Young people don’t need to worry about getting cancer, or do they?
Although cancer is a disease mainly affecting older people, research suggests a growing number of younger people are now developing cancers years before they should.
The number of under-50s diagnosed with cancer increased by nearly 80 per cent between 1990 and 2019 according to a major study published in BMJ Oncology. The number of deaths in younger patients rose by 28 per cent.
The Princess of Wales was just 42 when she was diagnosed with cancer earlier this year. Campaigner Dame Deborah James died of bowel cancer in 2022 at the age of 40 – 31 years younger than the average age for developing the disease, which is 71 in England and Wales. Girls Aloud star Sarah Harding died of breast cancer in 2021 at 39.
Kate, the Princess of Wales, was just 42 when she was diagnosed with cancer earlier this year
The growing trend of ‘early onset’ cases (as diagnoses in the under-50s are known) is alarming experts. For while ageing remains one of the main risk factors – eight out of ten cases of breast cancer are in the over-50s – more than 10,000 UK women under 50 are diagnosed with breast cancer every year, according to the charity Breast Cancer Now.
Last week the American Cancer Society identified six everyday habits that are linked to almost half of cancer cases. These are smoking, being overweight, alcohol intake, being inactive, eating a poor diet and getting too much sun.
But what’s driving the rise in cancer in young patients in particular?
One theory is that with bowel cancer at least, it may be linked to gut health and diet.
In a recent study, researchers at Ohio State University in the US examined the bowel tissue of patients under 50 with bowel cancer and found they contained cells that appeared to be 15 years older than the person’s actual chronological age.
Diets high in ultra-processed foods may change the balance of bacteria and cause inflammation in the gut, leading to ‘accelerated ageing’ in the colon, according to the researchers whose findings were presented to the American Society of Clinical Oncology.
Other research has shown that bacteria called fusobacterium, linked to diets low in fibre but high in sugar, increase inflammation in the gut, in turn raising the risk of cancer. Inflammation of the colon can cause rapid turnover of cells in the intestinal lining as the tissue struggles to heal, increasing the chance of irregularities that might lead to cancer.
Campaigner Dame Deborah James – ‘Bowelbabe’ – died of bowel cancer in 2022 at the age of 40 – 31 years younger than the average age for developing the disease
Yet as Professor Charles Swanton, chief clinician at Cancer Research UK (CRUK), explains, scientists don’t yet have ‘a good answer’ as to why more younger patients are developing cancer.
However there are ‘lots of ways’ people can reduce their risk of getting cancer young, stresses Claire Knight, senior health information manager at CRUK.
Mail+ asked leading cancer doctors for advice on the steps younger people can take to protect themselves.
Lose that spare tyre
Obesity is the second biggest cause of cancer in the UK after smoking cigarettes, responsible for one in 20 cases
Watching your weight is one of the most important ways to reduce your risk of developing cancer young, according to Karol Sikora, a cancer specialist and honorary professor of professional practice at the University of Buckingham Medical School.
He told Mail+: ‘My advice to young people who want to stay cancer free is watch your weight and maintain a healthy BMI. Being overweight, even not to a severe extent, is a huge risk factor for cancer.’
He adds that ‘a key change’ in recent years has been that younger people are more likely than those who are older to eat processed foods high in sugar and unhealthy fats and to lead more sedentary lifestyles.
‘Obesity is the second biggest cause of cancer in the UK after smoking cigarettes, responsible for one in 20 cancer cases and is helping to fuel the rise in cancer cases among the under-50s,’ adds oncologist Dr Peter Harper of the Leaders in Oncology Care Clinic in Harley Street.
‘Of children born today, 53 per cent will be obese by the time they are 35,’ he adds.
Research shows weight-loss injections such as Ozempic and Wegovy may cut the risk of cancer by one fifth, according to US scientists at Case Western Reserve University in Cleveland, Ohio.
They found that the drugs, which work by mimicking the hormone GLP-1 that tells the brain when the stomach is full, dramatically reduced the likelihood of getting breast, bowel and liver cancers.
This may be simply due to weight loss (as obesity itself is a risk factor) but the drugs may also reduce inflammation that increases the risk of these cancers.
Walk briskly
‘If you want to prevent cancer, take regular moderate exercise such as brisk walking, swimming and tennis,’ says Dr Harper, who co-founded the Oncology unit at Guy’s Hospital in London. ‘This is because exercise helps keep the immune system in tip-top condition.’
The immune system fights cancer in many different ways, including sending out white blood cells called T-cells: these see cancer as ‘foreign’ cells that don’t belong in the body, so can help deal with cancer before it takes hold. So your immune system needs to be fully charged.
‘The immune system is very responsive to exercise,’ says Dr Harper.
‘Regularly exercising at a moderate to vigorous intensity for up to 60 minutes is optimal for immune-boosting benefits. If you do this daily or almost daily, your immune and metabolic systems continue to strengthen.’
But you can overdo it: prolonged high-intensity training, such as bench pressing heavy weights for long periods – especially without appropriate rest between sessions — can suppress your immune system.
‘So don’t be a gym bunny, working out for hours building muscles. Opt for team games, tennis or walking to work regularly,’ says Dr Harper.
Get off your phone
High mobile phone use is a significant predictor of being what US researchers have termed an ‘active couch potato’ – someone who despite being physically active also spends at least eight hours a day sitting down. Numerous studies have linked sedentary behaviour, independent of physical activity, with a greater risk of heart disease and certain cancers, as well as premature death.
