There was a time when cancer was largely seen as a disease of later life, something doctors discussed with people in their 60s and 70s. Today, that picture is shifting. Doctors are increasingly seeing certain cancers in younger adults, including people diagnosed before 50. It does not mean cancer has suddenly become a young person’s disease. Older adults still account for most cases. But the rise in some early-onset cancers is significant enough to have doctors and researchers asking an important question: why are some cancers appearing earlier in life?

“Cancer is still predominantly a disease of older adults, but we are seeing a concerning increase in certain cancers among younger people,” says Dr Venugopal, Medical Oncologist and Hemato-Oncologist, Medicover Cancer Institute.




The rise is being seen across several cancers, including breast, colorectal, kidney, uterine and pancreatic cancers, as well as some lymphomas, melanoma, cervical, stomach, testicular cancers and myeloma. Among adolescents and young adults, breast, thyroid and testicular cancers and melanoma are among the more common types.


Colorectal cancer is particularly worrying. It has become one of the clearest examples of cancer appearing more often in younger adults, making doctors more cautious about brushing aside persistent bowel symptoms in people in their 30s and 40s. So, what is driving the shift? There is no single culprit.




lifestyle question


Obesity is a major factor under scrutiny. Rising excess weight among younger people has coincided with increases in cancers including colorectal, kidney, pancreatic, endometrial, liver and some breast cancers. Diet may play a role too. Processed and calorie-heavy foods can affect weight, metabolism, inflammation and the gut microbiome, while vegetables, fruit, whole grains and fibre support better overall health.

But Dr Nikhil Suresh Ghadyalpatil, Sr Consultant and Medical Director, Medical Oncology, Apollo Hospitals, cautions against making the issue too simplistic. “Lifestyle is important, but it is not correct to say that lifestyle alone causes cancer. Many people who live very healthy lives can still develop cancer,” he says.

Alcohol and tobacco remain major risks, while physical inactivity can also raise cancer risk. In India, smokeless tobacco is an added concern. Air pollution, along with exposures such as asbestos and arsenic, is also linked to cancer. Researchers are studying other possible factors, including pesticides, industrial chemicals and microplastics. But there is no single proven environmental cause behind the rise in early-onset cancer.

“There is no single explanation,” says Dr Ghadyalpatil. “Researchers are looking at obesity, diet, physical inactivity, alcohol, tobacco, environmental factors and the gut microbiome, alongside genetic and hereditary factors.” And what about our genes?

Genetics matters, especially when cancer strikes unusually early or runs in a family. Mutations such as BRCA1, BRCA2 and those linked to Lynch syndrome can increase risk, but genetics alone cannot explain the rise in younger adults. If several close relatives had cancer or it occurred unusually young, genetic counselling may be worth considering. Perhaps the most important issue is not what causes cancer, but what happens when symptoms are ignored.

A 32-year-old may dismiss rectal bleeding as piles, stomach problems as gastritis, or a breast lump as hormonal. Fatigue may be blamed on stress or lack of sleep. Most such symptoms are not cancer. But if something persists, feels unusual or gets worse, don’t ignore it. Get it checked. “Being young reduces the probability of cancer; it does not eliminate it,” says Dr Ghadyalpatil.

That distinction is crucial. The message is not to become frightened by every ache, lump or change in the body. It is to stop using age as the reason for ignoring something that does not go away.


WHEN SHOULD SCREENING START?

· No one-size-fits-all screening age

· Age, sex and family history matter

· High-risk people may need earlier screening

· Know your family cancer history

· Genetic counselling may help some families

· Screening is for people without symptoms

· Symptoms need medical evaluation at any age

THE WARNING SIGNS WORTH CHECKING

Some symptoms have many harmless explanations, but persistent or unexplained changes should be evaluated. These include:



· Unexplained weight loss

· A new lump or swelling

· Unusual bleeding or blood in the stool or urine

· Persistent abdominal or pelvic pain

· A lasting change in bowel or bladder habits

· Difficulty swallowing

· A persistent cough or voice change

· A breast or testicular lump

· Unexplained iron-deficiency anaemia

· A mole or skin lesion that changes

· Persistent, unexplained fatigue or fever

· The rule is simple: don’t panic, but don’t keep self-treating a symptom indefinitely without finding out why it is happening.


COLORECTAL CANCER: WHY DOCTORS ARE WORRIED

· Rising in younger adults

· Rectal bleeding shouldn’t be dismissed

· Persistent bowel changes need checking

· Unexplained anaemia can be a clue

· Don’t blame everything on piles or acidity

· Early evaluation can make a difference

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