Ten years ago, Dr. Kimryn Rathmell, a kidney oncologist who was then at Vanderbilt University, noticed a startling trend: Many younger patients were coming to her with kidney cancer, including an 18-year-old with metastatic disease, which Dr. Rathmell had never seen in someone so young.
She assumed these patients had been disproportionately referred to big cancer centers like hers. But this spring, when researchers at the National Cancer Institute published a report showing that, between 2010 and 2019, rates of 14 cancers increased among people under 50 in the United States, the significance of her experience came into focus.
“I realized that what I was seeing was a trend that was happening everywhere,” said Dr. Rathmell, a former director of the N.C.I. who now leads the cancer program at Ohio State. The data were striking.
“It makes me think differently even about a cancer I’ve studied for decades,” she said.
For years, studies and news articles have noted rising rates of “early-onset” cancers, generally defined as those occurring in adults under 50 years old. But the breadth of the trend over time and place, and across more than a dozen cancer types — including breast, colorectal, kidney, pancreatic, stomach, testicular and uterine cancer — is finally becoming clear.
Early-onset cancers remain rare. But data show that their global incidence has risen since 1990, amounting to thousands more new cases each year. For example, in 2019, there were 4,800 more early-onset breast cancer cases in the United States than would have been expected had 2010 rates persisted.
More screening and better detection probably explain some of the rise. But scientists say there are signs that something else, something more, is going on. Increasingly, they are marshaling their efforts to discover what that is.
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