Cancer in Young Adults

It’s hard to find what you’re not looking for.

If you were asked to picture a cancer patient, a young adult is probably not the first person who comes to mind. That’s only natural, considering more than 90% of cancers are diagnosed in people over age 45. Likewise, young adults tend not to think much about the possibility of getting cancer. Most tend to be fairly healthy, and it’s common for young people to see doctors only when they have a pressing need. Even when they do visit a doctor with symptoms that could indicate cancer, their symptoms are more likely to be attributed to other, more likely, causes.

Among older people, doctors recommend various cancer screening tests, such as breast and colorectal cancer screening. These allow doctors to identify developing cancers earlier, when they are generally more easily treatable with less invasive methods. Because cancer is much less common in young people, however, fewer cancer screening tests are recommended for them. Cervical cancer screening is an exception: the American Cancer Society recommends cervical cancer screening beginning at age 25, and the USPSTF recommends beginning at age 21. Additional screening tests or regular exams may be recommended for young people who have a family history of certain cancers or other factors that put them at high risk.

How many young adults get cancer?

Recent research shows that cancer is rising among young people, estimating 89,500 new cases and more than 9,000 related deaths in 2020. Some of the most common cancers in young adults include

• Carcinomas
• Breast cancers
• Lymphomas
• Melanomas
• Sarcomas (cancers of the bone and soft tissues)
• Cancers of the reproductive system (cervical, ovarian, testicular)
• Colorectal cancer
• Cancers of the brain and spinal cord

Cancer rates in young adults are rising.

A study of data from nearly 500,000 young adult cancer patients diagnosed between 1973 and 2015 revealed a sizable increase in cancers in this age group. Among 15- to 39- year olds, cancer diagnoses jumped 29.6% during this timeframe. Incidence of kidney carcinomas increased the most among both male and female patients. Overall, the most commonly diagnosed cancers in the study were breast cancers in females and testicular cancers in males.

This study identified some additional trends in young adult cancers:

• Incidence of carcinoma rose with age.
• Incidence of leukemia, lymphoma, and central nervous system cancers declined with age.
• Incidence of thyroid cancer increased significantly in young adults of both sexes.
• Astrocytomas (a type of cancer that grows in the brain or spinal cord) decreased significantly among young adults of both sexes.
• Incidence of gastrointestinal cancers has increased in young adults.
• Among the young adult females included in the study,
  • 7% had breast cancers
  • 6% had thyroid cancers
  • 5% had cancers of the cervix or uterus
• Among the males,
  • 5% had testicular cancer
  • 2% had melanomas
  • 6% had non-Hodgkin lymphoma

Possible reasons for the overall rise in cancer diagnoses in this age group include environmental factors, obesity, and changes in screening practices. At the same time, a decrease in tobacco smoking and laws limiting the use of toxic chemicals, and the rise of oral contraceptives are thought to contribute to decreases in specific types of cancer.

Young adults with cancer face special challenges.

The fact that young people are less likely to develop cancer means that support groups and other resources are not geared to support their distinct needs. Fortunately, that has begun to change. Groups like Stupid Cancer focus specifically on providing support and resources for adolescents and young adults dealing with cancer diagnosis. Stupid Cancer is currently hosting digital meetups to help young cancer patients connect and support each other during the COVID-19 pandemic.

Iowa Radiology provides a wide range of imaging services, which can play an important role in cancer detection and treatment. For more information on cancer detection, treatment, and more, subscribe to our blog or browse our other free online resources.

Resources

The American Cancer Society Guidelines for the Prevention and Early Detection of Cervical Cancer. Cancer.org. https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/cervical-cancer-screening-guidelines.html. Updated November 17, 2020. Accessed December 8, 2020.

Cervical Cancer: Screening. USPreventiveServicesTaskForce.org. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening. Published August 21, 2018. Accessed December 9, 2020.

Finding Cancer in Young Adults. Cancer.org. https://www.cancer.org/cancer/cancer-in-young-adults/finding-cancer-in-young-adults.html. Updated July 30, 2020. Accessed December 9, 2020.

Miller KD, Fidler-Benaoudia M, Keegan TH, et al. CA-Cancer J Clin. 2020;70(6): 443-459. Cancer statistics for adolescents and young adults, 2020. http://doi.org/10.3322/caac.21637.

Scott AR, Stoltzfus KC, Tchelebi LT, et al. Trends in Cancer Incidence in US Adolescents and Young Adults, 1973-2015. JAMA Netw Open. 2020;3(12):e20207738. http://dx.doi.org/10.1001/jamanetworkopen.2020.27738.