UK bowel cancer death rates forecast to rise by third among under-50s | Bowel cancer

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The rate at which people under the age of 50 in the UK are dying from bowel cancer is on course to rise by a third this year, according to projections that experts say are alarming and stem from a surge in obesity, poor diets and physical inactivity.

Death rates among those aged 25 to 49 are predicted to increase by 39% among women and 26% among men in 2024, compared with the average between 2015 and 2019, the last five-year period for which data was studied. The findings were published in the journal Annals of Oncology.

The research also forecasts that bowel cancer death rates will rise in women of all ages in the UK, another worrying trend that does not appear to be following the declining pattern of most other cancers.

Experts said the projections pointed to an urgent need to encourage adults to adopt healthier lifestyles earlier in life. The findings also prompted calls for people to undergo screening sooner.

More than half of bowel cancer cases in the UK (54%) are preventable, according to Cancer Research UK. More than a quarter of cases (28%) are caused by eating too little fibre, 13% are caused by eating processed meat, 11% are caused by obesity, 6% are caused by drinking alcohol and 5% are caused by too little physical activity.

Bar chart: UK cancer rates in under-50s

Meanwhile, there is mounting global concern about rising numbers of younger adults being diagnosed with cancer. The number of under-50s worldwide being diagnosed with the disease has increased by nearly 80% in three decades.

The latest research looked at the EU’s five most populous countries – France, Germany, Italy, Poland and Spain – as well as the UK, and predicted what cancer death rates in 2024 would be compared with average figures for the period between 2015 to 2019.

Overall, death rates for all cancers when taken together are predicted to fall. However, the study revealed concerns about younger people and bowel cancer death rates. Apart from France, bowel cancer death rates among people aged 25 to 49 years are forecast to rise in 2024 in the other countries.

Death rates are predicted to increase in Italy by 2.6% among women and 1.5% among men. In Poland and Spain, the increase among men was 5.9% and 5.5% respectively, while in Germany the rate among women is predicted to rise by 7.2%. However, the UK showed much bigger jumps of 39% among women and 26% among men.

The UK is also the only country of the six where bowel cancer death rates are forecast to rise in women of all ages, albeit only slightly (1.4%).

The study lead, Prof Carlo La Vecchia, a professor of medical statistics and epidemiology at the University of Milan, said: “Key factors that contribute to the rise in bowel cancer rates among young people include overweight, obesity and related health conditions, such as high blood sugar levels and diabetes. Additional reasons are increases in heavier alcohol drinking over time in central and northern Europe and the UK, and reductions in physical activity.

“Alcohol consumption has been linked to early onset bowel cancer, and countries where there has been a reduction in alcohol consumption, such as France and Italy, have not experienced such marked rises in death rates from this cancer.

“Early onset bowel cancer tends to be more aggressive, with lower survival rates, compared with bowel cancer that is diagnosed in older people.”

La Vecchia added: “National governments should consider strengthening policies to encourage increased physical activity, a reduction in the number of people who are overweight or obese, and a reduction in alcohol consumption.

“In terms of prevention, governments should consider the extension of screening for bowel cancer to younger ages, starting at ages 45 years.

“Screening programmes vary across Europe, but an increase in the incidence of bowel cancer among young people in the US has prompted the US preventive service taskforce to recommend lowering the age at which screening starts to 45 years.”

A spokesperson for the Department of Health and Social Care said: “The independent UK National Screening Committee – which is made up of clinical experts – considers scientific evidence and makes a decision on age cohorts to ensure a programme does more good than harm.”

In England, people aged 60 to 74 are invited for bowel cancer screening and the programme is being expanded to everyone aged 50 to 59. In Scotland and Wales, screening is offered from the age of 50 and 55 respectively.

The Northern Ireland bowel cancer screening programme offers screening every two years to people aged 60 to 74 who are registered with a GP.

Dr Panagiota Mitrou, the director of research, policy and innovation at World Cancer Research Fund International, said: “It is alarming to see the high predicted rises in bowel cancer death rates, especially in younger people in the UK.”

The findings were “not entirely surprising”, she added, given that young people were being exposed to risk factors such as obesity early on in life. Promoting healthy habits such as a balanced diet, having a healthy weight from early on in life, and avoiding alcohol were vital, Mitrou added.

Sophia Lowes, at Cancer Research UK, said: “These findings show a concerning rise in predicted bowel cancer deaths in people aged 25 to 49. However, it’s important to remember that the overall number of people dying from the disease under 50 is still quite small. Around 5% of UK bowel cancer deaths are in people aged 25 to 49, with most people who die from the disease in the UK being older.”

If people notice any changes that were not normal for them, no matter their age, they should not ignore them and speak to their doctor, Lowes said. “In most cases, it won’t be cancer, but if it is, spotting it early can make a real difference.”