In the U.S., more than a dozen kinds of cancer are on the rise in adults under 50. Among these early-onset cancers, colorectal and breast cancers have increased the most, and colorectal cancer is now the deadliest cancer for Americans ages 18 to 49.
Here’s what to know about detecting early-onset cancers.
1. Family history is one of the most important risk factors
Researchers have not been able to find a single cause for the rise in early-onset cancers. Instead, research suggests a myriad of factors play a role, including obesity, heavy alcohol use, environmental factors such as microplastics, and disruptions to gut health.
Doctors generally follow population-level guidelines for routine screenings—such as recommending mammograms starting at age 40 to screen for breast cancer—but physicians might recommend some patients get screenings as early as in their 20s. Doctors weigh a patient’s personal risks, including their family history of cancer.
2. Report unusual symptoms as quickly as possible
Being vigilant about unusual body changes or symptoms—and reporting those to your physician—gives doctors the information they need to determine your personal risk for cancer.
“For example, a lump in the breast, abdominal pain, changes in bowel habits that really are not going away,” said oncologist Dr. Veda Giri, director of the Early Onset Cancer Program at Yale Cancer Center. “Certainly blood in the stools. Sometimes, even symptoms such as unusual fatigue that doesn’t seem to go away.”
“It’s incredibly important to bring symptoms to your doctor,” Giri said.
3. Talk, then test, then talk again
Ads for at-home cancer tests are everywhere, so you might be tempted to use a screening kit instead of going in for an office visit or a standard screening, like a colonoscopy.
But not all tests are created equal, Giri said. It can be hard for laypeople to understand the accuracy of at-home screening kits, so they should talk to their doctor first.
“Some of these tests could lead to a ?false sense of either reassurance or false anxiety and alarm,” she said.
For people who decide to move forward with an at-home test, experts say they still need to consult with a physician. If you get any sort of abnormal result, your doctor is going to want to follow up with additional testing, such as a colonoscopy. Sharing your results, regardless of outcome, will help inform your care.
People and policy
The U.S. Preventive Services Task Force recently changed the recommended age for women to begin mammogram screenings for breast cancer from 50 to 40. But there’s a difference of opinion among national advocacy and medical groups about whether regular screenings should happen every year or every other year.
In 2021, the same task force lowered the recommended age to 45 for a first colonoscopy for colon cancer detection for people with average risk. Establishing a relationship with a trusted medical practitioner can help patients assess personal risk and sort through new information as research and public health guidance evolve.
If you feel uncertain about your personal risk for cancer or when you should start cancer screenings, one of the best ways to advocate for your health is to establish a relationship with a medical practitioner you trust and ask specifically about your cancer risk. You can also ask to consult with a genetic cancer risk specialist, a type of medical provider who helps patients evaluate their cancer risk, often with genetic testing.
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