Cancer Rates Are Rising in Young Adults: What to Know About Early Onset Cancer
Cancer is becoming more common in younger adults. Doctors call cancer diagnosed in adults under 50 “early onset cancer,” and rates have been rising for several decades across a range of cancer types, including breast, colorectal, and uterine cancer.
A cancer diagnosis at a younger age can bring different challenges, such as concerns about fertility, raising young children, building a career, or managing the cost of care with less savings. To address those needs, Yale Cancer Center and Smilow Cancer Hospital launched the Early Onset Cancer Program in 2023. The program brings together cancer specialists, researchers, and support services tailored to younger adults between the ages 18 and 45 who have cancer.
Why are cancer rates rising in younger adults?
The increase isn’t limited to one type of cancer.
“We're seeing this increase in early onset cancers across the spectrum of cancers, for example, breast cancer, colorectal cancer, endocrine cancer, and uterine cancer,” says Yale Medicine medical oncologist Veda N. Giri, MD, director of the Early Onset Cancer Program. “This rise is across a spectrum of cancer types and really deserves to be looked at as a broad issue.”
Researchers don’t yet know exactly what is driving the rise. Possible factors being studied include environmental exposures and lifestyle factors, such as diet. Inherited genetic factors may also play a role. Some cancers run in families, and certain inherited gene changes can raise a person’s risk at a younger age
One area Yale Cancer Center researchers are studying is the gut microbiome, the community of bacteria and other microorganisms that live in the digestive tract.
“The microbiome is connected with immune regulation,” says Dr. Giri, who is also a professor of internal medicine at Yale School of Medicine. “This immune regulation is important as surveillance for finding cancer cells, getting rid of them or even keeping them in check.”
Because diet shapes the gut microbiome, Dr. Giri says this research could help explain how diet may influence cancer risk.
What does the Early Onset Cancer Program offer?
The program connects specialists who treat many types of cancer with researchers studying the causes of early onset cancer.
- Care and support tailored to the medical, emotional, and practical needs of younger patients
- Research into why early onset cancer is increasing and how to detect it sooner
- Education and outreach to help the public and health care providers recognize that cancer can occur in younger adults
“We wanted to respond to the rise in early onset cancer with a comprehensive view,” says Nancy Borstelmann, PhD, co-director of the Early Onset Cancer Program. “We’re supporting patients with the complexity of psychosocial, more unique needs of this younger population. We’re also thinking about gaps in research that may exist.”
Why is early onset cancer sometimes diagnosed later?
Many younger adults don’t think of themselves as being at risk for cancer. Routine screening also doesn’t begin until certain ages for people at average risk. For example, colorectal cancer screening typically starts at 45, and breast cancer screening at 40.
As a result, cancer in younger adults may not be found through screening. Busy schedules can also lead people to dismiss symptoms or delay seeing a doctor.
“It is really important, from an education and awareness standpoint, to explain that cancers can occur in younger individuals,” Dr. Giri says.
When should younger adults see a doctor?
Most symptoms in younger adults are caused by something other than cancer. But it’s worth seeing a doctor about symptoms that are new, persistent, or unexplained, such as:
- Rectal bleeding or blood in the stool
- A lasting change in bowel habits
- A lump in the breast or elsewhere
- Unusual vaginal bleeding
- Unexplained weight loss
- Ongoing abdominal pain
If cancer runs in your family, talk with your doctor about whether you should start screening earlier or consider genetic counseling.
What is the CONNECT program?
A hallmark of the Early Onset Cancer program is Coordinated Outreach to address Needs and Navigation for Early onset Cancer Together (CONNECT), a no-cost support initiative that helps patients manage the life changes that can come with a cancer diagnosis. It’s currently available to patients with early onset solid tumors, including breast and gastrointestinal (GI) cancers, who receive care at Smilow Cancer Hospital care centers.
A cancer diagnosis can disrupt early adulthood in many ways. Borstelmann notes that younger patients may be hoping to start a family, raising young children, starting their careers, building relationships, or living with fewer savings than older patients given the competing life pressures.
“It's about personalized enhanced navigation,” says Borstelmann. “We reach out to new patients and do a special interview with them focused on their needs, concerns, and what's most important to help them. We want to remove any barriers that might be in the way of getting the best care possible, or that may be adding to distress.”
CONNECT navigation specialists work with each patient to create a plan based on their personal goals. They help patients find resources both within Yale Medicine and in the community, including personalized information and financial assistance.
How can CONNECT help with the cost of cancer care?
The cost of cancer treatment can put serious strain on patients and families. This financial burden is sometimes called financial toxicity.
“We've been learning from our patients how common financial toxicity is,” Borstelmann says. “We know from larger studies that have been done on financial toxicity that younger individuals report higher rates of serious financial distress than older cancer patients.”
“What we really want is to have our patients tell us what they’re struggling with, and then we can work with them to find resources that might help defray costs,” she says.
How can patients get started?
If you’ve been diagnosed with cancer and are 45 years old or under, ask your care team about the Early Onset Cancer Program and whether CONNECT is available to you.
Borstelmann and Dr. Giri recently discussed the Early Onset Cancer Program on Yale Cancer Answers. Listen to the full episode to learn more about the program’s resources and its research into risk-aware screening, an approach that tailors when and how people are screened based on their individual cancer risk.
