The New Face of Cancer: Youth and Women

More Americans are surviving cancer, but the disease strikes young, old and women more often, the American Cancer Society reported Thursday.

And despite overall improvements in survival, black and Native Americans die from certain cancers at rates two to three times higher than white Americans.

These trends represent a marked change for a disease that was long considered a disease of aging, and which affected men far more than women.

The change reflects a decline in smoking-related cancers and prostate cancer among older men and an increase in the cancer among people born since the 1950s.

Cancer is the second leading cause of death in the United States, but the leading cause among Americans under the age of 85. The new report says that about 2,041,910 new cases will occur this year and 618,120 Americans will die from this disease.

Six out of 10 cancers develop, including breast and uterine cancers. Colorectal cancer is also increasing among people under the age of 65, as well as prostate cancer, melanoma and pancreatic cancer.

Rebecca L. Seigel, an epidemiologist at the American Cancer Society and first author of the report, said.

“Of all the cancers that are increasing, some are increasing in men, but it’s skewed – more of this increase is happening in women.”

Women are also affected at a young age. Cancer rates are increasing among women under 50 (called early cancer), as well as among women aged 50 to 64.

Despite the recent increase in some cancers, such as colorectal cancer and testicular cancer, “the overall rate is the same for men under 50 and decreases from 50 to 64 years old,” said Ms. Seigel.

Several other worrying trends are mentioned in the report. One is the increase in new cases of cervical cancer – a disease considered preventable in the United States – among women aged 30 to 44.

Cervical cancer rates have been declining since the mid-1970s, when Pap smears became popular for detecting precancerous changes. But recent studies have found many women are delaying visits to the gynecologist.

A Harris Poll survey of more than 1,100 American women last year found that 72 percent said they put off visiting their doctor that might include a test; half said they did not know how often they should be screened for cervical cancer.

(Current recommendations are a little more complicated: Get a Pap smear every three years starting at age 21, or a combined Pap smear and test for human papillomavirus, which can cause cervical cancer, every five years.)

Another disturbing trend began in 2021 when for the first time the incidence of lung cancer in women under 65 exceeded that of men: 15.7 cases per 100,000 women under 65, while 15.4 per 100,000 in men.

Lung cancer has been on the decline over the past decade, but it’s declining faster in men. Women started smoking later than men and took longer to quit.

There was also an increase in smoking among people born after 1965, the year after the first surgeon general warned that smoking causes cancer.

Smoking remains the leading cause of preventable death in the United States, with an estimated 500 cancer deaths per day by 2025, mostly from lung cancer, according to the American Cancer Society.

“There is growing concern that e-cigarettes and vaping may contribute to this burden in the future, given their carcinogenic potential and popularity,” the report said.

Breast cancer rates have also increased over the years, increasing by about 1 percent per year between 2012 and 2021. The sharpest increases were seen in women under in the 50s, and there were significant increases among Hispanic Americans, Asian Americans, and Pacific Islanders. women.

The increase is driven by the detection of local tumors and some cancers caused by hormones.

Some of the increase is due to changes in fertility patterns. Breastfeeding and breastfeeding protect against breast cancer, but many American women are delaying childbearing – or choosing not to give birth at all.

Other risk factors include genetics, family history and heavy drinking – a habit that increases for women under 50. In older women, excess weight may play a role. in cancer risk.

Uterine cancer is the only cancer for which survival has actually decreased over the past 40 years, according to the ACS.

Death rates from liver cancer in women, and oral cancer in men and women are also increasing.

The incidence of pancreatic cancer has been increasing among men and women for decades. It is the third leading cause of cancer death. As with many other cancers, obesity is thought to contribute.

Little progress has been made in understanding and treating pancreatic cancer. The death rate has increased since records began, rising to 13 per 100,000 men and 10 per 100,000 women today, compared to about five per 100,000 for men and women. women in the 1930s.

The lack of progress has frustrated many scientists and doctors. The cancer is usually well advanced when diagnosed, and the five-year survival rate is only 13 percent.

“We need to move forward in understanding specifically what causes pancreatic cancer to develop, what treatments will prevent these cancers, what can prevent them in the first place, and how we can detect it early,” said the Dr. Amy Abernathy, an Oncologist who co-founded Highlander Health, which focuses on accelerating clinical research.

Some experts are beginning to agree that environmental exposures can cause early cancers, in addition to the usual suspects: lifestyle, genetics and family history.

“I think that not just one but the different types of cancer in young people, especially in young women, suggests that there’s something broader than just individual genetic changes or population genetics,” Neil said. Iyengar, an oncologist at Memorial Sloan. Kettering Cancer Center.

“It strongly points to the potential environmental and lifestyle exposure in the United States for the rise of cancer in young people.”

Public health efforts aimed at reducing high-risk behaviors have focused on high-risk populations and older Americans, who continue to bear the brunt of cancer, he noted.

However, risk factors may differ among young people.

Recent research indicates that maintaining regular sleep, for example, may help prevent cancer, he said.

Lifestyle and behavioral changes can reduce the risk of many cancers, Ms. Siegel said.

“I don’t think people realize how much control they have over their cancer risk,” she said. “There are many things we can do. The most important thing is not to smoke.”

These include: maintaining a healthy body weight; do not drink alcohol or eat in moderation; eating a diet high in fruits and vegetables, and low in red and processed meat; physical activity; and regular cancer screenings.

“There are all these things you can do, but it’s a personal choice, so just pick one that you can focus on,” he said. “Small changes can make a difference.”