Latest news with #earlyOnsetCancer
ABC News
07-07-2025
- Health
- ABC News
Why are so many younger people getting cancer?
Sydney Pead: Cancer has traditionally been a disease of old age, but younger Australians in their 30s and 40s are increasingly being diagnosed with cancer and scientists are desperate to understand why. Today, Dr Norman Swan on his Four Corners investigation into what could be causing the sharp rise in cancer rates among younger people and what can be done about it. I'm Sydney Pead, on Gadigal land in Sydney, this is ABC News Daily. Sydney Pead: Norman, you've been looking into the alarming increase in cancer rates in younger people. As a millennial, I'm pretty personally invested in this story. It's pretty concerning. So what kind of increase are we seeing here? Norman Swan: It varies according to cancer. So a lot of publicity has been about bowel cancer, but in fact, the data given to Four Corners by Cancer Australia shows 10 cancers rising in the under 50s. It's called early onset cancer, but it's particularly marked in 30 to 39 year olds. If you take the statistics from 2000 to 2024, bowel cancer has gone up 173%, prostate cancer in this age group 500%, pancreatic cancer 200%, liver cancer 150%, kidney cancer 85%. Breast cancer is going up, but at a lower rate than the others. Sydney Pead: Oh my goodness, that is such a worry. And you've actually been talking to people who have been diagnosed with cancer at a relatively young age. Can you tell me a bit about Fiona? Norman Swan: Fiona So trained in accounting and finance. She's got three kids and her and her husband live in Sydney. And she was diagnosed eventually after about six months of odd symptoms, which were not ignored. Fiona So, cancer patient: I started getting like itch all over my body. And we thought it might be an allergy. We did blood tests, everything. And you don't think liver cancer would happen to someone who's like just turned 40. Norman Swan: By the time they actually investigated that, she had a huge liver tumour, which ruptured before it could be operated on. I mean, really quite dramatic. Fiona So, cancer patient: You straight away think, why me? What have I done? I don't smoke. I don't drink. I wasn't obese. I didn't have any of those symptoms. You know, I was being healthy. I was living, trying to, you know, do all the right things and it still happens. Sydney Pead: Mm, absolutely. It's so shocking, really. So in Fiona's case, what did her treatment plan look like? Norman Swan: Fiona had major surgery to remove the tumour and part of her liver. Unfortunately, not long after the surgery, it was clear that the cancer had spread, partly because it had ruptured. And now she's on a clinical trial of another treatment. And that is keeping things under control. But sadly, it's not a cure. I mean, this is hugely traumatic for her, her three kids and her husband, David. Fiona So, cancer patient: The first thought I had was, I'm not going to watch them grow up. I'm not going to see them go to university. And it's not something you ever thought. You thought you get to grow old with your husband. You get to watch your kids grow up. And then suddenly that was something that could be taken away from you. Sydney Pead: And Norman, sadly, this situation that Fiona finds herself in, it's becoming more common in young people who are juggling work commitments and family and medical appointments. So I want to turn now to some of the causes that might account for this spike in cancer rates, because we hear so many things. Is it air pollution or microplastics or too many meat cold cuts? You've been speaking to Dan Buchanan, who is one expert. He looks at bowel cancer and he says changes in our gut are a big concern. Norman Swan: What Dan Buchanan has found, and he studies what's called oncogenomics. This is the pattern of DNA mutations that you see in cancers. He can pretty much tell the age of somebody with bowel cancer from the genetic mutations in their bowel tumour. In other words, there's been a generational change. So older Australians who get bowel cancer and you look at their genetic mutation pattern, there was a change with Gen X and then with millennials. So something has happened. And he believes that that something is related to the microbiome, the guts. Associate Professor Dan Buchanan, bowel cancer researcher: We have lots of bacteria in our gut, and it's that balance between good and bad bacteria that creates a healthy state. So we think that exposures or environmental toxins may change that balance between good and bad bacteria, allowing some not so friendly bacteria to produce toxins or agents that may damage our DNA. Norman Swan: What he and others have found in a proportion of people, it looks as though early in life they were infected with a bug called E. coli. Now we've got lots of E. coli in our bowels and there's lots of different forms, but this was a toxic form of E. coli. And the toxin, the chemical that it produced, damaged the bowel and changed the DNA in the bowel, leading to bowel cancer in some people. The reality is cancer causation is a slow process. You get multiple mutations over time and it's unusual for that to gallop. Most of the time it's a fairly steady and slow process that can take 10, 20, 30 years. So if you're getting cancer when you're 30 or 40, you've got to go back to your childhood or your mum's pregnancy. That's likely when the changes occurred. So for example, if you look at the microbiome, caesarean section rates were going up during that time to quite high levels. And when you're born by caesarean section, at least for the first few months, you don't have a normal microbiome. When you're born vaginally, you ingest the microbiome of your mum. It doesn't happen when you're born by caesarean section. Antibiotic use in kids wasn't going up particularly at that time, but