Recently a number organizations including Time magazine titled its cover of February 24, 2025 Our Cancer Mystery Why It’s now Striking Us so Young and and an inside article More young adults are getting cancer. Researchers are racing to understand why.

Also the memorial Sloan Kettering Cancer Center in New York, one of the world’s largest and recognized as one of the top hospitals in the United States known for cancer research wrote on the latest research on why young adults are getting cancers.

Time she light on globally the incidence of cancer in younger than 50 years of age rose by 79% from 1999 to 2019 according to a recent study published in British medical journal Oncology. In the U.S., breast cancer is most common type of early cancer, but the recent surges in cancers affecting digestive organs, including the colon, rectum, pancreas, and stomach are particularly dramatic within this category.

In fact, research suggests in today’s young adults are about twice as likely to be diagnosed with colon cancer, and four times as likely to be diagnosed with rectal cancer, as those born around 1950.

Overall, cancer is still overwhelmingly an older person’s disease. As of 2025, 88% of people in the U.S. diagnosed with cancer were 50 or older, and 59% were 65 or older, according to the American Cancer Society. But there is no question that the demographics are shifting. People under 50 are not only at increased risk of suffering from cancer, it is the only group group for which the risk is rising. 

All told, there are 17 types of cancer that are on the rise among U.S. adults in this age group. Some of the most common cancers in young adults are:

1. Breast Cancer
2. Lymphomas (non-Hodgkin and Hodgkin)
3. Melanoma
4. Sarcomas (cancers of connective tissues like muscles and bones), cancers of the female genital tract (cervix and ovary)
5. Thyroid cancer
6. Testicular cancer
7. Colorectal cancer
8. Brain and spinal cord tumors.

All cancers begin in cells when they become abnormal. It could happen when the cell is dividing meaning that the cell no longer understands its instructions. It can start to grow out of control. There have to be about 6 different mutations before a normal cell turns into a cancer cell.

The body normally eliminates cells with damaged DNA before they turn cancerous. But the body’s ability to do so goes down as we age. This is part of the reason why there is a higher risk of cancer later in life.

Each person’s cancer has a unique combination of genetic changes. As the cancer continues to grow, additional changes occur. Even within the same tumor, different cells may have different genetic changes.

Mutations in particular genes may mean one of the following three occurrences:

1. A cell starts making too many proteins that trigger a cell to divide
2. A cell stops making proteins that normally tell a cell to stop dividing
3. Abnormal proteins may be produced that work differently to normal

It can take many years for a damaged cell to divider and grow and form a tumor big enough to cause symptoms to show up on a scan.

How Mutations Happen?

Mutations can happen by chance when a cell is dividing. They can also be caused by the processes of life inside the cell. Also by things, coming from outside the body, such as the chemicals in tobacco smoke. And some people can inherit faults in particular genes that make them more likely to develop a cancer.

Some genes get damaged every day and cells are very good at repairing them. But over time, the damage may build up. And once cells start growing too fast, they are more likely to pick up further mutations and less likely to be able to repair the damaged genes.

Types of Genes that Cause Cancer

The genetic changes that contribute to cancer tend to affect three main types of genes; proto-oncogenes, tumor suppressor genes, and DNA repair genes. (These changes are sometimes called “drivers “of cancer).

1. Proto-oncogenes. These genes are normally involved in normal cell growth and division. However, when these genes are altered in certain ways, or become more active than normal, they become cancer-causing genes, or oncogenes, and allow growing and surviving, when they should not.
2. Tumor Suppressor Genes. These genes are also normally involved in controlling cell growth and division. Cells with these genes have certain alterations that allow dividing in an uncontrolled manner.
3. DNA repair genes are involved in fixing damaged DNA. Cells with mutations in these genes tend to develop additional mutations in other genes and changes in their chromosomes,= such as duplications and deletions of chromosome parts. These changes together may cause the cells to become cancerous.

Spreading of cancer to other parts of body called Metastasis:

During metastasis, cancer cells break away from where they first formed and form new cancers in other parts of the body. Metastasis cancers are called by the same name and the same type as the original, or primary cancer.

