Cancer rates rising faster in under-50s in England, study finds

Several cancers are becoming more common among adults under 50 in England, and some are rising faster in younger people than in older ones, according to a study published in BMJ Oncology.

Researchers examined cancer records from England's National Disease Registration Service between 2001 and 2019, comparing more than 20 types of cancer among people aged 20 to 49 and those aged 50 and over.

What they found

Among younger women, 16 of 22 cancer types showed significant increases. Among younger men, 11 of 21 did.

Eleven cancers linked to known lifestyle risk factors became significantly more common in under-50s: cancers of the thyroid, liver, kidney, gallbladder, bowel, pancreas, mouth, breast and ovary, along with multiple myeloma and endometrial cancer, which affects the lining of the womb.

Most of these also rose in older adults. But bowel and ovarian cancer stood out, because they increased significantly in younger adults but not in older people. Endometrial, kidney, pancreatic, thyroid cancer and multiple myeloma rose faster in younger women than in older women.

Obesity is part of the story

The team also looked at national survey data on smoking, drinking, diet, physical activity and body weight. Ten of the 11 cancers of concern are linked to obesity, and excess weight has risen.

But most other risk factors stayed the same or improved among younger adults. Red meat consumption fell sharply: among younger men, average daily intake dropped from 38g in 2008 to 17g in 2018. Fibre intake was poor, with more than 90% of younger adults not eating enough, but it was stable or slightly improving.

That raises the question of why cancer kept rising while several known risks were moving in a better direction. The researchers say obesity alone cannot explain the increases, and other factors are likely to be involved.

Still a big role for lifestyle

Established risk factors still account for a large share of cases. In 2019 the researchers estimated they were behind 68% of mouth cancers and 49% of bowel cancers in younger men.

What it means

Cancer remains far more common in older people, and the absolute risk for any individual under 50 is still low. But the trend matters for how doctors recognise symptoms in younger patients, who may not be suspected of having cancer.

Similar rises have been reported in other countries, and scientists are investigating possible explanations, including changes in diet early in life, gut bacteria, antibiotic use and other exposures.

The NHS advises anyone with symptoms that do not go away, such as blood in stools, a change in bowel habits, persistent bloating or unexplained weight loss, to see their GP whatever their age. Bowel cancer screening in England is offered from the age of 50.