antibiotics certainly were being used. That was round about the time when ultra-processed foods started booming. So that makes your microbiome vulnerable. We also found in the course of researching the Four Corners in 1975, which looked as if it was made last week, because it talks about plastics, plastic ingestion and toxins in plastic that might be the source of cancer. And why hadn't we banned them? Four Corners 1975: Today, when they sell us our daily bread, it comes in a plastic bag. Now it emerges that when we eat food packed in plastic, we might unknowingly be eating some of the plastic as well. And no one knows the effects of that. Norman Swan: Microplastics are a possible cause, again, with no proof at this point. But they do get mashed down to very tiny, almost molecular sizes, which then can penetrate into our bloodstream and cause inflammation, maybe affect our brains and our heart, maybe related to cancer. We just don't know. Sydney Pead: So concerning. Let's just stay on this topic of microplastics, because that is such a big concern. And unfortunately, plastic is something that's virtually impossible to avoid. So many of us get our takeaways in plastic containers or heat up leftovers in plastic in the microwave. So can we blame plastic for rising cancer rates? Norman Swan: The answer is we don't know. I spoke to Dr Christos Symeonides, who works for the Minderoo Foundation. He's a paediatrician and he studies chemical and plastics. And he argues that this is an area that we don't really like to confront. Dr Christos Symeonides, Paediatrician: We're exposed to a broad universe of synthetic chemicals that our biology isn't familiar with. And that has left a great deal of uncertainty. Within the universe of plastic chemicals, we're looking at the last academic count at about 16,000 chemicals that are used or present in plastics. Norman Swan: When you look at the chemicals in plastics, there are thousands and thousands of chemicals, only a few of which have actually been properly studied for their hazards in humans. Dr Christos Symeonides, Paediatrician: Of those 16,000 chemicals, only one third appear to have been evaluated for potential hazard. If we look back at that one third that have been evaluated, the substantial majority, around 75%, are identified to be hazardous from those assessments. But there's a limit to which that tells us about what they'll do in our full, complex biology of the human body. Norman Swan: But we assume that the ones that haven't been tested are safe and we allow them to be used, but they might not be. Sydney Pead: Yeah, that's right. And as you say, it's not a new problem. We've been talking about this even here at the ABC since 1975. Just a little more on that. What have we learned about these plastics and the other chemicals that we're exposed to in our environment because PFAS, for example, is just a huge concern. Norman Swan: With PFAS, the so-called forever chemicals, which are in non-stick frying pans, they're in cosmetics, they're in a lot of different products. They do persist and when they persist, you do worry about their long-term effects. There's a lot of doubt about whether they as a group do cause cancer. There's not a huge amount of evidence for that. There is one called PFOA, which is just being regulated for and banned for industrial use in Australia, but that's linked to kidney cancer and probably breast cancer as well. Now, it may be that some of the others are, but yet to be proven. Sydney Pead: So, Norman, for young Australians, these numbers are so worrying. Yes, we can throw away our plastic utensils or our non-stick frying pans or avoid bacon, but it's going to take a lot more than that. So does the government have a long-term strategy to tackle these increasing cancer numbers? Norman Swan: We still really haven't got an anticipatory strategy for chemicals anywhere in the world, really, not just Australia. And there's something called the precautionary principle. We talked about that a lot during COVID. The precautionary principle is if something looks as though it's causing a problem or could be causing a problem and there's no harm in removing it, then you should remove it. Or you should not introduce it until it's proven to be safe. In other words, you should not wait until a hazard has been found. And the problem here is 30-year-olds today could well be paying the price of things that happened 30 years ago in the environment, and we only find the hazards out when it's too late. Sydney Pead: So in the meantime, is there a stopgap solution like expanding the age range of cancer screening programs to catch these diagnoses earlier? Because too often these diagnoses are coming really late for younger patients. Norman Swan: First thing to say is we only screen for four cancers. Cervical cancer screening, which starts at the age of 25. Breast cancer screening, which starts at 50, despite the fact that 20% of breast cancers and probably a growing percentage occur in people who are under 50. Bowel cancer screening, which starts at the age of 50, but it's moved down to 45. But again, you've got to opt in rather than you automatically being in the screening program. And then finally, there's lung cancer, and that's for heavy smokers, either current heavy smokers or past heavy smokers with no symptoms. Now the thing with screening is screening is of a healthy population with no symptoms. You do not want a screening program to make people sick or worse. Cancer is still a disease of aging. The older you are, the more likely there is to be damage to your DNA, and you're more likely to have cancer. Therefore, in a screening program, if you are older and you find an abnormality, that abnormality is more likely to be serious than it is if you're young, despite this increase. And therefore, you're discovering in a screening program, more