Cancer Is Striking More Young People and Doctors Are Alarmed and Baffled

January 14, 2024 4:06 PM

A study in BMJ Oncology last year reported a sharp global rise in cancers in people under 50, with the highest rates in North America, Australia and Western Europe.
posted by folklore724 (48 comments total)

It isn't the fact that we're all chock full of microplastics?
posted by chaiminda at 4:18 PM on January 14 [24 favorites]

I was coming here to post TheGraduate-Plastics.gif.
posted by hippybear at 4:22 PM on January 14 [11 favorites]

came here to say microplastics, too
posted by torokunai at 4:30 PM on January 14 [3 favorites]

I mean, alternately, pass-thru medications and hormones, which are apparently as much everywhere as microplastics. And also forever chemicals, and we have no clue what they do.
posted by hippybear at 4:33 PM on January 14 [12 favorites]

A very dear friend of mine, in his forties, father of a five year old child, was just diagnosed with stage iv cancer. So, this article hits me.
posted by meese at 4:43 PM on January 14 [6 favorites]

BMJ link

"Genetic factors are likely to have a role, say the researchers. But diets high in red meat and salt, and low in fruit and milk; alcohol consumption; and tobacco use are the main risk factors underlying the most common cancers among the under 50s, with physical inactivity, excess weight, and high blood sugar contributory factors, the data indicate."
posted by paimapi at 4:45 PM on January 14 [15 favorites]

In my mind I'm thinking about the Rogan/Peterson-esque drive to 'animal proteins' in spite of soy being a perfectly adequate source of amino acids, Juul and other vape companies, cost of fresh fruits and vegetables along with the capitalist drive to extract maximal profits leaving little to no energy left after work for cooking/cleaning, the explosion of a whole 'healthy' snack food industry that's still incredibly high in salt content, and the general destruction of pedestrian culture and pathways to make way for car dominance.
posted by paimapi at 4:50 PM on January 14 [21 favorites]

Deaths of Despair are way up. Like, beyond any measure or estimate since the 1800s up. Which points to a wider use of coping mechanism, most of which Aren't Great for you long term. Stress is also very bad over a long period of time and people in despair are people who are stressing.

There will likely not be one root cause, just a large pile of "this isn't helping" causes.
posted by Slackermagee at 5:12 PM on January 14 [16 favorites]

I went to a conference this fall focused on GI cancer in young people. The clinicians attending said the young people they’re treating don’t drink, don’t smoke, aren’t overweight, eat healthy and are very active so the typical risk factors for cancer don’t fit. Some cases can be attributed to hereditary factors but very few. A lot of the current research was on the role of microbiome.
posted by kat518 at 5:33 PM on January 14 [39 favorites]

I'm suspicious about this "diets low in milk" correlation and trying to decide how far down the rabbit's hole I'm willing to go.
posted by unknowncommand at 5:35 PM on January 14 [14 favorites]

Stress.
posted by kaelynski at 5:38 PM on January 14 [6 favorites]

I had a co-worker in her late 20’s die of brain cancer, a colleague in her mid 40’s die of brian cancer, and currently know I guy in his early who is in a clinical trial after his 3rd reoocurance of Brian cancer.

my brothers best friend from high school had lymphoma is his late 30s but thankfully seems to be in full recovery.

Now idea what could cause Al those cancers, although the one of the guys was in the navy.


I saw my dad die of melanoma in his 70’s after a lifetime of sun exposure and a know of a number of lung cancer deaths I smokers. It all seems to random to me

I
posted by CostcoCultist at 5:51 PM on January 14

Glysophate, celebrating 50yrs of poisoning the planet. Interesting how Monsanto (poison company) is now known as Bayer (pharma company). You can change the toxic brand name to something friendly-sounding and still sell the toxic product. Which essentially means that these modern cancers are caused by capitalism.
posted by Thella at 5:54 PM on January 14 [10 favorites]

I'll tell you what, being all "no drink/no smoke" straightedger was pretty annoying in my teens, but now it is honestly a way of life I'm certainly happy to have re-adopted. Walking the dog daily is good too. My parents died in their 50's - one from cancer - and it's not a fate I'd like to repeat. (My fate is never retiring, like the rest of the Millennials!)
posted by alex_skazat at 6:01 PM on January 14 [1 favorite]

Stress is also very bad over a long period of time and people in despair are people who are stressing.

The Canadian Cancer Society has an interesting angle on this.

Though ... "research has not proven a definite cause-and-effect relationship between stress and cancer" [...]

"Stress can weaken your immune system. Your immune system defends your body against infections and diseases, such as cancer. A weakened immune system plays a role in the development of some types of cancer.

