Cancer diagnoses in people aged 50 and under are increasing in France (and beyond), prompting an oncologist to remind the public to stay alert to possible signs of the disease.
The warning comes after Catherine, Princess of Wales, aged 42, announced she was undergoing treatment for cancer after having had abdominal surgery earlier this year.
And a recent study, published in the scientific journal BMJ Oncology in September 2023, found that from 1990 to 2019 there was a significant rise in the rate of cancer diagnosis among people aged under 50.
This study found that the number of cancer diagnoses per 100,000 inhabitants in the under-49 age group rose worldwide from 1.82 million in 1990 to 3.26 million in 2019. This is an increase of 79%.
It also found that in 2019, more than one million people under the age of 50 died from cancer. Those with the highest mortality rates were cancers of the breast, tracheal, lung, intestines, and stomach.
Lead author of the study, Professor Helen Coleman, also found that the types of cancer diagnoses were changing. “Traditionally, in men, it was [most commonly] testicular cancer and brain tumours. This research instead shows an increase in colorectal cancer,” she wrote.
Read more: Cancer cases in France have doubled since 1990
Figures from French health body Santé publique France also show that people aged under 50 are increasingly more likely to be diagnosed with pancreatic, colon, skin and kidney cancer.
In contrast, rates of cervical cancer are declining due to HPV vaccination, said Dr Ilan Darmon to Le Point, “but the situation is not yet optimal,” he said.
Dr Darmon is a radiotherapy oncologist at the HORG radiotherapy centre in Boulogne-Billancourt, Paris (Hauts-de-Seine, Île-de-France). He has sought to explain this rise in cancer rates in the under-50s.
Greater awareness and earlier diagnosis?
In some cases, especially for breast cancer, greater awareness among younger people is leading to more and earlier diagnosis. As a result, this does not necessarily mean that there are higher numbers of breast cancer cases overall.
"In the case of breast cancer, women are made aware of the need for self-examination and screening at an early age,” said Dr Darmon. “Even though the official awareness campaign starts at the age of 50, many gynaecologists carry out individual screening of patients well before that.
“This enables them to spot lesions at an early stage.”
Lifestyle factors
However, not all cases are due to better medical care or earlier screening, he said. Many of these ‘new cancers’ are genuinely new cases, often caused by lifestyle factors.
He said: “We now know that smoking, excessive alcohol consumption, unbalanced diet, sedentary lifestyle, obesity and lack of physical activity are all risk factors for the development of cancer.”
Pesticides, endocrine disruptors, and pollution are also factors.
“On the other hand, a healthy diet, regular exercise, and limiting exposure to UV rays and certain occupational substances are all protective shields,” said Dr Darmon. “By limiting avoidable factors, 40% of cancers can be prevented.”
Read more: Cancer expert alarmed by ignorance of risk factors in France
Cancer stage, not patient age, most important
While more cancer cases in younger people may appear alarming, Dr Darmon added that the age of the patient is not necessarily the most important factor when it comes to mortality.
"What's important is not age but the stage of the cancer when it's discovered,” he said.
Cancer is usually categorised in stages, from Stage I (the earliest stage) to Stage IV. This is the last stage, which may mean the cancer has metastasised (spread to more than one area of the body), and may be much harder to treat. The earlier the detection, the better the outcomes.
Yet, cancer may grow faster in younger people, and have a higher chance of recurring, Dr Darmon said.
“In cancer, the disease develops by producing abnormal cells that proliferate anarchically and excessively. In young people, the potential for seriousness may be greater because of the speed at which cells multiply,” he said.
“The earlier the cancer appears, the more likely it is to go into remission. But the younger the cancer, the greater the chance of recurrence, because life expectancy is longer.”
Advice for younger people
Overall, Dr Darmon said that the most important thing in detecting early cancer is to be aware of your body, listen to any symptoms, and advocate for yourself if you believe there is something wrong.
This might include tracking or keeping a diary of symptoms, visiting the doctor despite any embarrassment, pushing for tests or imaging, and/or seeking a second or third doctor’s opinion.
"Young people are often more attuned to their symptoms,” said Dr Darmon. “Any unusual symptoms should prompt medical advice. We mustn't ignore the signals sent by the body.”
He said that some symptoms especially should be looked into, including:
Unusual and persistent fatigue
Unexplained weight loss
Unexplained changes in appetite, or bathroom habits
Unexplained bleeding
Any new lumps, bumps, or marks
Dr Darmon also said that young people who use healthcare apps may be more astute when it comes to gathering evidence and monitoring symptoms, as studies have confirmed that by gathering or storing information via smartphone apps can help build up a greater picture of health.