For example breast cancer that a metastatic tumor in the lungs is metastatic breast cancer, not lung cancer, and under a microscope the metastatic cancer cells look the same as the original cancer, and usually have the same molecular features.

Metastatic tumors can cause severe damage to the body functions, and more people die of metastatic cancer disease.

Tissue Changes that are not cancer

Not all body tissue cell changes may develop into cancer. The following are kind of tissue changes that will not cause cancer, but are still monitored because they could became cancer

1. Hyperplasia can occur when cells within a tissue multiply faster than normal and build into extra cells, but the cells and tissue still look normal under a microscope. Hyperplasia could be caused by several factors, or under certain conditions, such as chronic irritation.
2. Dysplasia is more advanced than hyperplasia. In dysplasia there is also buildup of extra cells. But the cells look abnormal and there are changes in how the tissue is organized. In general, the more abnormal the cells and tissue look, the greater is the chance that cancer will form. Some types of dysplasia, need to be monitored or treated, others not. An example of dysplasia is an abnormal mole that forms on the skin that can turn into melanoma, although most do not.
3. Carcinoma in situ is even more advanced condition. Although sometimes it is called stage 0 cancer, it is not cancer because abnormal cells do not invade nearby tissue the way of the cancer cells. 

But because some carcinomas in situ may become cancer, they are usually treated as such. Before cancer cells form in tissues of the body, the cells go through abnormal changes of hyperplasia and dysplasia.

In hyperplasia, there is increase in the number of cells in an organ or tissue that appears normal under a microscope. In dysplasia, the cells look abnormal under a microscope but are not cancer.

Hyperplasia and dysplasia may or may not become cancer.

Types and Categories of Cancer:

There are more than 100 types of cancer, and they are usually named for the organ or the tissue where the cancer is formed.

For example, lung cancer starts in the lung, and brain cancer starts in the brain. Cancers are also described by the type of cell that formed them, such as epithelial cell or squamous cell.

Following are some categories of cancers that begin in specific types of cells:

1. Carcinoma. Carcinoma is the most common types of cancer. They are formed by epithelial cells, which cover the inside and outside surfaces of the body. Epithelial cells often have a column-like shape when viewed under a microscope. Carcinomas forming in different epithelial cells are given specific names:

• Adenocarcinoma is formed in epithelial cells that produce fluids or mucus. Most cancers of the breast, colon, and prostate are adenocarcinomas.
• Basal cell carcinoma begins in the lower –basal layer of epidermis.
• Squamous cell carcinoma forms in squamous cell – epithelial cells just beneath the outer surface of skin. Squamous cells look flat like fish scales under the microscope.
• Transitional cell carcinoma forms in transitional epithelium, also called urothelium, which is made up of many layers of epithelial cells and is found in the linings of bladder, ureters, and parts of kidneys.

2. Sarcoma. Sarcoma is formed in soft tissues of the body, including muscle, tendons, fat, blood vessels, lymph vessels, nerves, and fibrous tissue around joints, such as tendons and ligaments.
3. Leukemia. Leukemia begins in the blood-forming tissue of the bone marrow. This cancer does not form solid tumors, but large number of abnormal white blood cells that build up in blood and bone marrow and crowd out normal blood cells. The low level of normal blood cells makes it harder for body to get oxygen to its tissues, control bleeding or fight infections. There are four types of leukemia, grouped under how quickly how quickly the disease gets worse 9acue or chronic) and type of blood cell the cancer starts (lymphoblastic or myeloid).
4. Lymphoma. This cancer begins in lymphocytes (T cells or B cells), the disease-fighting white blood cells are part of immune system. I lymphoma, abnormal lymphocytes build up in lymph nodes and lymph vessels, as well as in other parts of the body. There are two main types of lymphoma – Hodgkin lymphoma usually forms from B cells, and people with the disease have abnormal lymphocytes, also called Reed-Sternberg cells. Non-Hodgkin lymphoma is a large group of cancers that start in lymphocytes. These cancers can grow quickly or slowly and can form from B cells or T cells.
5. Melanoma. This cancer begins in cells that become melanocytes, specialized cells that make melanin (the pigment that gives skin its color). Most melanomas form of the skin, but they also form in other pigmented tissues, such as the eye.

