Can­cers tied to obe­sity in­creas­ing in young adults

The Hazleton Standard-Speaker - - HEALTH / WEATHER - BY MARIE McCUL­LOUGH

A new study has found that six obe­sity-re­lated can­cers are on the rise in young adults, another sign of the world­wide epi­demic of ex­cess weight.

The in­di­vid­ual risk of cancer re­mains small in young adults, and un­rec­og­nized fac­tors may also be at play. Still, the study found that for mil­len­ni­als and Gen­er­a­tion Z — people in their 30s and even their 20s — in­ci­dence rates are ris­ing for en­dome­trial, gall­blad­der, kid­ney, mul­ti­ple myeloma, pan­cre­atic, and col­orec­tal can­cers, all of which have been linked to obe­sity.

To put it in per­spec­tive, mil­len­ni­als (those born be­tween the early 1980s and mid-1990s) are twice as likely to de­velop four of those can­cers — col­orec­tal, en­dome­trial, pan­cre­atic and gall blad­der — as baby boomers (born from 1946 to 1964) were at the same age.

The re­searchers, from the Amer­i­can Cancer So­ci­ety and the Na­tional Cancer In­sti­tute, first re­ported the in­crease in col­orec­tal cancer among young adults — a trend that de­fies an over­all steady de­cline in colon cancer — sev­eral years ago. They ex­tended that anal­y­sis by us­ing cancer registries to ex­am­ine age-spe­cific trends over the last two decades for 30 types of can­cers, in­clud­ing 12 known to be linked to obe­sity.

Although the pub­lic is gen­er­ally not aware, sci­en­tists have found that cancer can be fu­eled by the same meta­bolic ab­nor­mal­i­ties that oc­cur in obe­sity and a re­lated dis­ease, diabetes.

The new study, pub­lished in Lancet Pub­lic Health, also looked at 18 can­cers that are not re­lated to obe­sity, in­clud­ing ma­lig­nan­cies caused by smok­ing and in­fec­tions. Only two of these can­cers (gas­tric and leukemia) were in­creas­ing in young adults, while the rest were sta­ble or de­creas­ing.

Cancer re­mains a dis­ease pri­mar­ily driven by ag­ing. Colon cancer is now di­ag­nosed in about one in 100,000 people in their 20s, com­pared with 50 in 100,000 people in their early 60s. Pan­cre­atic cancer strikes two in 100,000 people ages 25 to 49, com­pared with 37 in 100,000 adults ages 50 to 84.

How­ever, more Amer­i­cans are be­ing ex­posed to a car­cino­gen — namely, ex­cess weight — for most or all of their lives. Be­tween 1980 and 2014, the preva­lence of over­weight and obe­sity among chil­dren and ado­les­cents grew by 100 per­cent. More than a third are now over­weight, de­fined as a body mass in­dex of 25 to 29, or obese, de­fined as a BMI of 30 or more. The preva­lence dur­ing those years grew by 60 per­cent among adults, of whom 78 per­cent are now too heavy, ac­cord­ing to fed­eral data.

“The fu­ture bur­den of these can­cers could worsen as younger co­horts age, po­ten­tially halt­ing or re­vers­ing the progress achieved in re­duc­ing cancer mor­tal­ity over the past sev­eral decades,” said se­nior au­thor Ahmedin Je­mal, sci­en­tific vice pres­i­dent of sur­veil­lance at the Amer­i­can Cancer So­ci­ety.

That con­cern was echoed by Pamela Good­win, an on­col­o­gist at Mount Si­nai Hospi­tal and a pro­fes­sor at the Uni­ver­sity of Toronto who has stud­ied the role of diet, weight, and ex­er­cise in breast cancer.

“The study pro­vides a cau­tion­ary tale — that re­cent im­prove­ments in cancer mor­tal­ity, re­flect­ing fac­tors such as smok­ing ces­sa­tion, early di­ag­no­sis, and im­proved treat­ment, may not con­tinue,” she said. “The im­prove­ments may ac­tu­ally be re­versed by in­creased rates of obe­sity-as­so­ci­ated can­cers in those ex­posed to obe­sity in child­hood or early adult­hood.”

The pub­lic health im­pli­ca­tions are clear, ex­perts said.

“This study, and oth­ers like it, just high­light the need to con­tinue to in­form people, par­tic­u­larly chil­dren and young adults, about the im­por­tance of a healthy diet and lifestyle,” said Ryan Dowl­ing, a bio­chemist at Princess Mar­garet Cancer Cen­ter in Toronto who stud­ies how obe­sity dis­rupts me­tab­o­lism.

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