"Stress can alter the levels of certain hormones in your body. This may also put you at greater risk of developing cancer.

"stress may lead to unhealthy behaviours. Overeating, smoking and heavy drinking are all lifestyle factors that increase cancer risk."

Stress being defined by the W-H-O as ... "a state of worry or mental tension caused by a difficult situation."

Is anyone not in a difficult situation?
posted by philip-random at 6:10 PM on January 14 [14 favorites]

As someone suffering from pretty acute anxiety I do wonder if I'm doing a ton of damage to my brain with it being flooded with cortisol and other stress hormones constantly.
posted by hippybear at 6:12 PM on January 14 [21 favorites]

Article that's the basis of the BMJ press release. To quote from the concluding section:

Dietary risk factors, alcohol use and tobacco consumption were the main risk factors for top early-onset cancers in 2019. Additionally, it is necessary to conduct prospective life-course cohort studies to explore the aetiologies of early-onset cancers. Encouraging a healthy lifestyle, including a healthy diet, the restriction of tobacco and alcohol consumption and appropriate outdoor activity, could reduce the burden of early-onset cancer.
posted by cupcakeninja at 6:24 PM on January 14 [4 favorites]

So, basically you’re all saying the culprit is the one thing you each always expected to be a culprit? Huh, funny how that works.

…maybe leave it for the actual scientists and doctors? I mean, I’m pretty sure it’s because none of you have made appropriate sacrifices to my temples. It’s probably that, the thing I want it to be. Yeah, that must be the thing we can all blame. How convenient, that I should manage to be right once again.
posted by aramaic at 6:26 PM on January 14 [43 favorites]

MILLENIALS RUIN NOT HAVING CANCER
posted by clawsoon at 6:32 PM on January 14 [24 favorites]

My question is... were they testing for microplastics, forever chemicals, pass-through drugs and hormones? I did a very cursory search but didn't see that there was any of that in the data set because that's not something anyone is really doing testing for at this point. It's too new.

They're saying that these have a surprising increase in cancer, but young people aren't doing all these unhealthy things that cause cancer. They're not drinking and not smoking in levels that are alarming to the people selling alcohol and cigarettes.

Is this study saying that young people who are getting cancer are people who are smoking and drinking and they are getting it more often than earlier groups who were doing the same activities? If so, that doesn't say that smoking and drinking is causing the MORE cancer, is it?

I'm sorry, I'm probably too stupid to understand any of this, but if the youngs are having more healthy lifestyles than ever before but are getting more early cancer than ever before, how does saying the old vices that cause cancer, that the youngs aren't doing as much, are to blame?

Explain it to me like I'm five.
posted by hippybear at 6:39 PM on January 14 [9 favorites]

Could bioaccumulation be a factor?
posted by perhapses at 6:49 PM on January 14

And it’s still not clear to what extent screening... may be influencing the observed trends

If anyone has time to read the paper, I'd be interested to know to what extent they're taking the increases in early screening for cancer into account. How much are we seeing more simply because we're looking more?
posted by clawsoon at 6:52 PM on January 14 [10 favorites]

That's a good point, also using machine learning to spot cancers that wouldn't have been spotted by human eyes in earlier years. It could just be an increase due to better detection methods.
posted by hippybear at 6:58 PM on January 14 [1 favorite]

hippybear, I have no idea if anyone is seriously evaluating the impacts on humans of the things in your first paragraph, aside from perhaps hormones. My sense is that a lot of this (e.g. micro plastics) is hard to test for the long-term impacts of in people, and that the research just isn't there yet. My vague memory was confirmed by a quick glance at the literature, I see lots of microplastics research a decade ago, for instance, but much more in the "demonstrating that they are indeed accumulating in living organisms" than "what effect are they having in humans." The articles that pop up documenting current research when I search for the effects of micro plastics on human health appear very much to still be in the preliminary stages--review of possible impacts, lots of question marks, that sort of thing.

The article suggests to me that some of the things researchers have studied extensively and know to be problems continue to be problems. Not to be all "old man yells at clouds," but people in 1970 didn't start their day with a 96-ounce Coke, then proceeded to drink a cocktail of energy drinks, frappuccinos, and more pop throughout the day. That's one facet of one element ("diet"), but other aspects of that follow similar lines. God knows, no one wants to hear "people are more overweight these days," but worldwide obesity has tripled since 1975. There are many reasons for that, well-discussed on the blue in the past (poor nutrition, chemical hellscape food, stress leading to negative coping strategies, etc.).