people who have abnormalities that may not matter or may not turn into cancer. But the risk is that people have invasive investigations and sometimes invasive treatments, which they might not have needed. So you've got to work that one out. Then it's a question of economics for government. Can they afford to make these screening programs younger? It's likely to save lives, but there are economic costs involved. The main strategy that's left is early detection of people with symptoms. In addition to us all doing what we know does work for a lot of cancers, which is a decent amount of physical activity, a Mediterranean-style diet, where you're eating a lot of different vegetables, not eating a lot of red meat, and certainly not smoking burnt plants, whatever plants they may be, whether it's cannabis or tobacco. Sydney Pead: So certainly being made aware of the symptoms and to know what to be on the lookout for is going to be a huge part of this. Norman Swan: I have maybe three messages here. One is get yourself a general practitioner that you like, who gets to know you. A lot of younger people don't have a GP. It's important to find a GP and a practice. And sometimes that's a bit of a search to find a GP who's right for you. The second thing is, if something new happens to you, you've never had before, a headache, a lump, bleeding, bruising, anything virtually that you've just never had before, don't sit on it. Go and see your GP. Probably nothing, but it might not be. And thirdly, don't let it go. If it hasn't gone away, if it comes back, go back. It's your body and be assertive. Sydney Pead: Dr Norman Swan is a reporter for ABC's Four Corners and host of the Health Report podcast. You can watch Norman's Four Corners report on ABC iView. This episode was produced by Kara Jensen-McKinnon. Audio production by Sam Dunn. Our supervising producer is David Coady. I'm Sydney Pead. ABC News Daily will be back again tomorrow. Thanks for listening.
Daily Mail
07-07-2025
- Health
- Daily Mail
What is causing a huge spike in early onset cancers among Aussies? The data that everyone needs to see - as the country leads the world in one type of the disease
Australians in their 30s and 40s are being increasingly diagnosed with cancer, with at least 10 types of the disease rising at an alarming rate. The trend, known as early onset cancer, is worrying experts who have pointed to childhood obesity, ultra-processed foods and microplastics as possible reasons for the frightening phenomenon. Cancer Australia, the federal government's cancer agency, has released data on the staggering increases in cases between 2000 and 2024. In Australians aged 30 to 39, the rate of prostate cancer has increased by 500 per cent, pancreatic cancer by 200 per cent, liver cancer by 150 per cent, uterine cancer by 138 per cent and kidney cancer by 85 per cent. Professor Dorothy Keefe, the chief executive of Cancer Australia, has revealed approximately 10 types of cancer are now displaying unprecedented elevated rates in young adults. The likelihood of an adult being diagnosed with cancers such as bowel, breast and lung, has traditionally increased with age, but the worrying trend that has emerged in the last two decades contradicts this. Data from the United States shows Australia isn't alone with a dramatic rise in early onset cancers. But Australia is alarmingly a world leader when it comes to bowel cancer rates. Since 2000, bowel cancer cases among 30 to 30-year-olds have increased by 173 per cent and what's even more worrying is the fact diagnoses in this age group often occur at a later stage, when the cancer is harder to treat. Chris Burton, 39, told the ABC's Four Corners that he was planning his wedding when he noticed he was bleeding after going to the toilet. Six weeks later, it happened again and his GP referred him for a colonoscopy. After returning from his honeymoon, he had the procedure and was diagnosed with bowel cancer. 'Similar to a lot of young people, cancer's not at the forefront of what you think might be wrong with you,' he said. Mr Burton has understandably struggled following his diagnosis at a time that should have been a happy one. He learned of his diagnosis when his wife about to give birth to their second child. He said he often wonders if he could have done something to prevent the disease. 'That's the 3am thoughts that go through your head … have you done something to deserve it?' The specific reasons for the marked increase have not been pinned down, but theories are emerging in the scientific community. Many scientists believe environmental factors or the 'exposome' could partly be to blame for the increase in cancer cases in young adults. Understanding the environment of today's 30 to 40-year-olds when they were children could be the key, particularly societal changes between the 1960s and 1990s. Childhood obesity has increased in recent years, diets have become more reliant on ultra-processed foods, and antibiotics were more readily prescribed. Increased rates in caesareans could be a factor, as this may have disrupted the transfer of microbiomes from mother to child. This is something which could affect immune system development. Harmful microplastics and their growing presence in everyday life could also be a huge concern. Microplastics are small plastic particles, less than 5mm in diameter, which have been found in drinking water, food, and the atmosphere as they have become increasingly used in the modern world. A University of Newcastle report commissioned by the World Wide Fund for Nature found that the average individual could be ingesting as much as five grams of microplastics every single week. Mr Burton's wife Ali has since given birth to a baby girl, just three days after his latest surgery in June. 'It's a stormy dark period, but you know, it's possible to survive,' he added.
