Why are young people getting cancer?

Stacy Hernandez was 23 when she was told she had uterine cancer. She couldn’t believe it. Not only did she have cancer, but one that had an average diagnosis age of 60 years old.

“I remember I asked my doctor, ‘Why?’ Because supposedly, endometrial cancer only hits women that are already going through menopause,” says Stacy. “I’m in my early 20s. Why am I getting this? What is going on?”

Stacy, now 31, is one of thousands of patients facing cancer at a younger than usual age—creating a medical mystery for researchers and health care professionals.

A troubling trend

“If you ask one provider, with their one frame of reference, it’s anecdotal,” says Sachin Apte, MD, MS, MBA, chief clinical officer and physician-in-chief at Huntsman Cancer Institute and professor of obstetrics and gynecology at the University of Utah (the U). “I feel that in my clinic, I’ve seen more uterine cancer in younger people. But when you see data that’s national and global, it puts it in perspective that this is a growing problem.”

Advanced age remains one of the most significant risk factors for developing cancer. The American Cancer Society says the average age of diagnosis is 66, and 88% of people diagnosed with the disease are aged 50 and older.

But patients of many cancer types are trending younger. In fact, people under 50 were the only age group with an increase in overall cancer incidence between 1995 and 2020. A recent study published in BMJ Oncology found that cancer rates for adults between the ages of 18 and 49 increased by 79.1% between 1990 and 2019.

“Those cases that affect people under 50 are still much smaller in comparison to those that are 65 plus,” says Dr. Apte. “But it’s a troubling trend.”

The reasons why this shift is happening are unknown. Dr. Apte says scientists have a better understanding of the causative agents of cancer—such as environmental pollutants, smoking, obesity, and diet—than they did 25 years ago.

“On one hand, we feel like we’re getting healthier as science improves,” says Dr. Apte. “But with the trend of younger people getting cancer, it’s almost like we’re going backwards in terms of knowledge. I think that’s what’s very disconcerting to a lot of people that see this. It causes us to pause and scratch our heads.”

Breast, gastrointestinal, and female reproductive system cancers are the most common among younger people. The rise in colon cancer cases has received significant media attention, especially after the high-profile death of actor Chadwick Boseman from the disease at age 43. A study published in the Journal of the National Cancer Institute found that while overall rates of colon cancer are dropping, younger people are getting the disease in greater numbers.

Uterine cancer cases are also on the rise, increasing 1% per year since the mid-2000s. Those rates are higher for Black, Hispanic, Asian American, and Pacific Islander women.

As these diseases are more common in older patients, early-onset cancers can be hard to identify.

Trust your instincts

Stacy Hernandez always had irregular periods during her youth in Los Angeles. Sometimes she bled for weeks. Other times, she missed her period for months. Doctors prescribed different birth controls to regulate her cycle, but the intervals of heavy bleeding became more and more intense. After several trips to urgent care, Stacy had been through enough.

“Finally, I put my foot down,” says Stacy. “You need to check me for everything. This is not okay. I’m almost two years in with this bleeding.”

That’s when her doctors in California discovered she had stage 1 endometrial cancer. They surgically removed the tumor from her uterus and told her to monitor her condition with frequent doctor visits.

She’s glad she spoke up for herself.

“Honestly, it’s your right to fight for answers,” says Stacy. “And if you know something’s not right, you can always ask for another doctor. And there’s someone out there that’s going to care and going to want to help you.”

Stacy moved to Salt Lake City in 2020. Just three years later, she found out her cancer had returned. She had started bleeding again and noticed problems with dizziness. While working as a teacher’s aide in special education, one of her students accidentally hit her in the back with a table.

“I was in such pain,” she says. “It was a pain that I would wish upon no one. I couldn’t even get out of bed, and my work was like, ‘you need to go get checked.'”

She eventually made her way to Huntsman Cancer Institute in the fall of 2023, where specialists found three tumors: one in her uterus, one pressing against her spine, and one in her chest. Stacy had surgery on her back and now visits Huntsman Cancer Institute every three weeks for chemotherapy.

Don’t fear the future

Doctors don’t know why Stacy was diagnosed with a cancer typically seen in older women.

Dr. Apte says uncovering why young people are getting cancer at higher rates will not be easy. Some researchers suspect the prevalence of processed foods and microplastics may be culprits.

“I mean, imagine all the things that are in the environment now that weren’t there 100 years ago. There’s so much to learn about, and it will take time, unfortunately,” says Dr. Apte. “Data is what will help us and guide us through this. Before we can make conclusions in terms of the causative agents, you need information. You need to prove, scientifically, what the cause is. Only then can you start figuring out what to do about it.”

Until more data is available, Dr. Apte says young people should control what they can. He recommends avoiding smoking, drinking, and maintaining a healthy weight. People should also be aware of their genetic history and stay up to date on screenings.

Dr. Apte adds that it’s important not to catastrophize, despite the unknowns.

“Yes, it is scary,” says Dr. Apte. “But our response should not be one of fear but one of rolling up our sleeves and figuring it out. Which means studying the problem.”

Until then, Stacy encourages younger cancer patients to try to stay positive and be there for each other.

“Even though there are times where it gets really hard, and I do get depressed. It hits me, what I’m going through. But I get so excited for my appointments, like ‘It’s chemo day!’ And everyone is like, ‘You weirdo, why are you dancing? Why are you happy to go to chemo?'” says Stacy. “Because I know that it’s working. I know that they’re doing everything they can to get me better.”