Cancer Sometimes Does Not See Age

Gastrointestinal (GI) cancer, which includes the GI tract and other organs within the digestive system, typically affects patients aged 50 years and older. But, recently, there has been a rise in younger patients receiving diagnoses of GI cancer. In addition to this increased incidence, some studies indicate that younger patients are receiving diagnoses at a more advanced stage than older patients.

Some questions arise as GI cancers become more prevalent in younger patients. What is the reason behind this increase? Is it related to the obesity trend, other dietary/environmental factors or a combination of these? Guidelines have recently been changed to start screening for these cancers at 45 rather than 50, but should they apply for even younger individuals if risk factors are present? Will people be motivated to get screened earlier?

Beyond screening, GI cancers might behave differently in younger patients than in older patients. If that is the case, should younger patients be treated differently? There are currently no strong data to support this.

Because GI cancers are more prevalent in older populations, there is limited information about younger patients to point to specific causes and treatments, making it difficult to understand why the incidence is increasing. This represents a dilemma that epidemiologists and other researchers are endeavoring to solve.

It is difficult for anyone to receive a cancer diagnosis, but when someone who is younger than average finds out they have GI cancer, they may face other challenges. For example, there may not be as many young people to connect with who experienced a similar cancer journey, they are more likely to be uninsured, or they may not have a primary physician to evaluate and counsel them. Additionally, the financial burden of cancer treatment may be more onerous earlier in life.

It is important that we as doctors remember that although we may be biased by age, a cancer diagnosis may not. We need to adjust our threshold for when we obtain diagnostic testing. And for those young people experiencing discomfort, new GI symptoms or pain: See your doctor. If you have a family history of cancer, it is vital that you be screened according to the latest recommendations.

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