Tumors (benign or malignant):

1. Brain and spinal Cord tumors. These are named on the type of cell in which they are formed and where they first formed in the central nervous system. For example, a tumor in the star-shaped brain cells called astrocytes which normally keeps nervous cells healthy is called astrocytic tumor. It could be benign or malignant (cancer).
2. Germ Cell tumors. These tumors begin in the cells that give rise to sperm or eggs. They can start almost anywhere in the body, and could be either benign or malignant.
3. Neuroendocrine tumors. These tumors form from cells that normally release hormones into the blood in response to a signal from the nervous system. The tumors which could be benign or malignant make higher than normal amounts of hormones, and cause many different types of symptoms.
4. Carcinoid tumors. These are a type of slow growing neuroendocrine tumors usually found in the gastrointestinal system, most often in the rectum and small intestine. These tumors may spread to the liver or other sites in the body, and may secrete serotonin or prostaglandins causing carcinoid tumors.

According to Cancer Society the types of cancer seen in young adults (ages 20 to 39) are not unique to this age group, but the most common types in this age range. They are largely different from those in children or older adults.

The most common cancers in older people are cancers of the skin, lung, colon, and rectum, breast (in women) and prostate (in men). Many cancers in older adults are linked to life style –related risk factors (such as smoking, having excess body weight, and not getting enough physical activity) or other environmental factors.

A small portion is strongly influenced by mutational changes in person’s genes that they inherit from their parents.

Cancers that start in children or in teens are much less common. The type of cancers that develop in children and teens are often different from the type developing in adults. Children cancers are often the result of gene changes that take place very early in life, sometimes even before birth. Unlike many cancers in adults, cancers in children and teens are not strongly linked to lifestyle or environmental risk factors.

The types of cancers seen in young adults (ages 20 to 39) are not unique to this age group, but the most common in this age range are largely different from those in children or older adults. . Even within this age group, some of these cancers become more or less common as people age. For example, lymphomas are more common before age 25, whereas breast, cervical, and colorectal cancers become more common after age 25.

These cancers are discussed in the following:

Breast cancer: Breast cancer occurs most often in older women. It is rare before before age 30, and has become more common as women age. The most common is in a lump that is not cancer.

In fact, the younger the woman is the more likely it is benign, but there is always a chance that the lump may be cancer, even in a younger woman. Other possible signs of breast cancer include breast pain or swelling, thickening of breast skin, changes in the nipple, or fluid leaking from the nipple. No matter what age a woman is, breast lump and other changes need be checked by a doctor to be sure they are not breast cancer.

Lymphomas: Lymphomas are cancers that start in immune cells called lymphocytes. They most often affect lymph nodes or other lymph tissues, like the tonsils or thymus. They can also affect the bone marrow and other organs.

Lymphomas can cause different symptoms depending on where the cancer is. Some of the more common symptoms are weight loss, fever, sweats, tiredness, and swollen lymph nodes under the skin in the neck, armpit or groin.

There are two types of Lymphomas. Hodgkin lymphoma and non-Hodgkin, and both can occur in young adults. Hodgkin lymphoma is most common is most common in early adulthood (ages 15 to 40, but usually people in their 20s) and late adulthood (after age 55). This type of cancer is similar in all age groups.

Non-Hodgkin Lymphoma is less common than Hodgkin lymphoma in young adults, but the risk goes up as people get older. There are many types of these , some types are seen in young adults and tend to grow quickly and require intense treatment , but also tend to respond better than in older adults.

Melanoma: It is a type of skin cancer, more common in older adults, but it is also in younger people. In fact, melanoma is one of the most common cancers in people younger than 30 (especially younger women). Melanoma that runs in families can occur at a younger age.

The most important warning sign for melanoma is a new spot on the skin that’s changing in size, shape or color. It you have any of these warning sign, get it checked by a doctor. It could treated early it could, the chance of curing is very good, but if left alone, it could grow, spread and harder to treat.

Soft tissue Sarcomas: These cancers can start in any part of the body , but often develop in the arms or legs. Rhabdomyosarcoma is a cancer that starts in cells that normally develop into skeletal muscle cells, is most common in children younger than 10. but it can also develop in teens and young adults.

