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Why are cancer cases in adults under 50 increasing?
Breast cancer is becoming more common in both premenopausal and post menopausal women. PHOTO | COURTESY
What you need to know:
- A research published by the BMJ Oncology on September 5, revealed that there are more people under the age of 50 who are being diagnosed with cancer more than ever before.
October is breast cancer awareness month. While middle aged women are at risk of this cancer, different cancers have different age distributions. Some are common in children and others are more pronounced among the elderly. Previous reports indicated that there was an increased risk of cancer with age, however, new research shows there is an alarming increase in the early onset of cancer.
A research published by the BMJ Oncology on September 5, revealed that there are more people under the age of 50 who are being diagnosed with cancer more than ever before.
The global study analysed data from 204 countries covering 29 types of cancer between 1990 and 2019 and found that the number of early cancer cases globally has increased by about 80 percent and cancer deaths by 28 percent.
It also shows that sub-Saharan Africa has the lowest number of early-onset cases compared to North America, Australia and Western Europe. In low and middle-income countries, early onset cancer had a much greater impact on women than on men, in terms of poor health and deaths.
“Currently, cancer control efforts, prevention policies and strategies in Africa are inadequate, and most African countries have limited cancer registries and poorly organised cancer reporting systems,” the researchers noted.
Breast cancer is said to be on the rise among both premenopausal and postmenopausal women but at a faster rate among younger, premenopausal adults. This type of cancer accounted for the largest number of cases and associated deaths, at 13.7 and 3.5 for every 100,000 of the global population respectively.
The study emphasizes that lung cancer cases have been decreasing in both the under and over-50 age groups but the proportion of lung cancer cases among nonsmokers in the under-50 age group is rising. Women are making up an increasing proportion of lung cancers diagnosed in patients under 50, with men contributing to a steeper decline in those cases than women.
Uganda’s case
In 2018, it was estimated that at least 56,238 people were living with cancer and 21,000 cancer related deaths occurred in Uganda.
In Uganda, according to Dr Nixon Niyonzima, the head of research and training at the Uganda Cancer Institute (UCI), there are 34,000 new cancer cases every year and although some cancers are known to affect older populations, they appear in the younger people.
He remarks that, “Generally, there is an earlier onset and diagnosis of cancer among the people than it was in the past. The average age of cancer cases in Uganda is 45 years but there are earlier cases.”
Why worry anyway?
This is a cause for worry because cancer patients under 50 are at a peak point in their lives and may be students, parents of young children, family breadwinners or even caregivers to aging parents.
Their cancer treatment causes a financial burden that hits during their prime income-earning years. The cancers come with other health complications, such as loss of a body part, infertility, heart disease and secondary cancers.
Dr Niyozima remarks that a patient averagely spends between Shs300,000 and Shs400,000 on a single visit for cancer treatment. Since the patient is not usually admitted, they need to spend on transport, rent, meals and medication in cases of stock-outs.
On average nine out of 10 cancer patients incur out of pocket expenses on cancer care and treatment and because of these costs people wait until they are so sick and the cancer has advanced to a stage that is very hard to treat.
Among the 34,000 new annual cases in Uganda, only 20 percent (6,800) of these get access to cancer care and treatment and the 80 percent (27,200) do not get the care they need because of the distance and the costs involved.
“Our cancer care system as a country is overwhelmed. The number of patients with cancer is very high. This is why we are building four new cancer centres so that patients do not have to travel very long distances to come to the UCI to get cancer care.”
The commonest cancers in Uganda are cervical, breast, prostate, kaposi's sarcoma and liver cancers among adults while leukemia, lymphoma, wilms tumors generally affect children.
Contributing factors
There are several factors that are contributing to the increase in the number of these cases according to Dr Niyonzima. He points out that the increased population, and sensitisation as the leading factors.
He says, “With more knowledge about cancer, more people are seeking health care. People used to die of cancer and such cases were not reported to hospital because they thought it was witchcraft.”
According to the BMJ journal, “Diets high in red meat, low in fruit, high in sodium and low in milk, as well as alcohol and tobacco consumption, are the main risk factors for early-onset cancer.”
The study also showed that obesity is the biggest contributor to cancer diagnosis among young people. Heavy alcohol consumption is considered a risk factor for all stomach cancers, including early-onset cases.
“Apart from dietary risk factors, alcohol consumption, high BMI, tobacco use, high fasting plasma glucose and low physical activity contributed to early onset. Of these risk factors, high BMI, especially obesity, was identified as a strong risk factor,” the researchers state.
Dr Jackson Orem, the executive director of the Uganda Cancer Institute (UCI), also remarks that increased HIV cases in the country also contribute to higher risks of cancer, especially those that are HIV related such as Kaposi’s sarcoma.
“Many people today are living a sedentary lifestyle and are not exercising which is a contributor to overweight and obesity. Also, increased air pollution and poor farming methods such as use of pesticides and artificial fertilisers are great contributors of cancer cases in adults below 50 years,” he says.
According to the study, a woman’s smoking, diet, alcohol consumption and obesity during pregnancy may play roles in her child’s future cancer risk.
Prevention
Cervical cancer in Uganda contributes to 21 percent of all the cancer cases but it can be prevented by taking on HPV vaccination for girls below the age of 14 or those that are not sexually active. Also, early screening can help detect the cancer early enough because it is curable if it has not advanced into late stages.
Cancer of the liver is also preventable by taking Hepatitis B vaccination, treating hepatitis C and limiting the intake of alcohol.
Dr Niyonzima also advocates for organic farming in order to reduce residual chemicals that increase the risk of liver cancers. “Good farming practices can prevent the development of aflatoxins in grains and nuts while organic farming can prevent residual chemicals and drugs from pesticides in fruits and vegetables,” says Dr Niyonzima.
It is recommended that parents provide children with healthy meals, limit ultra-processed and sugary foods in their diets, encourage them to exercise, watch their weight and avoid their exposure to second-hand smoke may help reduce their future cancer risk.
“Any amount of exercise can make an impact. It is important to stay physically active to avoid a sedentary lifestyle. Even a modest amount of exercise each week, including brisk walks can help you maintain a healthy weight,” Dr Orem says.
Some people wait until the recommended age to start some cancer screenings. However, this may be too late. It is therefore important to improve your chances of detecting cancer early.
Paying attention to changes in your body is very key in the prevention of cancer. Changes such as a lump in your breast, bloody vaginal discharge, chronic fatigue, blood in your stool, a sudden weight loss or gain may need to be investigated.
Getting an annual full body checkup including blood and urine tests may help you catch your cancer early enough. You do not have to wait until you have pain to seek medical attention.