RNZ News
07-07-2025
- Health
- RNZ News
Cancer rates in Australians under 50 are rising at a pace that's alarming doctors and scientists
By Norman Swan , Elise Potaka , Maddy King and Anushri Sood , ABC Since 2000, rates of bowel cancer in 30 to 39-year-olds have increased by 173 per cent in Australia. (File photo) Photo: A. BENOIST / BSIP Chris Burton was planning his wedding when he noticed he was bleeding after going to the bathroom. He thought it was strange, but figured it was a one-off. Six weeks later, it happened again. His GP referred him for a colonoscopy, and Burton arranged to have the procedure after he and his wife returned from their short honeymoon. The 39-year-old had advanced bowel cancer. The test results stunned him. "That's probably similar to a lot of young people. Cancer's not at the forefront of what you think might be wrong with you," he says. Australians aged in their 30s and 40s are experiencing unprecedented and in some cases world-leading rates of at least 10 different types of cancer - and scientists are desperate to understand why. It's a question Burton has struggled with since his diagnosis and one that's arrived at what should be a joyous time - the couple's about to have a baby, a little sister for their older daughter Isobel. "That's the 3am thoughts that go through your head … have you done something to deserve it?" Burton says. "If there's not bowel cancer in your family, how come you've got cancer and how come you got it at a young age?" The technical term for this phenomenon is early onset cancer and it is rising steeply. Data provided to Four Corners by Cancer Australia, the federal government's cancer agency, paints a concerning picture for young people. Between 2000 and 2024 - in 30 to 39-year-olds - early onset prostate cancer increased by 500 per cent, pancreatic cancer by 200 per cent, liver cancer by 150 per cent, uterine cancer by 138 per cent and kidney cancer by 85 per cent. Some increases, such as prostate cancer, might be explained by changes in the way they are diagnosed - but most cannot. "There are approximately 10 [cancers] that have this increase to varying percentages," says Cancer Australia's chief executive, Dorothy Keefe. "Cancer has traditionally been a disease of ageing, and bowel cancer, breast cancer, lung cancer, they all increase with age. "But over the last 20 years, there's been a real - it's small in absolute numbers - but it is a real increase in the number of younger adults developing these cancers." Australia isn't the only country seeing higher rates of cancer in young people either. Large amounts of data from US cancer registries show an even more pronounced trend. Philip Rosenberg, a leading cancer bio-statistician who recently retired from the US National Cancer Institute, says there is a clear difference when comparing cancer rates between generation X and baby boomers. "There were really very notable differences, for colon, rectum, thyroid, and pancreas, and as well prostate for men and ER (oestrogen receptor) positive breast cancer for women," Dr Rosenberg says. "Overall, it's about half of the different cancer types." Worryingly, Australia is a world leader when it comes to bowel cancer. Since the year 2000, rates of bowel cancer in 30 to 39-year-olds have increased by 173 per cent - and the stage the cancer is at when diagnosed is often late, meaning it is more likely to have spread and harder to treat. Associate Professor Dan Buchanan a tumour's DNA is 'like a fingerprint'. (File photo) Photo: George Prentzas / Unsplash Dan Buchanan, associate professor at the Peter MacCallum Cancer Centre, is trying to find out why Australia's bowel cancer rates are so high compared to the rest of the world. "The statistics around early onset bowel cancer are really alarming," Dr Buchanan says. It's a shift he can see just by looking at a tumour's DNA mutations. "In the youngest group of people that developed early onset colorectal cancer, we're seeing a much higher proportion that have a particular type of DNA damage pattern," he says. That generational difference is so pronounced, he says he can tell whether a person is young or old from their tumour's DNA. "It's like a fingerprint; something's happened. It's dramatic," Dr Buchanan says. He says it suggests that there are factors or "exposures" that are contributing to an earlier diagnosis age for a group of colorectal cancers. What is causing this generational damage however is less specific - but scientists are starting to get a clearer understanding. It is fiendishly difficult to tie down the exact causes of any cancer, even though we know all cancers are caused by genes. There are inherited genetic mutations that cause cancer in their own right - for example, the BRCA genes for breast and ovarian cancer, and the Lynch Syndrome for bowel cancer. But young people behind this rise in early onset cancers do not carry such genes. Instead, most experts believe toxins or toxic influences in the world around us are interacting with genes to cause malignant changes. In other words, you might unknowingly carry a gene that's only altered when you're exposed to a particular chemical, whereas someone else who doesn't have that version of the gene would be unaffected. "Cancer is not a single disease, it is many different diseases," explains associate professor Gianluca Severi, a senior cancer epidemiologist based at the National Institute for Health and Medical Research (INSERM) in Paris. "Within a disease that is called breast cancer, there are actually many diseases, but we know that there are different subtypes of breast cancer. "It's important because that means that the causes of these