Early-onset gastrointestinal (GI) cancers, diagnosed before age 50, are on the rise globally, with colorectal cancer being the most common type, according to a recent review published in JAMA. The authors emphasize the need for enhanced prevention strategies and early detection to address this alarming trend.
Early-onset GI cancers, including breast cancer, gastric, pancreatic, esophageal, and biliary tract cancers, are increasing faster than any other type of early-onset cancer. The rise is attributed to a “birth cohort effect,” suggesting changes in environmental exposures as the primary cause.
Obesity, dietary patterns, sedentary behavior, and lifestyles are linked to an increased risk of developing these cancers at an age under 50. Colorectal cancer, gastric cancer, esophageal cancer, and pancreatic cancer are among the most common types, with the latter two making up about 5% of all cases.
Modifiable risk factors include obesity, poor diet, sedentary lifestyle, cigarette smoking, and alcohol consumption. Nonmodifiable risk factors include family history, hereditary cancer syndromes, and inflammatory bowel disease. Genetic testing is recommended for individuals with early-onset GI cancers to guide treatment and screen for other cancers.
Treatment challenges arise due to the young age of diagnosis, with patients often facing more challenges after diagnosis than older patients. Multidisciplinary care, including fertility counseling and psychosocial support, is essential for these patients.
Currently, screening is not recommended for most early-onset GI cancers, except for colorectal cancer. Despite this, fewer than 1 in 5 US adults aged 45-49 years were screened in 2021, highlighting a significant gap in early detection efforts. The authors emphasize the need for prompt diagnosis and adherence to screening recommendations to prevent advanced or metastatic stages of cancer.
The research highlights the importance of prevention strategies and early detection for early-onset GI cancers, with colorectal cancer being a prime target for screening and intervention.
Source: https://www.medscape.com/viewarticle/alarming-rise-early-onset-gi-cancers-calls-early-screening-2025a1000kbr