It is our belief that cancers are diseases of old age. It is true and still most cancers happen in people above 50 years. But there are trends in some cancers which require the attention of younger people.
Findings from literature review suggests that in the last decade there has been rising trend of Breast, Uterine, colorectal, pancreas and kidney cancers in people less than 50 years of age. This finding is rather strong for colorectal cancers. At Vydehi cancer center, Bangalore we do see more and more youngsters coming with colon and rectal cancers and getting devastated with the diagnosis and treatment outcomes. Who would not be, if a treatment is likely to lead to lifelong permanent stoma or affect the ability for reproduction and also jeopardise work/ career. When we look at gender, more women than men are found to be affected at younger age. Especially for breast cancer. On the brighter side some cancers have shown downward trend in youngsters. These include lung, laryngeal and bladder cancers. Clearly the effect of decreased usage of smoking tobacco. Cancers like stomach esophagus and ovary have equivocal findings. There is no clear evidence to suggest decrease or increase in these cancers.
The reasons for this shift is not clear but following findings need attention. Colorectal cancers in young have clear genetic predisposition. Especially if there is a family history of colonic polyps or cancers. A familial syndrome called Lynch syndrome is a culprit which predisposes to wide range of cancers in young adults. Fortunately we are able to detect them using molecular genetic tests, provided we hold significant threshold of suspicion. This is where the awareness of an Oncologist is vital for early diagnosis and intervention. In practice many young women have come to us with breast cancers. Some times the family history was too obvious but was sadly ignored.
Like in many cancers, early diagnosis and intervention yields very good outcomes. Sometimes the intervention is prophylactic. Like in familial polyposis coli syndrome, the chances of developing colorectal cancer by age 40 is near 100%. So if the genetic test confirms the presence of a gene called APC, we advise patients to undergo prophylactic removal of total colon and rectum.
There is no other way of saving life. Same is done for some other cancers too. These are called as risk reduction surgeries.
The wake up call is- not to be under the false impression that young age is immune for cancer development. Act if there are suspicious symptoms. If one has family history of cancers, check if it is a type which carries genetic predisposition. Ask your Oncologist if there are genetic tests to check predisposition.
A genetic counselling, targeted testing and correct advice can prove crucial and may be the difference between good and poor outcomes.
Senior Surgical Oncologist & Head of Vydehi cancer center