More than two million Americans will be diagnosed with a cancer for the first time this year, according to estimates that would mark a grim new record.

Cancer cases have been rising for decades, partly due to better testing and diagnostics, poor diets, obesity and physical inactivity – having risen from 1.2 million in 2003 to just under two million in 2023.

The surge is being driven in part by an alarming rise in people under 50, which has been linked to poor diets, sedentary lifestyles and exposure to chemicals.

While overall cancer deaths have fallen 33 percent since 1991, in young people, some cancer rates are rising sharply, including colorectal cancer. 

The cancer was the fourth-leading cause of cancer death in both men and women younger than 50 years in the late-1990s but is now the leading cause in men and second-leading cause in women. 

Among adults 65 and older, adults 50 to 64 and those younger than 50, ‘people aged younger than 50 years were the only one of these three age groups to experience an increase in overall cancer incidence during this time period,’ the new report from the American Cancer Society said.

‘Cancer patients are increasingly shifting from older to middle-aged individuals,’ it added.

Cancer was thought to be a disease of the elderly, but the report found that the share of cases in people 65 and older are declining – from 61 percent in 1995 to 58 percent in 2020, despite the population growth of this age group from 13 percent to 17 percent.

In contrast, new cases among those aged 50 to 64 have increased since 1995, from 25 percent to 30 percent in 2020.

Declining deaths are due to a variety of factors, including more effective treatments being discovered to treat the diseases, better diagnostics to pinpoint and track cancer in the body, as well as the success of educating the public through health campaigns about what symptoms to flag to their physicians so that tumors are spotted early, when they are easiest to treat.

Dr William Dahut, chief scientific officer at the American Cancer Society, said younger patients tend to be diagnosed at later stages, when the cancer is more aggressive.

‘People younger than 65 are less likely to have health insurance and more likely to be juggling family and careers,’ said Dr Dahut.

‘Also, men and women diagnosed younger have a longer life expectancy in which to suffer treatment-related side effects, such as second cancers.

‘So it’s not only having a colorectal cancer — it’s colorectal cancer that’s more difficult to treat, which is why we’re seeing these changes in mortality,’ he added.

Gastroenterologist at the University of Chicago Dr Christopher Lieu predicted last year: ‘Colorectal cancer will be the number one cause of cancer-related deaths in [patients] 20 to 49.

‘This is a humongous issue.’

Meanwhile, Dr Kimmie Ng, director of the Young Onset Colorectal Cancer Center at Dana-Farber Cancer Institute in Boston, said the American Cancer Society’s report confirms what he has been seeing in practice for years.

‘For a couple of decades now, we have been noticing that the patients coming into our clinic seem to be younger and younger,’ he told NBC News.

‘What this report now cements for us is that these trends are real.’ Dr Ng was not involved with the new report.

While cancer diagnosis has improved in general, doctors do not think to look for cancers in young people, which can lead to misdiagnoses. 

Colon cancer in particular has broad symptoms including abdominal pain, diarrhea and weight loss, meaning it can go unnoticed for years.

But the face of cancer is changing, and diagnoses are shifting earlier. Within the next decade, experts expect colon cancer to become the number one cause of cancer-related deaths among under-50s.

Experts are not sure what’s behind the unprecedented rise and are exploring whether modern diets, antibiotics or even fungal infections could be at play.

A study last year suggested high-fat diets could be driving America’s colorectal cancer epidemic in young people. 

Researchers at the Salk Institute and the University of California, San Diego, found that high-fat diets change gut bacteria and alter digestive molecules called bile acids in mice.

These caused inflammation, which increased the chance of colorectal cancer, a notoriously difficult-to-treat type of the disease.

Data from JAMA Surgery showed that colon cancer is expected to rise by 90 percent in people ages 20 to 34 by the year 2030. Doctors are not sure what is driving the mystery rise

Data from JAMA Surgery showed that colon cancer is expected to rise by 90 percent in people ages 20 to 34 by the year 2030. Doctors are not sure what is driving the mystery rise

Dr Ronald Evans, study author and director of the Salk Institute’s Gene Expression Laboratory, said: ‘The balance of microbes in the gut is shaped by diet, and we are discovering how alterations in the gut microbial population (the gut microbiome) can create problems that lead to cancer.

‘This paves the way toward interventions that decrease cancer risk.’

Other explanations include the overuse of antibiotics and fungal infections in the intestines.

Dr Suneel Kamath, an oncologist specializing in colorectal cancers at the Cleveland Clinic, previously told ‘What we suspect is happening is that when there’s excess antibiotic use, there is a change in what was a normal, healthy microbiome, and then bad pathogens, if you will, get introduced into that.

‘Those can trigger inflammation or other things that cause mutations in cells.

‘[These] can lead to an overdrive of the cell sort of dividing and replacing itself — and when you do that faster than you should, that can lead to mutations occurring and then tumors forming as a result.’

Published Wednesday, the report estimated there will be roughly 2,001,140 new cancer cases – the equivalent of about 5,480 diagnoses each day.

California, Florida and Texas are all predicted to see the highest amounts of new cancers, as would be expected due to their large populations.