different types of cancers are different." The name for the physical, chemical, psychological and social exposures in the environment which can affect human health is the exposome. Dr Severi is investigating such exposures in relation to cancer. In May, an international group of researchers announced a massive undertaking called the Human Exposome Project, which is documenting and studying these exposures. "It basically encompasses all the environmental factors but also lifestyle and their connections and interactions to try to explain the causes of different diseases," Dr Severi says of the project. But the challenge to determine when the exposures occurred is another variable which makes tracking cancer causes hard - because tumours can take decades to develop. To get a better understanding, researchers say we need to look at the environment when people in their 30s and 40s today were children or in utero. That means the environment - or the exposome - between the 60s and 90s is crucial to understanding this puzzle. For instance, it was during those decades when the childhood obesity epidemic began. Childhood obesity became more of an issue from the 1960s and beyond. (File photo) Photo: 123RF "It is very likely that childhood obesity and increasing obesity in young adults is part of the cause of this increase in early onset cancers," Dr Severi says. That connection is something liver specialist professor Simone Strasser finds in her patients. Primary liver cancer - or hepatocellular carcinoma - is another of the fast-rising early onset tumours. "The problem with obesity and diabetes driving liver disease is that we are seeing this in children and adolescents," she says. "Then 20 years of that history… you're still a young person at the time that you're running into problems from that and developing cirrhosis and liver cancer." There is also evidence that our gut bacteria - our microbiome - may have changed too, through antibiotic use, and eating ultra-processed foods. Caesarean section rates were also increasing during these decades, meaning babies didn't acquire the same microbiome as those born vaginally. That could potentially affect their immune system development. These changes could have made our gut more vulnerable to dangerous bacteria and is a major focus for Dr Buchanan. "We have lots of bacteria in our gut … and it's that balance between good and bad bacteria that creates a healthy state," he says. Research suggests exposure early in life could be driving some mutations. (File photo) Photo: Flickr "We think that exposures or environmental toxins may change that balance between good and bad bacteria, allowing some not so friendly bacteria to produce toxins that may damage our DNA." Research is finding that exposure - probably early in life - to a toxin from a bowel bug called E. coli could be driving some of the mutations that Dr Buchanan is seeing in his bowel tumour samples. He's convinced it's one of the causes. "The story for that particular gut bacteria has gone well beyond an association into causation," he says. But there are other toxins which scientists believe are affecting our genes - and they aren't from bacteria. Since World War II, we have been exposed to more and more chemicals and plastics in our day to day lives. Christos Symeonides is a paediatrician who studies chemical and microplastic exposures through his work at the Minderoo Foundation. "We are exposed to a broad universe of synthetic chemicals … that our biology isn't familiar with, and that has left a great deal of uncertainty," Dr Symeonides says. "Within the universe of plastic chemicals , we're looking at the last academic count at about 16,000 chemicals that are used or present in plastics." Dr Symeonides says only one-third of those chemicals appear to have been evaluated for their potential hazard, and about "75 per cent" of those evaluated have been identified as hazardous. "But there's a limit to which that tells us about what they'll do in our full complex biology of the human body," he says. For the two-thirds of chemicals that haven't been tested, Dr Symeonides says their hazard rate can't be assumed to be the same - but that doesn't mean they're safe either. It's one of the problems he has with the way chemicals are regulated. "It seems that the system is currently based on exactly that assumption, that until you establish and prove harm, a chemical is considered to be safe, whether you've looked for harm or not," he says. Dr Symeonides has reviewed the evidence and concluded that only five classes of chemicals - comprising fewer than 100 individual chemicals in total - out of the thousands have been studied to the depth required to find human effects if they exist. "For all five of those classes, there were serious health impacts with strong evidence of a link between exposure and those health impacts," he says. Concerns about the health effects of plastics are nothing new. In fact, when generation X were babies or in utero, we already knew that some of these chemicals were harmful. "There's a group of chemicals that had a use in plastic as flame retardants but had much broader use that we now regulate very tightly called PCBs or polychlorinated biphenyls," Dr Symeonides says. There's also another group of persistent chemicals, known by their generic name of per or poly fluoroalkyl substances (PFAS) that are suspected of causing harm. These chemicals can be found in non-stick cookware, food packaging, and even some cosmetics, and are often called "forever chemicals" because of their environmental persistence. One of them, called PFOA, has been associated with kidney cancer, and Dr Symeonides says there