Most other types of soft tissue sarcomas become more common as people age. Symptoms depend on where the sarcoma starts, and can include lumps (which might or might not cause pain), swelling, or bowl problems.

Bone sarcomas: The two most common types of bone cancer, osteosarcoma and Ewing sarcoma, are most common in teens, but can also develop in young adults. They often cause bone pain that gets worse at night or wit activity. They can also cause swelling in the area around the bone.

Osteosarcoma usually starts near the ends of the leg or arm bones. The most common places for Ewing sarcoma to start are the pelvic (hip) bones, the bones of the chest wall (such as the ribs or shoulder blades), or in the middle of the leg bones.

Cancers of the female genital tract (Cervix and ovary):

Cervical cancer occurs in midlife, most often in women in their 30s, 40s, or 50s. It rarely occurs in women younger than 20. Most cancers found early can be prevented with screening tests. Vaccines against Hepatic Papilloma Virus linked to most cervical viruses can help prevent it. The most common symptom of cervical cancer is abnormal bleeding.

Overall, ovarian cancer is much more common in older women than in women younger than 40. But some less common types of ovarian cancer s, known as germ cell tumors are more common in teens and young women than in older women.

Early ovarian cancer usually does not have symptoms, but some women might feel full quickly when eating or they might have abnormal bloating, belly pain, or urine problems. Women who might any of these symptoms lasting more than a few weeks should see their doctor.

Thyroid cancer: The risk of thyroid cancer goes up as people get older, but it is often found at a younger age. It is more common in in women than men.

The most common symptom of thyroid is a lump in front of neck. Most thyroid lumps are not cancer, but it is important to have checked them to be sure. Other symptoms of cancer include pain or swelling in the neck, trouble in breathing, or swallowing and voice changes. The curing of these caners is very good, especially in young adults.

Testicular cancer: Testicular cancer often develops in younger men, and about half occur in men between the ages of 20 and 40. Often the first symptom is a lump on the testicle, or the testicle becomes swollen or larger. Some may be painful, but most time they are not, and it is important to get them checked as soon as possible. The prognosis for testicular cancer is very good, and most often these cancers can be cured.

Colorectal cancer: Cancers of colon and rectum are more common in older adults. In young adults, they are more likely linked to an inherited genetic condition. Screening can often find these cancers early, but screening in young is not recommended unless a strong risk factor is known.

Symptoms of colorectal cancer include rectal bleeding, dark colored stools, changes in bowl habits, belly pain, loss of appetite, and weight loss. Outlook for these cancers is better among young adults than those who are older.

Brain and spinal cord tumors: There are many types of these, and treatment and outlook for each type is different. In children, most brain tumors start in the lower part of the brain, such as cerebellum (which coordinates movement), or brain stem (which connects brain to the spinal cord). Adults are more likely to develop tumors in upper parts of the brain. Spinal cord tumors are less common than brain tumors in all age groups.

Brain tumors can cause headaches, nausea, vomiting, blurred or double vision, dizziness, seizures, trouble walking, or handling objects, and the like.

The University of Texas, MD Anderson Cancer Center in Houston, and the Memorial Sloan Kettering Cancer Center in New York City are ranked number one and number two respectively in Newsweek’s World’s Best Specialized Hospitals 2025 list published on September 24, 2024.

The MSK website says, “The people of Memorial Sloan Kettering Cancer Center are united by a singular mission: ending cancer for life. Our specialized care teams provide personalized, compassionate, expert care to patients of all ages. Informed by basic research done at our Sloan Kettering Institute, scientists across MSK collaborate to conduct innovative translational and clinical research that is driving a revolution in our understanding of cancer as a disease and improving the ability to prevent, diagnose, and treat it.

MSK is dedicated to training the next generation of scientists and clinicians, who go on to pursue our mission at MSK and around the globe. One of the world’s most respected comprehensive centers devoted exclusively to cancer, we have been recognized as one of the top two cancer hospitals in the country by U.S. News "World Report for more than 30 years."

The following is a summary of an article dated January 16, 2025 by Bill Piersol of the MSKCC is titled “The Latest Research on Why Young Adults Are Getting Cancer.”