There's a bit about colorectal cancer in the article that's sobering:

Except for dietary risk factors, alcohol use, high BMI, tobacco consumption, high fasting plasma glucose and low physical activity contributed to early-onset CRC. Of these risk factors, high BMI, particularly obesity, has been identified as a strong risk factor for early-onset CRC. The increasing prevalence of obesity in younger generations has led to a substantial increase in early-onset CRC cases


I am not a health researcher, so I can't speak to how all of that balances out against decreases in alcohol consumption or tobacco use, in terms of net ups or down for overall health.


(clawsoon, there is a line about increased testing -- Besides advancements in screenings and diagnostics, other possible reasons for variations in health outcomes could be differences in age demographics and the presence of genetic and lifestyle risk factors -- but it does not go into detail about whether increased early testing is more or less responsible for our seeing these heightened instances of cancer.)
posted by cupcakeninja at 7:27 PM on January 14 [4 favorites]

(To be clear, I did not do a professional-quality search of the literature, nor am I a medical professional or researcher.)
posted by cupcakeninja at 7:28 PM on January 14

Thank you cupcakeninja, that was a very nice summary of things that went beyond what I could have possibly assembled for myself put in a way that I understand clearly. I greatly appreciate that! Virtual internet stranger hugs of thanks.
posted by hippybear at 7:35 PM on January 14 [6 favorites]

The article is paywalled for me, but IIRC we're seeing not just more under-40 diagnoses of many cancers but more under-40 deaths from them, yes? I don't see how more screening gets to more deaths without an actual increase in the rate of the disease. (Mislabeling the deaths would do it. Do we think we're doing that?)
posted by clew at 8:01 PM on January 14 [2 favorites]

Or the deaths were previously misattributed to other causes, and are now more likely to be counted correctly? (I don’t know whether or not this is happening, just pointing out another possible explanation.)
posted by mbrubeck at 8:43 PM on January 14 [2 favorites]

My quick skim is that this study is basically a retrospective analysis of existing data, so the data available were going to be things typically asked during medical care (alcohol/tobacco use, weight, age, exercise, etc). I’m guessing doctors and hospitals are not now, and were not in the past, routinely testing for things like microplastics (how do you even do that?), so therefore those data aren’t available in electronic health records and you can’t look for ways they might have impacted specific diseases. So I kinda think that’s why the same typical risk factors showed up, because there was likely no actual data in the dataset about these other, newer potential risk factors.
posted by DiscourseMarker at 8:44 PM on January 14 [4 favorites]

I don't see fine particle pollution on the list of factors
posted by thegirlwiththehat at 11:10 PM on January 14

The anti-vaxers are gonna loooooove this.
posted by inexorably_forward at 1:15 AM on January 15 [2 favorites]

The original article shouldn't be paywalled for anyone, in theory, as I was able to access it from a machine without any proxies, etc. enabled.

From the first lines of the article:

Objective This study aimed to explore the global burden of early-onset cancer based on the Global Burden of Disease (GBD) 2019 study for 29 cancers worldwid.

Methods and analysis Incidence, deaths, disability-adjusted life years (DALYs) and risk factors for 29 early-onset cancer groups were obtained from GBD.


So, yes, it is drawing on pre-existing work. As to the "are they testing for [thing that oncologists do not test for]," they are not able to gather that data, which does not exist. I think learning those things via original research would be interesting, but doing that on a global scale (the focus of this article) would be a massive undertaking with, as the article notes elsewhere, some truly breathtaking local variations and data gaps.
posted by cupcakeninja at 2:58 AM on January 15 [2 favorites]

It's hard to study causes of cancer risk because cancer usually happens more than 10 years after the exposure to the cause. Environmental causes of cancer like microplastics and waterproofing forever chemicals are especially hard to study because everyone gets exposed, so how do you find an unexposed group (that is not vastly different from the exposed group) to compare?

(I'm not saying environmental pollutants don't cause cancer -- I believe they do -- but I wish we could be better at regulation and not just allow stuff to go into wide use to the point that it becomes difficult to ban.)

Anyway, I grew up in Cancer Alley, so I'm probably doomed.
posted by antinomia at 5:01 AM on January 15 [7 favorites]

Archive link to the original WSJ article.

Obesity is linked to cancer and has been increasing since 2000 ("From 1999–2000 through 2017–2018... obesity increased from 30.5% to 42.4%... severe obesity increased from 4.7% to 9.2%") so that does seem like a possibility.
posted by TheophileEscargot at 5:43 AM on January 15 [4 favorites]

Interesting how Monsanto (poison company) is now known as Bayer (pharma company). You can change the toxic brand name to something friendly-sounding and still sell the toxic product.