is also a strong link between exposure to PFOA and breast cancer. A ban on the industrial use of PFOA is now in force in Australia, but its effects could be with us for years to come due to its persistence in the environment. The ORIGINS project in the northern suburbs of Perth aims to answer some of these questions for today's children. They are following the health and wellbeing and recording medical observations of 10,000 children. In fact, the researchers at Joondalup Health Campus and The Kids Research Institute Australia are measuring these families' exposome as best they can. "There's this whole concept of developmental origins of disease where things that happen early in your life do impact on people later on," says professor Desiree Silva, the project's co-director. "The ORIGINS study will help to understand the microbiome because we are collecting samples in pregnancy in mums, and then we're collecting samples in those children. "Because we've got longitudinal bio samples and data, we can actually look at that environmental impact on what may be the causal pathways of cancer." It will be many years before ORIGINS has answers for today's kids. Meanwhile, the generations before them are confronting the reality of living with cancer. For Burton, he's focusing on his family and their future. His wife Ali gave birth to a healthy baby girl at the end of June, just three days after his latest surgery. All are doing well. "It's a stormy dark period, but you know, it's possible to survive," he says. "I like to think about us growing old together, raising the girls, and we can look back on this time period and think, 'That was really hard, but we made it through.'" - ABC
ABC News
06-07-2025
- Health
- ABC News
Cancer rates in Australians under 50 are rising at a pace that's alarming doctors and scientists
Chris Burton was planning his wedding when he noticed he was bleeding after going to the bathroom. He thought it was strange, but figured it was a one-off. Six weeks later, it happened again. His GP referred him for a colonoscopy, and Chris arranged to have the procedure after he and his wife returned from their short honeymoon. The 39-year-old had advanced bowel cancer. The test results stunned him. "That's probably similar to a lot of young people. Cancer's not at the forefront of what you think might be wrong with you," he says. Australians aged in their 30s and 40s are experiencing unprecedented and in some cases world-leading rates of at least 10 different types of cancer — and scientists are desperate to understand why. It's a question Chris has struggled with since his diagnosis and one that's arrived at what should be a joyous time — the couple's about to have a baby, a little sister for their older daughter Isobel. "That's the 3am thoughts that go through your head ... have you done something to deserve it?" Chris says. The technical term for this phenomenon is early onset cancer and it is rising steeply. Data provided to Four Corners by Cancer Australia, the federal government's cancer agency, paints a concerning picture for young people. Between the year 2000 and 2024 — in 30–39 year olds — early onset prostate cancer increased by 500 per cent, pancreatic cancer by 200 per cent, liver cancer by 150 per cent, uterine cancer by 138 per cent and kidney cancer by 85 per cent. Some increases, such as prostate cancer, might be explained by changes in the way they are diagnosed — but most cannot. "There are approximately 10 [cancers] that have this increase to varying percentages," says Professor Dorothy Keefe, Cancer Australia's chief executive. "Cancer has traditionally been a disease of ageing, and bowel cancer, breast cancer, lung cancer, they all increase with age. Australia isn't the only country seeing higher rates of cancer in young people either. Large amounts of data from US cancer registries show an even more pronounced trend. Philip Rosenberg, a leading cancer biostatistician who recently retired from the US National Cancer Institute, says there is a clear difference when comparing cancer rates between Generation X and Baby Boomers. "There were really very notable differences, for colon, rectum, thyroid, and pancreas, and as well prostate for men and ER (oestrogen receptor) positive breast cancer for women," Dr Rosenberg says. Concerningly, Australia is a world leader when it comes to bowel cancer. Since the year 2000, rates of bowel cancer in 30–39-year-olds have increased by 173 per cent — and the stage the cancer is at when diagnosed is often late, meaning it is more likely to have spread and harder to treat. Associate Professor Dan Buchanan is trying to find out why Australia's bowel cancer rates are so high compared to the rest of the world. "The statistics around early onset bowel cancer are really alarming," Dr Buchanan says. It's a shift he can see just by looking at a tumour's DNA mutations. "In the youngest group of people that developed early onset colorectal cancer, we're seeing a much higher proportion that have a particular type of DNA damage pattern," he says. That generational difference is so pronounced, he says he can tell whether a person is young or old from their tumour's DNA. "It's like a fingerprint; something's happened. It's dramatic," Dr Buchanan says. He says it suggests that there are factors or "exposures" that are contributing to an earlier diagnosis age for a group of colorectal cancers. What is causing this generational damage however is less specific — but scientists are starting to get a clearer understanding. It is fiendishly difficult to tie down the exact causes of any cancer, even though we know all cancers are caused by genes. There are inherited