The growing number of young people under 50 are being diagnosed with an over dozen forms of cancers around the world is especially worrying in women according to statistics released by the AMC which found cancer incidence rates “in women under 50 are now 82% higher than their male counterparts, up from 51% in 2002.”

Types of Caners Becoming More Common in Young People:

Men and women in the prime of their lives are increasingly diagnosed with serious cancers including colorectal, breast, prostate, urine, stomach (gastric), pancreatic, and more. One forecast predicts cancer for this group will increase by 30% globally from 2019 to 2030. ”This is not a blip,” according to Andrea Cercek, MD, gastrointestinal oncologist.

Is Obesity Causing More Young People to Get Cancer? An obvious cause for rising cancers is obesity, highly processed foods, and sedentary lifestyles, which are epidemic in America and growing in many countries. “Obesity causes inflammation, which can lead to cancer,” according to Dr. Goldfarb.

Promising leads for the Mystery of Increasing Rates of Cancers in Young Adults:

MSK experts agree there is not a single smoking gun, if there was researchers would have found it, instead there are likely several causes. The working hypothesis is that there is an environmental exposure, or multiple exposures, that people born starting 1950s came in contact with. It is possible that exposures began in the1960s or 70s and have been continuously present since then,” according to Dr. Cercek . What MSK researchers don’t yet know what that exposure might be, they have discovered promising leads.

Listen Now: What’s causing Cancer Rate to Rise in Gen X and Millennials?

In this episode of “Cancer Straight Talk’, MSK cancer experts discuss the troubling rise in cancer rates among young generations. How prenatal exposures, environmental toxins, and various lifestyle factors may be contributing to the alarming trend and how these insights could impact our approach to screening and treatment in the future.

How Microbiome Diversity Affects Cancer Rates?

In May 2024, Dr. Mendelsohn presented preliminary data at a medical conference about the microbiome of people with early onset colorectal cancer. The microbiome, also known as the invisible organ is the enormous community of bacteria and other microbes that live in our gut, which help regulate our digestive system.

“We found that younger people with colorectal cancer have less diversity in their microbiome than older patients, said Dr. Mendelsohn. “And the make-up of two groups’ microbiome is different too.” That’s important because more diversity generally means better health.

By scouring the vast amount of lifestyle data younger patients at MSK have provided, she says, MSK is “investigating factors we know affect the microbiome, including dietary changes, medications such as antibiotics, and even factors from childhood, such as breastfeeding and C-section patterns, age of parents at birth, and more.” 

The goal, says Dr. Mendelsohn, is to “look for a possible trigger that would explain why the microbiomes of these patients are different.”

Stomach cancer research by gastroenterologist Monika Laszkowska, MD, MS, focuses on another angle: how to identify younger people at high risk so they can be screened. “We know that certain groups, such as people of East Asia ancestry, are at higher risk of stomach cancer, which is often triggered by a microbe called Helicobacter pylori,”.

She explained. “Our stomach involving patients at MSK also found other groups, such as younger Hispanic women, are more likely to develop early-onset stomach cancer.” That insight could lead to more awareness among Hispanic and Latina women and their doctors.

Research by Dr. Laszkowska raises new questions. “Stomach cancer is slow-moving. So why is it developing more quickly in younger people?” She asks. “Could the malignancy be growing through a different pathway? Or could it be spurred by another condition, such as an autoimmune disease?”

Is Early-Onset Cancer Biologically Different?

These questions led to another question. Is early-onset cancer biologically different and more aggressive than cancer in older people?

A study led by Dr. Cercek discovered an intriguing dynamic in colorectal cancer. Her colorectal patients at MSK responded the same way to chemotherapy “whether they were 17 or 70.” Those in younger group were more likely to have rectal cancer, but the biology of the disease looked the same in older patients.”

There are more dangerous subtypes appearing in Breast Cancer in Younger Women:

Breast cancer was not a single disease, but appeared to have 400 different diseases, according to Dr. Goldfarb. “Breast cancer was over 400 different diseases. Subtypes triple-negative and HER2-positive were more common among young women and had worse prognosis.”

“Some of the risk factors for breast cancer are increasingly found in younger people,” she explained.” “For example, they are exposed to more years of unopposed reproductive hormones because they are experiencing menstruation earlier and having children later.”

