A recent study published in the Annals of Internal Medicine reported a sharp and troubling rise in appendix cancer rates among younger generations, particularly Millennials and Generation X. According to The New York Times, the rare form of cancer, previously seen mostly in older individuals, is now increasingly diagnosed in younger adults.
Appendix cancer, which occurs in the appendix, is a very rare malignancy, with about 3,000 new cases diagnosed annually in the United States compared to over 150,000 cases of colorectal cancer. This stark contrast underscores the rarity of the disease, as reported by The New York Times.
Researchers from Vanderbilt University Medical Center analyzed data from the National Cancer Institute's SEER program, tracking age-specific incidence rates of appendiceal adenocarcinoma from 1975 to 2019. They found that incidence rates among Generation X and Millennials increased. Rates more than tripled among individuals born in 1980 and quadrupled among those born in 1985 compared to those born in the 1940s.
This trend suggests a "birth cohort" effect, where a disease becomes more common among successive generations, indicating that appendiceal adenocarcinoma is increasingly prevalent in younger populations. Assistant Professor Andreana Holowatyj, lead author of the study, emphasized the concerning nature of these findings.
"One of the things we often think about is, what has changed across birth cohorts over time?" said Assistant Professor Holowatyj, according to the New York Post. She pointed to several possible factors: the use of antibiotics in childhood and in the food chain, industrialization of the food industry, changing lifestyle patterns, the tripling of obesity since the 1970s, increasingly sedentary behavior, and environmental exposures that have changed over time.
Obesity has become a problem among young people today, and rates of metabolic disorders like obesity and diabetes increased over time, contributing to the rise in gastrointestinal cancers among younger adults. Diet is one possible shared risk factor, with increased consumption of ultraprocessed foods, particularly processed meats and sugar-sweetened beverages, being linked to higher cancer risks.
Dr. Andrew Chan, a professor of medicine at Harvard Medical School, noted that the generational effects observed in colorectal and gastric cancers suggest shared risk factors with appendix cancer, emphasizing the need for further investigation. "Young people, in particular, may be increasingly exposed to the negative effects of obesity and diabetes during a time of life when they are possibly more susceptible to developing cancer," said Chan, according to The New York Times.
Appendix cancer is often discovered only after an appendicitis. About 95% of appendix cancers aren't spotted until after a person has appendicitis and the appendix is removed and examined by pathologists, indicating the lack of standardized screening tests for these cancers. This makes early detection challenging.
"Unlike other cancers of the GI tract, appendix cancers aren't easily found because they're not as easy to see on abdominal scans and won't be picked up by colonoscopies," said Dr. Deborah Doroshow, an associate professor of medicine at the Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai in New York City, according to NBC News.
Experts suggest possible causes for the increase in appendix cancer rates include changes in lifestyle, diet, exposure to microplastics, and environmental factors. However, health experts aren't exactly sure what could be causing the jump in appendiceal adenocarcinoma cases.
The researchers identified a total of 4,858 persons aged 20 years or older who were diagnosed with pathologically confirmed appendiceal adenocarcinoma between 1975 and 2019. These patterns suggest a need for etiologic research and increased awareness of appendix cancer among physicians and the public.
Assistant Professor Holowatyj hopes the study encourages the public to be aware of appendix cancer and to know the signs and symptoms. Symptoms can be vague, such as bloating, changes in bowel habits, and loss of appetite, making early diagnosis challenging. Common symptoms also include abdominal pain, especially in the lower abdomen or pelvic area; an increase in waist size without weight gain; persistent diarrhea or constipation; nausea or vomiting without any apparent cause; and feeling full after eating only a small amount.
"There's an opportunity and a window for intervention there," said Holowatyj, according to The New York Times. She emphasized the importance of people with symptoms seeing a healthcare professional in a timely manner because it's critical to detect appendix cancer early.
Doctors are urging patients to be alert for persistent abdominal pain, weight loss, or fatigue, as these symptoms should not be ignored. "Don't ignore symptoms, even if you're young," warned Doroshow, emphasizing the importance of awareness regarding subtle signs of cancer, as reported by NBC News.
While there is no good way to screen for appendix cancer right now, scientists hope that more knowledge about the disease will lead to greater awareness of the symptoms and, perhaps, earlier detection. A research effort called the Appendiceal Cancer Consortium is working to pool data and specimens from across studies to better understand the risk factors and biological markers specific to appendix cancer.
"I think it's going to be a constellation of factors that may be driving appendiceal cancer development," concluded Holowatyj, as noted by the New York Post. She added, "I think the fact that we're seeing birth cohort or generational effects across a plethora of cancer types is indeed alarming because it really stresses the need to understand what is underpinning this pattern in order for us to be able to actively reverse it."
The preparation of this article relied on a news-analysis system.