genetic mutations that cause cancer in their own right — for example, the BRCA genes for breast and ovarian cancer, and the Lynch Syndrome for bowel cancer. But young people behind this rise in early onset cancers do not carry such genes. Instead, most experts believe toxins or toxic influences in the world around us are interacting with genes to cause malignant changes. In other words, you might unknowingly carry a gene that's only altered when you're exposed to a particular chemical, whereas someone else who doesn't have that version of the gene would be unaffected. "Cancer is not a single disease, it is many different diseases," explains Associate Professor Gianluca Severi, a senior cancer epidemiologist based at the National Institute for Health and Medical Research (INSERM) in Paris. "Within a disease that is called breast cancer, there are actually many diseases, but we know that there are different subtypes of breast cancer. The name for the physical, chemical, psychological and social exposures in the environment which can affect human health is the exposome. Dr Severi is investigating such exposures in relation to cancer. In May, an international group of researchers announced a massive undertaking called the Human Exposome Project, which is documenting and studying these exposures. "It basically encompasses all the environmental factors but also lifestyle and their connections and interactions to try to explain the causes of different diseases," Dr Severi says of the project. But the challenge to determine when the exposures occurred is another variable which makes tracking cancer causes hard — because tumours can take decades to develop. To get a better understanding, researchers say we need to look at the environment when people in their 30s and 40s today were children or in utero. That means the environment — or the exposome — between the 1960s and 1990s is crucial to understanding this puzzle. For instance, it was during those decades when the childhood obesity epidemic began. "It is very likely that childhood obesity and increasing obesity in young adults is part of the cause of this increase in early onset cancers," Dr Severi says. That connection is something liver specialist Professor Simone Strasser finds in her patients. Primary liver cancer — or hepatocellular carcinoma — is another of the fast-rising early onset tumours. "The problem with obesity and diabetes driving liver disease is that we are seeing this in children and adolescents," she says. "Then 20 years of that history … you're still a young person at the time that you're running into problems from that and developing cirrhosis and liver cancer." There is also evidence that our gut bacteria — our microbiome — may have changed too, through antibiotic use, and eating ultra-processed foods. Caesarean section rates were also increasing during these decades, meaning babies didn't acquire the same microbiome as those born vaginally. That could potentially affect their immune system development. These changes could have made our gut more vulnerable to dangerous bacteria and is a major focus for Associate Professor Dan Buchanan at the Peter MacCallum Cancer Centre. "We have lots of bacteria in our gut … and it's that balance between good and bad bacteria that creates a healthy state," he says. "We think that exposures or environmental toxins may change that balance between good and bad bacteria, allowing some not so friendly bacteria to produce toxins that may damage our DNA." Research is finding that exposure — probably early in life — to a toxin from a bowel bug called E. coli could be driving some of the mutations that Dr Buchanan is seeing in his bowel tumour samples. He's convinced it's one of the causes. "The story for that particular gut bacteria has gone well beyond an association into causation," he says. But there are other toxins which scientists believe are affecting our genes — and they aren't from bacteria. Since World War II, we have been exposed to more and more chemicals and plastics in our day to day lives. Christos Symeonides is a paediatrician who studies chemical and microplastic exposures through his work at the Minderoo Foundation. "We are exposed to a broad universe of synthetic chemicals … that our biology isn't familiar with, and that has left a great deal of uncertainty," Dr Symeonides says. "Within the universe of plastic chemicals, we're looking at the last academic count at about 16,000 chemicals that are used or present in plastics." Dr Symeonides says only one-third of those chemicals appear to have been evaluated for their potential hazard, and around "75 per cent" of those evaluated have been identified as hazardous. "But there's a limit to which that tells us about what they'll do in our full complex biology of the human body," he says. For the two-thirds of chemicals that haven't been tested, Dr Symeonides says their hazard rate can't be assumed to be the same — but that doesn't mean they're safe either. It's one of the problems he has with the way chemicals are regulated. "It seems that the system is currently based on exactly that assumption, that until you establish and prove harm, a chemical is considered to be safe, whether you've looked for harm or not," he says. Dr Symeonides has reviewed the evidence and concluded that only five classes of chemicals — comprising fewer than 100 individual chemicals in total — out of the thousands have been studied to the depth required to find human effects if they exist. "For all five of those classes, there were serious health impacts with strong evidence of a link between exposure and those health impacts," he says. Concerns about the health