However, she stressed that this - along with the rise of obesity – does not fully explain why more women under 50 are developing particularly aggressive forms of breast cancer.” MSK’s investigation into why includes every tool at researchers’ disposal, from surveys that reveal all aspects of lifestyle and personal history to next generation genomic testing to determine what’s happening on the genetic level.

Dr. Goldfarb pointed to research by breast oncologist Pedram Razavi, MD, PhD. to uncover minimal residual disease in patients. She also uses blood tests that lookn for mutations in tumors to help guide treatment options.

Comprehensive Cancer Care for the Needs of Younger People. Alongside investigations MSK specialists support the unique needs of younger adults. ”Our program helps with specific concerns of this stage of life, including fertility preservation, talking with children, parents and colleagues about a cancer diagnosis, discussing impact of work, dating, sexual health, and much more”, said Dr. Goldfarb. “When a person is diagnosed with cancer, it turns their world upside down, We’re there to help not just their physical health, but their entire social and emotional well-being.”

According to the American Cancer Society the main types of treatment for cancer in young adults are the same as those used for other age groups; the choice depends mainly on the type and stage (extent) of cancer. Often more than one type of treatment is used. There are very few doctors who focus on young adults with cancer, so it is always clear which type of doctor (or treatment0 might be best.

Young adults with cancers that are more common in children such as acute lymphocytic leukemia (ALL), bone sarcoma, and rhabdomyosarcoma are often best treated by (or at least with input from) pediatric oncologists, who have more experience with these types of cancers. On the other hand, young adults with “adult” cancers such as breast cancer, colorectal cancer, or melanoma are more likely to benefit from doctors who treat older adults and see these types of cancers more often.

Doctors tend to use more intense treatments when treating children with cancer than when treating adults. Children’s bodies are better able to recover from more intense treatments (such as higher doses of chemo) than are adult’s bodies. And in general, childhood cancers often respond better to chemo because they tend to be cancers that grow quickly (and chemo works better against fast-growing cancers).

For some cancers (especially “childhood” cancers (like ALL and bone sarcomas), the more aggressive treatments used for children have been found to improve outcomes for young adults as well, but for other cancers the results are not clear. Again, this can depend on the patient’s age and the type of cancer.

It is important to discuss all treatment options, as well as possible side effects to help make the best decision that fits the specific needs. Surgery is a common treatment, especially for early stage cancers.

Radiation therapy is the use of high-energy rays or particles to kill cancer cells. Young adults are less likely to have major side effects than children because their bodies are no longer growing as quickly. But many parts of the body can still be effected by radiation, and radiation some late or long-term effects.

Chemotherapy is the use of drugs to treat cancer; some can be swallowed, others injected into a vein or muscle. Chemo is often used to treat cancers that have spread, but it can be also used for some earlier stage cancers. Chemo drugs can cause side effects because they affect cells that are dividing quickly.

Young adults can usually withstand higher doses than older adults, but higher doses can cause more side-effects.

For some types of cancer, newer targeted therapy drugs can be used instead of or along with standard chemo therapy. These drugs work by attacking certain parts of cancer cells (or nearby cells) that help them grow. They tend to have different (and often less sever) side-effects.

Some types of cancers, such as some breast cancers grow in response to certain hormones in the body, and can be treated with hormone therapy, which stops the cancer cells from responding to these hormones.

Some medicines help the body’s own immune system attack the cancer cells. Immunotherapy can help against some types of cancer which tend type have different side effects than chemotherapy.

Stem cell transplant also known as bone marrow transplant is a way for doctors to give doctors very high doses of chemo (sometimes alongside radiation therapy) is an option for treating some cancers, usually if other treatments are not working . In stem cell transplant, d forming stem cells are firs collected from the blood or bone marrow of either the patient, or a matched stem cell donor.

The stem cells are kept frozen while the patient gets very high doses of chemo (and sometimes radiation) to kill the cancer cells. Afterward, the stem cells are given into the vein much like blood transfusion, It settles in the bone marrow and start making new blood cells

A stem cell transplant is a complex treatment that can cause serious, sometimes life threatening side effects. It often requires a lengthy hospital stay. It is important to to understand the possible benefits, risks, and cost of this procedure if it is an option.