NBC News
Gastrointestinal cancers, which include colorectal, stomach and pancreas, are drastically increasing in young adults, although doctors are not totally sure why. They even believe that some of the possible causes should better investigate, they said.
According to an analysis published this Thursday in the JAMA scientific journal, gastrointestinal cancers have become the type of fastest growing cancer that is diagnosed in adults under 50 in the United States.
The analysis, one of the most extensive reviews of gastrointestinal cancer trends, summarized the findings of the main international and American cancer databases, in addition to 115 scientific articles on gastrointestinal cancers published between January 2014 and March 2025.
The authors of the analysis underlined the need for people to undergo the recommended studies according to their age to detect possible types of collorrectal cancer. Experts suggest that people who have an average risk of suffering from begin to undergo exams – generally a colonoscopy or a feces analysis – from 45 years. Since in the United States doctors do not perform routine analysis of pancreas cancers, stomach and esophagus, authors also ask for new ways to detect these cancers in more people.
“This really points out the importance of trying to improve early analysis and detection,” said Dr. Kimmie NG, co-author of the revision and director of the Center for Colorectal Cancer of Young Start of the Dana-Farber Oncological Institute.
According to the report, colorectal cancer is very gastrointestinal cancer of early early appearance, with almost 185,000 cases registered worldwide in 2022 and about 21,000 cases registered that same year in the United States. Diagnostics in the country have increased annual 2% in people under 50 since 2011, according to the American cancer society.
“It never used to happen in this age group, and now a very significant increase in people of 20, 30 and 40 years are contracting colon cancer,” said Dr. John Marshall, head consultant chief of the non -profit organization Colorectal Cancer Alliance, who did not participate in the investigation. In one of the most popular examples, actor Chadwick Boseman was diagnosed with colon cancer in 2016 and died of the disease four years later, at 43 years.
Cases of early occurrence of pancreas cancer, stomach and esophagus are also increasing, according to the new study. Previous investigations have shown that a disproportionate part of these gastrointestinal cancer diagnoses occurred between black and Hispanic people. Pancreatic cancer is one of the deadliest, since only 13% of patients survive five years after diagnosis.
Since colorectal cancer is the most common, doctors said they have a better understanding of what could be contributing to these cases of early appearance compared to others.
“If we are able to understand what happens in colorectal cancer, I think it will serve as guidance to understand the other cancers of the gastrointestinal tract,” said Dr. Scott Kopetz, professor of gastrointestinal medical oncology at the MD Anderson Oncological Center of the University of Texas.
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It is likely that the increase in early appearance cases is due to multiple factors, according to Kopetz.
“The main theory is that there is no single main theory,” he said.
The new NG review in JAMA suggests that most gastrointestinal cancers in people under 50 are associated with lifestyle related factors, such as obesity, lack of exercise, poor diet, tobacco or alcohol consumption. A study included in the review discovered that women who consumed more sugary drinks during adolescence had an increased risk of developing early appearance cancer.
“It is really what people did or what they were exposed when they were a baby, child or adolescent that probably contributes to their risk of developing cancer in adulthood,” said Ng.
The Secretary of Sinses and Human Services (HHS), Robert F. Kennedy Jr., has mentioned the relationship between sugary drinks and health problems, including cancer. On Wednesday, the president, Donald Trump, pointed out that Coca-Cola will begin to be made with cane sugar instead of corn syrup in the United States, but the company did not commit to change when NBC News, Telemundo News sister chain, asked about it.
Marshall said that it suspects that the increase in colorectal cancer of early appearance could have something to do with the changes in people’s intestinal microbiome, that is, the bacteria that live in our gastrointestinal tract. It is likely that diet, antibiotic consumption, microplastics and exposure to environmental chemicals influence a person’s intestinal bacteria, but scientists still do not have a clear idea of what a healthy microbiome is like or how it affects our health. It is a booming field of research.
NG’s review also discovered that between 15% and 30% of people with gastrointestinal cancer of early appearance are carriers of hereditary genetic mutations that may have predisposed them to suffer from cancer at an early age. Therefore, he said, “we recommend that all young patients diagnosed under 50 under test to detect hereditary conditions.”
The global survival rates of gastrointestinal cancers have improved over time, thanks to improvements in medical treatment and analysis. But NG’s review discovered that younger patients usually have worse results, although they usually receive more treatments, such as more surgery, radiation and aggressive combinations of chemotherapy.
One of the reasons could be that primary care doctors can overlook symptoms such as abdominal pain, constipation, acidity or reflux in younger patients, thus delaying their diagnosis.
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“My personal impression is that we are due to the fact that we detect them in a more advanced phase, because people do not really think of colon cancer or other gastrointestinal cancers when you see a young person with these nonspecific discomforts,” said Dr. Howard Hochster, director of gastrointestinal oncology of the Rutgers and RWJBarnabas Health Institute Health in New Jersey.
But NG pointed out that, even after controlling the stadium in which patients are diagnosed, young people seem to continue having worse survival rates.
“This makes us ask ourselves as researchers if that means that cancers that develop in younger people can be biologically different and more aggressive, or they can be more aggressive,” he said.