effects of plastics are nothing new. In fact, when Generation X were babies or in utero, we already knew that some of these chemicals were harmful. "There's a group of chemicals that had a use in plastic as flame retardants but had much broader use that we now regulate very tightly called PCBs or polychlorinated biphenyls," Dr Symeonides says. There's also another group of persistent chemicals, known by their generic name of per or poly fluoroalkyl substances (PFAS) that are suspected of causing harm. These chemicals can be found in non-stick cookware, food packaging, and even some cosmetics, and are often called "forever chemicals" because of their environmental persistence. One of them, called PFOA, has been associated with kidney cancer, and Dr Symeonides says there is also a strong link between exposure to PFOA and breast cancer. A ban on the industrial use of PFOA is now in force in Australia, but its effects could be with us for years to come due to its persistence in the environment. The ORIGINS project in the northern suburbs of Perth aims to answer some of these questions for today's children. They are following the health and wellbeing and recording medical observations of 10,000 children. In fact, the researchers at Joondalup Health Campus and the Kids Research Institute at the University of Western Australia are measuring these families' exposome as best they can. "There's this whole concept of developmental origins of disease where things that happen early in your life do impact on people later on," says Professor Desiree Silva, the project's co-director. "The ORIGINS study will help to understand the microbiome because we are collecting samples in pregnancy in mums, and then we're collecting samples in those children. "Because we've got longitudinal bio samples and data, we can actually look at that environmental impact on what may be the causal pathways of cancer." It will be many years before ORIGINS has answers for today's kids. Meanwhile, the generations before them are confronting the reality of living with cancer. For Chris Burton, he's focusing on his family and their future. His wife Ali gave birth to a healthy baby girl at the end of June, just three days after Chris's latest surgery. All are doing well. "It's a stormy dark period, but you know, it's possible to survive," he says. Watch Four Corners' full investigation, Generation Cancer, on Monday from 8.30pm on ABC TV and ABC iview.
Daily Mail
29-05-2025
- General
- Daily Mail
Australia sets grim new world's worst cancer rate - as the possible reasons for the surge in cases are revealed
Young Aussies have been warned they are facing a 'stark reality' and to be vigilant for symptoms as cases of a serious form of cancer surge. New research from the University of Melbourne unveiled this week revealed that bowel cancer diagnoses have more than doubled for Australians below the age of 50 over the last three decades. The study found that more than 28,265 Aussies aged 20-49 were diagnosed with 49 early-onset bowel cancer between 1990 and 2020. The authors suggested that, during the same period, there has been an increase in cases which resulted in an additional 4347 diagnosed with the early-onset condition. Bowel Cancer Australia advocate Stephanie Bansemer-Brown was 42 when she was diagnosed with stage three bowel cancer in 2012. 'The GP dismissed my symptoms as haemorrhoids and put my tiredness down to being a busy mother of a toddler,' she told Daily Mail Australia on Thursday. 'I knew something wasn't right with my body so eventually I insisted on a colonoscopy.' Ms Bansemer-Brown was diagnosed with stage three rectal cancer and had extensive surgery followed by chemotherapy. 'I am lucky I pushed for further investigation otherwise my now-teenage son would have been without a mother. That is the stark reality,' she said. Earlier this year, a global study published in The Lancet found Australia has the highest rates of early-onset bowel cancer in the world, with a faster surge in cases found among women. But Professor Mark Jenkins from University of Melbourne's colorectal cancer unit has warned the cause of the increasing number of cases remains unclear. 'More and more people are diagnosed with early-onset bowel cancer each year and we don't know why,' he told ABC Radio National. 'Probably the strongest theory at the moment is it's something to do with the bacteria in our gut, which we call the microbiome... Maybe they've become more toxic.' Professor Jenkins and his colleagues have also looked at theories centred on trends of increasing obesity and decreasing physical activity among Australians. He also suggested there are theories focused on the decline in aspirin use during childhood, which protects people from the cancer, and the presence of microplastics in food. 'But it could be something else completely. It could be an unknown factor that we haven't thought of,' he said. Professor Jenkins and other advocates have urged Aussies to be aware of 'red flags' ahead of Bowel Cancer Awareness Month in June. Those aged 45-49 are eligible for the national bowel cancer screening program which helps with diagnosing cases. Younger Aussies are also urged to be vigilant for symptoms including blood in stool, changes to bowel habits and unexplained or unexpected weight loss or tiredness. Twelve years since her diagnosis, Ms Bansemer-Brown shared her story to raise awareness. 'You are never too young for bowel cancer and I encourage everyone to recognise the signs and symptoms,' she said. 'You must be a champion for your own health and if you are not happy with the response then seek another opinion. 'You know your body better than anyone.'
