Early-onset cancer cases on the rise, and alcohol may be key culprit

• While there was a decrease in overall cancer death rates in the United States between 1991 and 2021, experts from the American Association for Cancer Research predict there will have been more than 2 million new cancer cases diagnosed in 2024.
• Scientists have found that 40% of all cancers in the U.S. are associated with modifiable risk factors.
• In addition to smoking and excess body weight, excessive alcohol intake is another important risk factor, with 5.4% of all cancers in attributable to alcohol use, according to the latest available data.
• Researchers report that despite recent advancements in cancer research and treatment, there still remain barriers to early detection and vaccine-preventable cancers.

According to the 2024 edition of the American Association for Cancer Research’s Cancer Progress Report, advances in cancer research and treatment have helped decrease the age-adjusted overall cancer death rate in the United States by 33% between 1991 and 2021.

However, barriers to certain prevention tools like vaccines and early screenings, as well as unhealthy lifestyle choices — such as excessive alcohol use — lead researchers to predict that more than 2 million new cases of cancer will be diagnosed in the U.S. in 2024.

“Remarkable progress has been made in reducing cancer mortality over the last 30 years, which came about because of strong, concerted efforts on a number of fronts,” Ernest Hawk, MD, MPH, head of Cancer Prevention and Population Sciences at The University of Texas MD Anderson Cancer Center, who was not involved in this report, told Medical News Today.

“This includes effective tobacco control, a greater awareness and uptake of cancer screening to identify many cancers earlier at a more treatable stage, and more effective treatments that can often be delivered while minimizing toxicities. While very encouraging, the rising rates of many incident cancers also indicates that there’s much more to be done,” Hawk noted.

MNT has spoken with four cancer experts to discuss the report’s most striking findings. Here is what they had to say.

According to the latest Cancer Progress Report, 40% of all cancer diagnoses in the U.S. are linked to modifiable risk factors.

“I think the report really highlights something that a lot of people are not aware of — 40% of cancers in the U.S. are associated with modifiable risk factors,” Wael Harb, MD, a board-certified hematologist and medical oncologist at MemorialCare Cancer Institute at Orange Coast and Saddleback Medical Centers in Orange County, CA, told MNT after reviewing the report. “So by reducing these risks, we can prevent cancer altogether.”

“These include quitting smoking, moderation of alcohol intake, maintaining a healthy diet and weight, staying physically active, and protecting the skin from UV radiation,” Harb detailed.

“With these things in mind, there’s a lot we can do for any individual at the risk of developing cancer — [it’s] really important to detect early or prevent it in the first place, so we don’t deal with advanced cancer situations,” he emphasized.

Out of all the modifiable risk factors associated with cancer, the report highlighted excessive alcohol use as one with a strong impact: 5.4% of all cancer cases diagnosed in the U.S. in 2019 were attributable to alcohol use.

“This is a reminder of the impact of lifestyle choices that can have on cancer risk,” Harb said.

“There’s definitely a link between excessive alcohol intake and multiple cancers, including breast, colorectal, [and] liver cancer. It’s really important for public health initiatives to focus on reducing alcohol consumption, increasing awareness about these dangers. I think that will lead to decreased risk of developing cancer.”

– Wael Harb, MD

MNT also spoke with Anton Bilchik, MD, PhD, surgical oncologist, chief of medicine and Director of the Gastrointestinal and Hepatobiliary Program at Providence Saint John’s Cancer Institute in Santa Monica, CA, about this report.

Bilchik commented that while the role of alcohol in cancer development is obviously important, the report does not provide sufficient information on the quantities of alcohol involved.

“We know that alcohol in large quantities is associated with many diseases, including cirrhosis and cancer, but we also know that the Mediterranean diet — that has been well prescribed [and] which [often] includes one glass of red wine at night — is actually protective against heart disease,” Bilchik continued.

For those looking to lower their alcohol-use-related cancer risk, Bilchik said a person’s biological sex and metabolism may play a role in this equation, too. He noted that, in female bodies, less alcohol may lead to higher risk than in males.

“I think limiting alcohol to half a glass of wine a night is unlikely to be dangerous, but every person is different, the metabolism of every person is different,” Bilchik advised.

The Cancer Progress Report states that another obstacle that still needs to be overcome is making early detection screenings and vaccines for vaccine-preventable cancers like cervical cancer accessible to everyone.

The report found that early-onset cancers are on the rise, including diagnoses rates for colorectal, breast, and other cancers in young adults younger than 50 years of age.

Additionally, the overall cervical cancer rate in women between the ages of 30 to 34 rose by 2.5% between 2012 and 2019.

“Cancer is the second leading cause of death in the U.S.,” Jamie Koprivnikar, MD, oncologist and hematologist in the Division of Leukemia at the The John Theurer Cancer Center at Hackensack University Medical Center in New Jersey — who was not involved in this report — told MNT.

“It represents a major public health crisis. Alarmingly, reports suggest that there has been a nearly 80% increase in early-onset cancer cases worldwide since 1990. The old adage prevention is worth a pound of cure definitely holds weight in this situation,” she added.

Koprivnikar told us that, while it remains unclear why the number of early-onset cancer cases is increasing, experts do have some theories:

“While there is no clear answer as to why early-onset cancers are increasing, we believe that this may largely be due to diet and lifestyle factors. Specifically, we believe that obesity, smoking, alcohol consumption, eating processed foods, and a sedentary lifestyle may underlie this recent spike in earlier-onset cancer.”

All of the experts we interviewed agreed that, while progress is being made in the fight against cancer, more work remains to be done.

“I think this is very important work,” Koprivnika said. “Every day, I have a patient question ‘why me?’ with regards to his or her cancer diagnosis. To be honest, in many situations, we do not understand why one individual developed cancer and another did not.”

”While I don’t think that this [report] provides all of the answers, it is certainly a step in the right direction. More importantly, if we better understand cancer risk factors, this allows us to more effectively counsel our patients about behaviors that will ultimately help to prevent cancer diagnoses,” she added.

“The 40% reduction in the risk of cancer is largely attributed to the risk factors we’ve mentioned, but also the ability to get screened, and underserved populations have less access to screening and therefore have a higher mortality. At the end of the day, the 40% preventable reduction in getting cancer attributable to lifestyle, smoking, and screening, and that’s really the take home message, but also that there are big disparities in healthcare worldwide.”

“There has been great progress against cancer and cancer-associated mortality over the last 30 years through careful scientific investigations into the causes of cancer and how the process of cancer development can be identified earlier, more accurately, and more reliably,” Hawk also told us.

“Nevertheless, to realize [cancer] research’s promise, it’s critical that we act on scientific discoveries to improve our personal lifestyle choices, medical-care practices, and public-health actions — including health-related public policies implemented at the population level,” he advised.

“I’m optimistic and we’re definitely making good progress in the fight against cancer — there’s new therapeutics, cutting edge technologies, improving survival and quality of life for the patient,” Harb commented. “There are still some challenges that we have.“

“We’re far from taking care of all cancer in all patients and we’re seeing some increased incidence of cancer in certain cancers, especially the young population, which is concerning and we need to address that. It’s good to always look back and look at the big picture and assess where we’re at and where we need to go from here,” he pointed out.