Shuji Ogino, MD, PhD, MS (HSPH / BWH / HMS/ Broad Institute) Professor of Pathology, Harvard Medical School; Brigham and Women's Hospital Department of Pathology Professor, Department of Epidemiology Harvard T.H. Chan School of Public Health

Early Onset Cancers Rising Worldwide, Especially of GI Tract

MedicalResearch.com Interview with:

Shuji Ogino, MD, PhD, MS (HSPH / BWH / HMS/ Broad Institute) Professor of Pathology, Harvard Medical School; Brigham and Women's Hospital Department of Pathology Professor, Department of Epidemiology Harvard T.H. Chan School of Public Health

Dr. Ogino

Shuji Ogino, MD, PhD, MS (HSPH / BWH / HMS/ Broad Institute)
Professor of Pathology, Harvard Medical School;
Brigham and Women’s Hospital
Department of Pathology
Professor, Department of Epidemiology
Harvard T.H. Chan School of Public Health

MedicalResearch.com: What is the background for this study?

Response: Evidence indicates that the incidence of early-onset cancers (diagnosed before age 50) in various organs has been rising in adults <50 years of age in many parts of the world, but no prior study has comprehensively investigated the incidence trend. In addition, no prior study comprehensively examined temporal trends of possible risk factors including early life exposures.

MedicalResearch.com: What are the main findings? What types of cancers are either increasing in number or detection or both? ie HPV related cancers, melanoma, lung cancer? Is mortality from all/some cancers also increasing?

Response:  We found that the incidence of early-onset cancers in the breast, colorectum, endometrium, esophagus, bile duct, gallbladder, head and neck, kidney, liver, bone marrow, pancreas, prostate, stomach, and thyroid has increased in multiple countries. The rising incidence of early-onset cancers is likely at least partly attributable to enhanced screening and early detection. However, there seems a genuine increase in incidence of early-onset cancers in several organs such as the colorectum, pancreas, liver, etc. Notably, among the 14 early-onset cancer types with rising incidence, eight of those relate to the digestive system, indicating the potential pathogenic importance of both diets and the oral and intestinal microbiome. We did not examine the mortality of early-onset cancers. However, we speculate that the rise in mortality due to early-onset cancers is going to emerge. In fact, early-onset colorectal cancer, which spearheads the early-onset cancer epidemic, is associated with higher stage and mortality compared to later-onset colorectal cancer

MedicalResearch.com: What should readers take away from your report?

Response: We should be aware of the rise of early-onset cancer incidence. We need to increase prevention efforts. Improving the early-life environment will contribute to not only prevention of both early-onset and later-onset cancers but also much additional health benefits.

We recommend actions (at both the individual and societal levels) including:

  • Avoid western-style diets rich in highly processed foods, animal fat, desserts, and excessive red meat
  • Avoid sugar
  • Do regular exercise
  • Avoid smoke / smoking (your smoke badly affect secondhand smoking status of your children and other close relatives)
  • Avoid alcohol
  • Take well balanced nutritious foods and drinks
  • Take good sleep with regular schedule (avoid bright light at night)
  • Decrease night shift jobs as much as possible (just sleep at night unless you need to stay up)
  • Start all of the above habits earlier. The earlier the better. As early as you are in uterus or just born, meaning cancer risks of your babies and children depend on you.
  • Get available vaccines for cancer-causing microorganisms such as HPV and Hepatitis B 

MedicalResearch.com: What recommendations do you have for future research as a results of this study?

Response: To study risk factors for early-onset cancers, we need prospective cohort studies with early-life biospecimens and data. Electronic health records including early life information of large populations may be utilized. Interdisciplinary collaborations of investigators with divergent expertise in biomedical and population sciences are essential to address this challenge. We need long-term investments and commitments to research.

MedicalResearch.com: Is there anything else you would like to add? Any disclosures?

Response: Competing interests: Dr. Weiderpass is an employee of the IARC/WHO. The authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy, or views of the IARC/WHO. The other authors declare no competing interests

Citation: Tomotaka Ugai, Naoko Sasamoto, Hwa-Young Lee, Mariko Ando, Mingyang Song, Rulla M. Tamimi, Ichiro Kawachi, Peter T. Campbell, Edward L. Giovannucci, Elisabete Weiderpass, Timothy R. Rebbeck, Shuji Ogino. Is early-onset cancer an emerging global epidemic? Current evidence and future implications. Nature Reviews Clinical Oncology, 2022; DOI: 10.1038/s41571-022-00672-8

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