same protection, alarming scientists.
Former Bachelorette star Katie Thurston discovered a breast cancer lump at 34. Jessie J recently shared her breast cancer diagnosis at 37. Teddi Mellencamp was 41 when doctors found a malignant lump. Kate Middleton was 42 when she went public with her cancer diagnosis. Olivia Munn was 43 when she underwent a double mastectomy and hysterectomy due to stage one breast cancer. All of this begs the question: What is happening?
Younger women are often diagnosed with cancer later than they might otherwise be because screenings aren't routinely performed. Screenings for most common cancers don't begin until age 40 or later. Those at average risk are advised to begin mammograms between 40 and 45 and colorectal cancer screenings at 45, according to the American Cancer Society. This age is recommended partly due to the burden earlier screening would place on the healthcare system and because screening technology effective for older adults may not be as effective for younger people.
Dr. Ann Partridge, interim chair of medical oncology at the Dana-Farber Cancer Institute, explains that mammograms are less reliable in younger women due to their tendency to have denser breast tissue. "You'd be looking for a needle in a haystack, unfortunately," she said.
Researchers still have much to learn about who is at highest risk to begin screenings earlier. In the meantime, some may turn to expensive private companies offering cancer-screening blood tests or full-body MRIs, but these methods aren't yet widely available, says Dr. Veda Giri, director of the Early-Onset Cancer Program at Yale Cancer Center.
While awaiting improved research, tumors in individuals under 50 are becoming larger, and symptoms are more severe. "If colon cancer is diagnosed at 42, it’s not because of screening, it’s because of symptoms," says Dr. Therese Bartholomew Bevers, medical director of the Cancer Prevention Center at MD Anderson Cancer Center.
For 27-year-old Jenna Putala, diagnosis took years. Throughout her college athletic career, she was plagued by unexplained injuries and health issues, leading her to orthopedists and neurologists. "No one did any imaging," she recalls. "Doctors just said, ‘Keep going, keep stretching, you’re fine.’"
It wasn't until last year, when an orthopedist sent her for a back MRI, that the results revealed the tip of an 8 cm tumor lower down, on her pelvis. Doctors believe she had been living with PEComa, a rare type of sarcoma, since 2018.
Due to the tumor's size, location, and her age, doctors were hesitant to remove it, as it would significantly alter her quality of life. She could lose part of her bowel or sciatic nerve, or her pelvis could be compromised. Instead, Putala attempted egg retrieval to preserve her fertility (but couldn't due to the tumor’s estrogen sensitivity), underwent 40 rounds of radiation, and is currently undergoing chemotherapy.
"I really don't think doctors considered that I might have cancer," she said. "I was a college athlete, always at the gym, eating healthy. I was doing all the things that supposedly help prevent cancer, so why did I get it?"
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Illustration of cancer cells. Photo: Sci Tech Daily |
Illustration of cancer cells. Photo: Sci Tech Daily
Doctors are racing to understand the reasons for the increasing cancer rates, but the truth remains elusive.
Diets have changed across generations. Today, ultra-processed foods make up more than 50% of the American diet and 70% of grocery store space. Foods like processed meats, sugary drinks, spreads, and condiments have been linked to cancer. Compared to previous generations, people are consuming ultra-processed foods at increasingly younger ages, meaning the damage may start earlier.
These dietary shifts can impact gut microbiome, inflammation, and insulin levels—all of which may play a role in cancer development, says Dr. Jeffrey Meyerhardt, co-director of the Center for Gastrointestinal Oncology at the Dana-Farber Cancer Institute.
Younger generations may also differ in body composition. From 1990 to 2020, adult obesity doubled, while childhood obesity quadrupled, according to the World Health Organization. The International Agency for Research on Cancer has linked obesity to 13 different cancers, including colorectal, endometrial, and ovarian cancers. "We think it's because excess body weight can lead to chronic inflammation," Dr. Bevers says.
Physical activity may also contribute. Exercise is thought to lower cancer risk due to its effects on factors like inflammation, insulin, body composition, and hormones, Dr. Meyerhardt says. While that doesn't specifically explain the rise in cancer rates in young people, globally, a third of adults didn't meet recommended physical activity levels in 2022.
These potential risk factors leave us with more questions than answers, especially for those who don't have any of them. "Diet, activity, obesity—that’s not going to explain everything," Meyerhardt says.
Doctors recommend eating a healthy diet (focusing on whole foods, including fruits, vegetables, and whole grains, while limiting processed foods, sugar, and red meat). Aim for 150 to 300 minutes of moderate-intensity or 75 to 150 minutes of vigorous-intensity activity per week. Get recommended vaccinations, especially for HPV. Avoid smoking and limit alcohol as much as possible. Alcohol and tobacco are Group 1 carcinogens, meaning there's sufficient evidence classifying them as cancer-causing to humans. UV radiation is also a Group 1 carcinogen—so protect yourself from the sun.
Be aware of symptoms. Any new lumps, unexplained weight loss, changes in bowel habits (like blood in the stool or black, tarry stools), abdominal pain, or coughing are symptoms to take seriously, Dr. Bevers says. The American Cancer Society also lists severe fatigue, problems eating, skin changes, unusual bleeding or bruising, and bladder changes as potential signs.
"Whether it's a new lump, a new pain, a new discomfort—something that's different and doesn't go away—make sure you tell your doctor," Giri says. Feeling that something is off can bring up a range of emotions, including fear, guilt, and embarrassment, but it's important not to let that stop you.
That's the rule Harris has lived by since her diagnoses. After she casually mentioned to her doctor that her throat was swollen and felt itchy one evening while at a friend's house, her doctor sent her for an ultrasound, which revealed the thyroid cancer. Now, "any little concern—even if I think it sounds stupid, even if it's embarrassing, I really don't care—I tell my doctors," she shares.
What if you mention it to your doctor and they dismiss it or offer recommendations that don't help? "Don’t feel discouraged. Bring it up again," Giri says.
Hoang Dung (From Women's Health)
