Is the Rise in Early-Onset Cancer Real?
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What Could Go Right? is a free weekly newsletter from The Progress Network written by our executive director, Emma Varvaloucas. In addition to this newsletter, which collects substantive progress news from around the world, The Progress Network is also home to the anti-apocalypse conversational podcast also called What Could Go Right?.
You’ve likely heard that the rates of cancer in young people are rising, and you don’t have to look far for evidence. Remember the shocking death of Black Panther actor Chadwick Boseman from colon cancer at 43? There’s also Dustin Diamond—Screech on Saved by the Bell—and LFO frontman Devin Lima (millennials will remember “Summer Girls”), who was 41 when he died from adrenal cancer.
All of these celebrities have something else in common besides dying before their time: They were members of Generation X, the first generation in which a worrisome trend of escalating cancer incidence emerged globally. That trend now continues in the millennial generation.
This has prompted a discussion about whether the surge in early-onset cancer—cancer that appears before age 50—is simply the product of more frequent, available, and perceptive screening or actually a sign that something is in the air, so to speak. One study’s findings—that early-onset incidence had increased most in North America and least in Sub-Saharan Africa—illustrates the uncertainty perfectly. Sub-Saharan Africa has poor screening access, disorganized cancer reporting, and low-tech imaging; North America, the opposite. It would make sense that cancer is being caught more frequently in one place than the other.
But North America is also the global capital of the environmental changes ($) that researchers have fingered as possible contributing factors to the trend: poor diet and processed foods, microplastics, heavy alcohol consumption, and some experimental drugs that were once given to pregnant women.
So should young adults be worried?
Enter a new paper published in JAMA Internal Medicine, which considers whether the rise in early-onset cancer is more apparent than real. The researchers, examining eight cancers with the fastest-growing incidence in the United States, concluded that their rise is more a function of overdiagnosis than anything else—that is, of testing that is more perceptive of even small irregularities, and more of it, in addition to lower thresholds of what counts as cancer. No mysterious something has caused cases to increase, they argue. We’re simply finding more of the indications of disease that were always present.
Foundational to their conclusion is the fact that while the incidence of these cancers has doubled since the 1990s, mortality rates have remained flat or declined—except in the case of two, colorectal and endometrial cancers. Rates of metastatic cancer have risen slightly but are far from matching the pace of overall incidence. The argument goes: if so many more cases are occurring, shouldn’t these related figures march up in tandem?
To the obvious question this raises—could incidence be climbing while mortality rates are flat because we’ve gotten better at treating cancer—the study authors have an answer. They think that is implausible, as the rate of new cases would have to be perfectly counterbalanced by the rate of improved treatment.
Overdiagnosis may even be playing a role in one of the exceptions, colorectal cancer, for which incidence is rising much faster than mortality. “Overall,” the researchers conclude, “the rise in early-onset cancer appears to be less an epidemic of disease and more an epidemic of diagnosis.”
This is just one paper, not the end of the discussion. Other experts think that better treatment and earlier detection do explain the study results, at least in part. But amid plenty of news reports about potential causes of early-onset cancer, it’s worth questioning whether we should temper our anxiety—not least, because overdiagnosis has its own detriments, from unnecessary medical procedures to emotional distress. We can go crazy if we view everything in our lives as a threat, especially if those things are inextricably embedded in the modern world. Synthetic chemicals, for example, are literally everywhere.
There is also still plenty within our control. Dr. Shuji Ogino, chief of molecular pathological epidemiology at Brigham and Women’s Hospital in Boston, tells The New York Times that about 40% of cancer risk can be cut through lifestyle changes. If you don’t smoke or binge drink and maintain a healthy weight, you’ve already significantly depressed the odds of experiencing many cancers. (Obesity is correlated to both colorectal and endometrial cancers, the two exceptions to the paper’s findings.)
We should also right-size the issue. These days, suicide, car crashes, and drug overdoses are four times more likely to take the life of a young adult in the US than cancer, which accounts for only 10% of deaths in those under 50. And once diagnosed, the likelihood that we’ll beat it is better than ever: for young people, mortality has nearly halved since the 1990s.
In short, take cancer seriously, but don’t let the fear of it dominate your headspace—especially if you’re young.
—Emma Varvaloucas
What Could Go Right? S7 E31: Turning Down the Headline Noise
Let’s close out Season 7! Zachary and Emma look back on seven months of thought-provoking positive conversations, from global politics to the depths of sci-fi, exploring how to stay hopeful in a world hooked on negative news. They dive into protecting your mental health by controlling your news intake while also celebrating how social media platforms empower 8 billion voices to be heard! | Listen now
By the Numbers
62%: Drop in civilian fire deaths per capita in the US between 1980 and 2023
>50%: Share of new UK car registrations that are electric or hybrid
80%: Lesser likelihood that Waymo self-driving cars will get into a serious crash compared to human drivers
120M: Drop in the number of tobacco users worldwide since 2010
Quick Hits
☀️ In the first half of 2025, renewables overtook coal as the world’s biggest source of electricity, according to energy think tank Ember. There was growing electricity demand everywhere, but it was entirely met by wind and solar only in developing countries; renewable growth in the US and EU couldn’t keep up, and those regions burned more fossil fuels.
🔬 AI can not only discover new antibiotics, it can create new ones, too—plus what else is new in biology this month, here.
💉 HPV vaccines may one day create “herd immunity” against cervical cancer, according to new research. Researchers have also developed a new low-cost test for HPV that could make screening in the developing world easier and faster.
🔌 EV fast-charging stations have multiplied along US highways. Most of the country is now within a 50-mile drive of a fast charger, making long road trips feasible. ($)
⚖️ California will have the nation’s first AI safety law, requiring major AI companies to reveal their safety protocols. It also became the second state, after Massachusetts, to allow Uber and Lyft drivers to join a union.
⚡ The Middle East’s least electrified country has its first large-scale solar plant. In Yemen, the Aden Solar Plant is helping nearby residents and businesses get through electricity shortages. Its capacity is planned to double in 2026.
🦠 A new vaccine is being rolled out across Africa’s “meningitis belt.” The vaccine targets all five subtypes of the bacterium that causes nearly all meningitis cases there. An older vaccine was effective against only the main type.
🔞 Burkina Faso raised the legal age for marriage to 18. The West African country has one of the world’s highest child-marriage rates, with more than 1 in 2 girls marrying before the age of 18.
👀 What we’re watching: Next-generation geothermal projects are scaling up, including one in New Mexico that will supply Meta’s data centers with clean electricity. And, could embryos made from human skin one day solve our fertility problems?
💡 Editor’s pick: After a mass shooting in Buffalo, counties in New York learned how to implement a strategy, developed by the Secret Service, to intervene before the violence starts. In one school, it may have already worked.
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