The term ‘early-onset digestive cancers’ refers to cancers arising in people under the age of 50. When it comes to digestive cancers, what is worrying is that, until recent decades, digestive cancers were considered a disease that affected the older and elderly population. However, early-onset digestive cancers are an urgent concern. Epidemiology data indicate a significant increase in the incidence of colorectal cancer in younger populations in the past three decades. Other recent evidence also demonstrates a similar trend in gastric, pancreatic, and biliary tract cancers. For some digestive cancers, such as gastric cancer, incidence is decreasing in older populations but successively increasing in younger populations.

Early-onset digestive cancers hold a different impact picture compared to cancers in later life. Firstly, treatment options for (mostly) otherwise-healthy individuals are different to older people with the same cancers. Secondly, early-onset digestive cancers have a psychosocial impact during a different lifespan period (often traditionally the most active and productive in terms of career and fertility), leading to unique challenges. Also, with a high recovery rate, survivors of early-onset digestive cancers face decades of living with treatment effects and quality of life modifications, thus they have specific survivorship needs.

Data on screening for early-onset cancers are lacking. It is not yet clear which part of the younger population should undergo screening (with the exception of those with a positive family history of colorectal cancer).

With increasing numbers of younger people developing early-onset digestive cancers, research is focussing on possible causative but modifiable lifestyle factors. Most of these early-onset cancers are sporadic; that is, they arise without hereditary or family history (up to 97%). Therefore, this sporadic onset leads scientists to think that behavioural, lifestyle, nutritional, microbial, and environmental factors have a key role in cancer development. All of these factors are modifiable, in some way or another, thus there is realistic hope that these epidemiological trends can be reversed.

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Author:
Fiona Beck