Each additional hour of ‘couch potato’ behaviour increases all these health risks by an additional 11 per cent, according to researchers at Kent State University, in a study published in the journal Digital Health in 2019.
‘Even if you can cut your phone use for one hour a day and spend that time doing something more active, you can improve your fitness,’ says Dr Harper.
Using a screen filter to cut blue light emissions from phones and tablets may help reduce the risk of breast cancer. Blue light was linked to breast cancer in a study published in the Journal of Biomedical Physics and Engineering, although the researchers stressed more research is needed. One suggestion is that these visible light emissions at night can disrupt the body’s circadian rhythm, disrupting sleep.
However, another study, published in April in the same journal, did not find a strong relationship between exposure to blue light and the development of breast cancer, so the jury is still out.
Eat like it’s the stone age
The University of Cambridge found that two-thirds of the calories consumed by adolescents came from junk or ultra-processed foods
Pancreatic cancer has a low survival rate, with 5 per cent of patients living for five years. Worryingly, the number of under-55s diagnosed with it is now growing more rapidly than in older age groups. Incidence is also growing more rapidly in women than men, according to a 2023 article in The Lancet Gastroenterology and Hepatology.
The cause of this rise in younger people is unclear – but a 2021 review of previous studies by scientists at the Veneto Institute of Oncology in Padua suggests it could be linked to diets low in fibre.
‘Adolescents and young adults in the UK typically eat diets low in fibre, so this is a worry,’ says Professor Sikora, adding that an easy way to boost dietary fibre is replace meat twice a week with a plant-based meal.
Cutting down on – or avoiding – junk food, which usually contains little or no fibre is another strategy, he says.
Research last year by the University of Cambridge, found that two-thirds of the calories consumed by adolescents came from junk or ultra-processed foods that are low in fibre and nutrients, and high in saturated fats, added sugar or salt.
Professor Sikora instead advises making sure you eat plenty of fruit, vegetables and wholegrains: ‘Go back to the Stone Age, when people ate mainly a high-fibre, plant-based diet with meat only when it was available.’
Avoid fizzy pop
British teenagers typically consume more than double the recommended amount of added sugar by their late teens – 70g a day instead of the recommended 30g, according to UK Research and Innovation.
A large proportion of this comes from sweetened fizzy drinks.
‘There’s nothing in the fizz that is linked to developing cancer earlier, but high levels of sugar in fizzy drinks can lead to higher levels of obesity and type 2 diabetes, known risk factors for cancer,’ explains Professor Sikora.
Fruit juice also contains high levels of sugar in the form of fructose.
‘Better to drink water and eat fruit, which contains fibre and slows down the absorption of fructose into the bloodstream,’ says Professor Sikora.
Forget that ‘Love Island’ tan
Cancer Research UK recently predicted that a record 20,800 cases of melanoma would be diagnosed this year – nine in ten of which are preventable
‘The number of young people diagnosed with melanoma, a malignant kind of skin cancer, has doubled over the last 30 years,’ says Professor Sikora, who believes a change of travel habits could be responsible, with young people ‘much more likely to jump on a plane and spend two weeks in Spain on a beach than in the past’.
Bronze tans may be fashionable among young people but the risk is your skin burning and DNA damage.
Cancer Research UK recently predicted that a record 20,800 cases of melanoma would be diagnosed this year: but around nine in ten are preventable, caused by too much ultraviolet (UV) radiation.
The under-20s are also the age group most likely to use sunbeds, at least two or three times a year, according to the charity Melanoma Focus.
‘Opt for a safe tan with fake tan from a bottle,’ says Professor Sikora.
The standard advice is to stay out of the sun in the heat of the day in the UK and be careful to protect your skin when abroad – ‘don’t be a lobster and come home with red sun-burned skin’, advises Professor Sikora.
‘Wear a hat in the sun, particularly if you have thin hair on top. Scalp melanoma represents 35 per cent of cases of head and neck melanomas.’
Don’t smoke – or vape
The highest risk factor for cancer is smoking cigarettes. While the number of young people smoking tobacco has declined dramatically – the latest NHS England figures, for 2021, suggest just 4 per cent of boys and 3 per cent of girls aged 15 now smoke (compared with a quarter of 15-year-olds in 1982) – some are now vaping instead.
And while ‘vaping and heated cigarettes are, we believe, 98 per cent less harmful than smoking’, says Dr Haper, vaping is not risk-free.
As the Centre for Disease Control in the US advises: ‘If you don’t vape, don’t start.’
It points out that ‘most e-cigarettes contain nicotine, which is highly addictive and is a health danger for pregnant people, developing foetuses and youth. Aerosol from e-cigarettes can also contain harmful and potentially harmful substances. These include cancer-causing chemicals and tiny particles that can be inhaled deep into lungs’.
Draw a family health tree
Some early-onset cancers can run in families, including breast cancer caused by the faulty BRCA1 and BRCA2 genes; as well as bowel cancer and prostate cancer which occur before the age of 50.
‘Make sure you know about your family history of cancer,’ says Professor Sikora.
‘If you have several close family members who have developed the same kind of cancer, that could suggest that you may be more at risk.
‘Talk to your GP who can send you to a genetic counsellor to help your decide if you want to take a genetic test.’
Once a genetic mutation has been confirmed, regular checks can detect early changes that might indicate cancer.
‘Many cancers are highly treatable if they are caught in their early stages,’ says Professor Sikora.