MOSCOW, September 9, Vladislav Strekopytov. A large study of the prevalence of cancer found that over 30 years, the number of cancer cases in those under 50 worldwide has increased by almost 80 percent. And this is true in all countries, and not just where an early detection system has been established. About possible reasons – in the material.
Cancer is getting younger
Cancer is considered a disease of the elderly: 90 percent of cancer patients are over 50. But doctors increasingly noted that cancer was getting younger. And scientists have confirmed this.
A group of experts, based on the Global Burden of Disease (GBD) project, implemented since 1990 under the auspices of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, analyzed information on 29 types of cancer in 204 countries and regions. It turned out that from 1990 to 2019, the number of cancer diagnoses in those under 50 increased from 1.82 to 3.26 million (80 percent), and mortality increased by 27.7 percent. More than a million people under 50 years of age die from cancer every year.
Breast cancer causes the most (13.7 new cases and 3.5 deaths per 100 thousand women in 2019 – this is the worst indicator), trachea, prostate, lungs, intestines and stomach. The mortality rate from tumors in the kidneys and ovaries suddenly increased sharply.
Morbidity and mortality are growing most noticeably in the developed countries of North America, Western Europe, and Australia, although the trend is the same in Asia. Scientists predict that by 2030 the number of diagnoses and deaths will increase by another 31 and 21 percent, respectively, and everyone over 40 will be at risk.
The reason is the Western image
Researchers note that this is partly due to improved screening and reporting, as well as population growth in countries with large proportions of young people.
But the main role, they believe, is played by behavioral factors: insufficient physical activity, smoking, alcohol, unhealthy diet. Environmental pollution, widespread use of antibiotics and genetically modified foods contribute to this. Breast cancer is promoted by oral contraceptives, late childbirth or absence of children, and refusal to breastfeed.
If you add carcinogenic factors such as chronic stress, lack of sleep, a diet high in sugar and red meat, leading to obesity and diabetes, you get a complete set of elements of the Western lifestyle, which has been actively spreading in recent decades in developing countries where previously adhered to the traditional way of life.
Carcinogenic diet
The review's authors place particular emphasis on nutrition, noting that a diet high in ultra-processed and processed foods, as well as alcohol consumption, significantly increases the risk of cancer.
“Highly processed foods—ready meals, frozen pizza, breakfast cereals, supermarket bread, sandwiches, cookies, donuts and chocolate—have become commonplace. They are affordable, shelf-stable, and appealing to the taste buds. But they are very unhealthy.” , writes Professor Devi Sridhar, chair of global public health at the University of Edinburgh, in an article in The Guardian.
Increasing evidence suggests that these foods change the composition of the gut microbiome, which plays a key role in digestion, immune system regulation and protection from pathogenic bacteria. It is no coincidence that the highest rates of growth in the incidence of colorectal cancer, which is especially sensitive to nutritional patterns, are observed in developed countries. But not in all.
In Japan the statistics are much better. They eat a lot more vegetables, fish and seafood there, they like to walk and ride bicycles. But in ethnically and economically similar South Korea the situation is the same as in the West.
Expert opinions
The scientific community was skeptical about the published review.
“The authors report a reduction in age-standardized cancer mortality, which is in principle consistent with the results of previous studies,” says Montserrat Garcia-Closas, professor of epidemiology at the Institute of Cancer Research in London. “But their findings are based on absolute values and do not take into account changes in demographics. In addition, the quality of data provided by different countries varies, which calls into question overgeneralizations.”
“From 1990 to 2019, the world’s population increased by 46 percent, and so did disease rates,” said Dorothy Bennett, professor of cell biology at St. George’s University of London. “Although I don’t know the exact percentage for the 14-45 age group, there is an increase in mortality In any case, there is noticeably less cancer in it.”
We also noticed that there is especially a lot of information on cancer of the breast, intestines, stomach, and lungs. They have a common set of risk factors: alcohol, smoking, poor diet. And, for example, liver cancer, which is becoming less and less common, is mentioned only in passing.
Nevertheless, most experts admit: cancer is getting younger, and it is no longer a disease of the elderly.
“Practicing doctors, unfortunately, see this,” emphasizes the chief physician of the Gemotest laboratory, Maxim Maskin. “Most often, young people are diagnosed with cancer of the respiratory system and gastrointestinal tract, and women are diagnosed with breast cancer. Of course, the improvement is affecting diagnostics. Laboratory tests and instrumental methods now make it possible to detect malignant tumors at the earliest stages. But this, obviously, is not the main reason for such frightening figures.”
“There are many factors here,” continues Maskin. “They are all connected in one way or another with lifestyle. The diet of a modern person is strikingly different from what was usual half a century ago. The consumption of protein foods has increased, and the consumption of fresh vegetables, herbs and fruits has decreased. This is bad for the digestive system. Constant stress, bad habits, and lack of exercise weaken the body's immune defense and over time can provoke cancer.”
But the worst thing, in his opinion, is the abundance of carcinogens, chemicals that cause cancer. In water, soil, air, products, household chemicals, cosmetics. The materials used to build houses and infrastructure can be carcinogenic. Herbicides and antibiotics used in agriculture are also not good for health.
“Global trends in morbidity and mortality are numerous and even often opposite in countries of different geography, culture and socio-economic development,” explains Vasily Vlasov, professor of the Department of Management and Health Economics at the Higher School of Economics, Doctor of Medical Sciences. “It is important that all studied types of cancer are tumors not of childhood, but characteristic of adults, but registered at an atypical, relatively young age. This aspect of the problem is important, since oncological diseases that occur at an early age are especially aggressive.”
“It is true that some types of cancer have become more common in young people, for example, colon, due to obesity, but in general the incidence is almost the same, and thanks to progress in prevention, diagnosis and treatment, mortality has decreased by about a third,” says the oncology surgeon and chemotherapist, candidate of medical sciences Anton Ivanov. – Perhaps young patients with oncology are simply more active in declaring their diagnosis in the information environment. Previously, this was not accepted.”
“I have been involved in diagnostics for almost 15 years and recently “I am increasingly finding malignant neoplasms at a younger age,” says a doctor of the highest category, candidate of medical sciences Liana Martirosyan. “Cancer is getting younger, it’s true. This is due to the environment, stress, and an unhealthy lifestyle.”
All experts agree on one thing: the world in which people live has changed dramatically over the past 30 years, and the body cannot help but react to this. The task of scientists is to assess risks, put forward hypotheses and develop new treatments.