Bayer purchased the Monsanto corporation in 2018. It wasn't a name change to avoid anything, Roundup is still a product on the market and Bayer has been working to clear the myriad of lawsuits ever since.
posted by 68091A50 at 6:15 AM on January 15 [11 favorites]

Historically, the Bayer name has way more baggage.
posted by Selena777 at 6:27 AM on January 15 [10 favorites]

This is pretty shocking given that Gardasil was approved in 2006 and HPV-related cancer has nosedive.
posted by bq at 7:55 AM on January 15 [3 favorites]

“This was chemically predictable" (Kristine Vike)

“Perfluorooctanoic acid (PFOA), the most well-studied PFAS, was first classified in 2014 as a possible human carcinogen, and in 2023, the working group upgraded PFOA to a human carcinogen.”

“The strongest epidemiological evidence shows that kidney and testicular cancers are associated with higher levels of PFAS. Weaker evidence exists for prostate cancer, and studies of other cancers have been largely inconsistent or provided no indication of an association.”

Yes, obesity causes more harm than PFAS, but the PFAS contribute towards some cancers.

At least smoking has declined over the time period studdied here. Also, individual coal plants became cleaner, ships switched off the worst oil, etc. Yet, our economic growth has increased microparticles, partially from overall increase activity, including increased shipping, cars, planes, etc., so not necessarily PFASs, plastics, or from fossil fuels. I've not found good data, but likely this matters too.
posted by jeffburdges at 8:44 AM on January 15 [1 favorite]

The anti-vaxers are gonna loooooove this.

in my experience, it's a conclusion they'd already drawn. Though now I suppose, we have what one could construe as confirmation of that bias. See also cell phones whose ubiquity has only really kicked in over the past twenty years. Also wireless internet. And for that matter, any technology or product or ingredient that has gained in use/popularity since 1999.

Correlation is a helluva drug.
posted by philip-random at 8:56 AM on January 15 [2 favorites]

Post hoc, ergo propter hoc.
posted by mark k at 11:06 AM on January 15 [1 favorite]

The anti-vaxers are gonna loooooove this.

in my experience, it's a conclusion they'd already drawn. Though now I suppose, we have what one could construe as confirmation of that bias. See also cell phones whose ubiquity has only really kicked in over the past twenty years. Also wireless internet. And for that matter, any technology or product or ingredient that has gained in use/popularity since 1999.

Yep. Sometimes I look in on those corners of the internet, and from what I can tell this is a boon to their pet belief systems (including, again, chemtrails?! chemtrails are back in a big way) and they're gaining followers based on people (reasonably) wanting to avoid cancer but drifting toward the loudest voices in the room.

I wouldn't be upset if some widespread adoption of those beliefs led to less reliance on plastics & wifi everywhere. But that probably can't happen without more mainstream acceptance of all the other odious beliefs they're pushing, like anti-vax living and parenting. And they're also big into raw milk these days too, calling into question the motives of Louis Pasteur, and I just can't. It's too bleak to seriously contemplate a world where people voluntarily die of viral & bacterial infection, but with some sense of purity intact? I mean I get it but I don't get it.
posted by knotty knots at 11:30 AM on January 15 [1 favorite]

I guess if they're voluntarily dying of viral & bacterial infection, they're not dying later of cancer, so... win?
posted by heatherlogan at 3:16 PM on January 15 [1 favorite]

> I'm suspicious about this "diets low in milk" correlation and trying to decide how far down the rabbit's hole I'm willing to go

I'm curious about that one, too; I don't remember running into it before.
posted by The corpse in the library at 5:30 PM on January 15 [1 favorite]

Wait why would the assumption be that living in these countries would be more stressful than living in a developing nation?
posted by Selena777 at 9:08 AM on January 16

Similarly for other explanations offered here (like microplastics): Why would this be affecting people in the US and Australia many times more than people of the same age in, say, Japan or Mexico or New Zealand or India? Do the former countries really have that much more plastic in the environment/water/food, compared to the latter countries? Why Western Europe but not Scandinavia or the Baltics?
posted by mbrubeck at 10:36 AM on January 16

(Perhaps some of the differences between countries could be linked to urbanization, though South America and Northern Europe would still need a different explanation.)
posted by mbrubeck at 10:44 AM on January 16

why would the assumption be that living in these countries would be more stressful than living in a developing nation?

as a for instance, I recall an aid worker talking about Calcutta saying, despite all the poverty etc, nobody there was lonely, they didn't really even have a word for it. Or something like that -- it was a long time ago.
posted by philip-random at 12:26 PM on January 16 [1 favorite]

It seems incredibly stressful to not have time to yourself.
posted by Selena777 at 12:52 PM on January 16