Following the same vein, New York, Pennsylvania, and Illinois were next on the list.

At the other end of the scale, the least-populated states, Wyoming, Alaska and Vermont, all have the lowest predicted amounts of new cancers, as well as the District of Columbia.

On a positive note, cancer deaths have lowered 33 percent between 1991 and 2021, thanks to lower smoking rates, earlier detection and improved treatments. 

And Americans are more likely to survive a cancer diagnosis compared with people a generation ago – the five-year survival rate has increased from 49 percent in the mid-1970s to 69 percent between 2013 and 2019.

The American Cancer Society collated the latest data on cases up to 2020 from cancer registries and mortality data through 2021 from the National Center for Health Statistics and used them to project cases and deaths. 

Daniel (right) became best friends with makeup mogul Jeffree Star after the pair met in the early 2000s in Los Angeles

Daniel at the hospital receiving treatment for his colon cancer

Daniel (right in left picture) became best friends with makeup mogul Jeffree Star after the pair met in the early 2000s in Los Angeles. Daniel (right picture) at the hospital receiving treatment for his colon cancer

Daniel Lucas was 27 when he started to get blood in his stool in 2017. He was misdiagnosed for two years while doctors thought he had colitis, Crohn’s disease, and appendicitis.

The tumor was not spotted until it had progressed to stage three, meaning it had spread outside the colon. Daniel died aged 35 in 2022.

Jordan Knight, from Bethel Park in Pennsylvania, was robbed of seeing his son grow up after he was diagnosed with stage four colon cancer aged just 29.

Daniel was a talented makeup artist from the San Francisco Bay Area in California.

In late 2016, he started feeling tired and having bowel trouble, but put off going to the doctor because he thought it was just nerves or stress.

Blood in his stool in 2017 finally prompted him to see a doctor, but for two years, his cancer would be misdiagnosed.

Initially, doctors thought he had irritable bowel syndrome (IBS) and sent him home from the hospital. 

Then, they thought it was colitis, then appendicitis, and he underwent surgery to remove his appendix, which turned out to be unnecessary.

Daniel and his aunt Tami in Central Park on a trip to New York in March 2022

Daniel and his aunt Tami in Central Park on a trip to New York in March 2022

After healing from the operation, Daniel’s symptoms persisted. Medics suspected he might have Crohn’s.  

His aunt, Tami Pangelina, told ‘They never once offered him a colonoscopy or talk about maybe colon cancer, nothing, because of his age. He was so young.’

Daniel was finally diagnosed aged 27 with stage three colon cancer.

But should the cancer not be detected until stage three, the five-year survival rate drops to 71 percent. At stage four, just 14 percent of patients live for another five years.

Daniel started seeing an oncologist in Las Vegas, Nevada, where he was living, and went through several rounds of chemotherapy and radiation.

Doctors told him they were able to get rid of it all, but his symptoms returned several months later. 

The cancer had come back, so he had more chemotherapy and radiation and was declared cancer-free again.

Ms Pangelina said: ‘He was happy. He was trying to live life. He had so many things to look forward to.’

In April 2021, while Daniel was driving with his best friend, makeup mogul Jeffree Star, at Star’s ranch in Wyoming.

The black ice caused the pair to have a car accident in which the car rolled over. While in the ER, doctors found a mass in Daniel’s stomach again.

He flew back to Las Vegas to see his doctors, but they told him there was nothing more that could be done.

The cancer grew to the point where Daniel could no longer eat food because the tumors were blocking his intestines, meaning he could not digest anything. 

He had to get another bag for his stomach, which he wore 18 hours a day to get his nutrition in liquid form.

‘Everything that he loved — food, beauty, his aesthetic as a human — was taken away from him. It was really, really, really devastating,’ his aunt said.

‘We went to the hospital, and he was gone five days later,’ Ms Pangelina said. Daniel died on November 26, 2022.

Jordan (center) with his parents. He died from colon cancer age 31, leaving behind a wife and son

Jordan (center) with his parents. He died from colon cancer age 31, leaving behind a wife and son

Meanwhile, Jordan, from Pennsylvania, started noticing he was losing weight in October 2018, when he started noticing that he was having bowel issues, losing weight and blood in his stool.

His doctor suggested he get a colonoscopy. 

 His mother, Lynne Ireland-Knight, told ‘Thank goodness his doctor didn’t just say, you’re young, it’s not an issue, because that’s what people hear all the time, unfortunately.’

Regular screening for colon cancer in America does not begin until age 45.

Ms Ireland-Knight was getting ready to go to work when Jordan called her, and said immediately: ‘Mama, they found a mass.’

‘That’s when our whole world just shifted,’ she said.

The 29-year-old was diagnosed with stage four colon cancer. He tried multiple different treatments and surgeries, and took part in clinical trials.

After his initial round of chemotherapy, he had surgery to remove the tumor, but the surgeon found that the cancer had spread to his liver.

In January 2021, the surgeon told Jordan and his family there was nothing more that could be done. 

They recommended Jordan transfer to a hospice, but he was not receptive to it. ‘He was very angry, and rightly so. He was 31 years old,’ said Ms Lynne Ireland-Knight.

Jordan died on March 8, 2021.

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