RePercussion Section: “Now It Get You When You’re Young”: Update on Rising Rates of Early-Onset Cancer
by Sandra Steingraber, SEHN Senior Scientist
Performing under the mononym Welles, rising star folk singer and songwriter Jesse Welles is just 23 years old. With a voice like Bob Dylan, the lyricism of John Prine, and a passing resemblance to Jim Morrison, Welles brings a jester’s approach to the social issues of the day. If the jester were heartbroken.
His new release “Cancer,” for example, starts like this:
Cancer's getting meaner, and it ain't never been fun
Supposed to get you when you're old, and now it get you when you're young
Cancer's always been depressin', cancer's never been pleasant
It don't care if you're royal, don't care if you're a peasant
[pre-chorus] Well then, what causes it?
Everything you ate, the sleep you didn't get
Your job and the air and the water and your bed
The sun and red meat, all the fishes in the sea
Thеy're all a bunch of cantankerous cancer-causin' carcinogеnic S.O.B.s
It's like them apocalyptic folks off the newer Mad Max
Monsanto Clause delivered all the cancer in your ass
In what might be the only mention of the polycarbonate ingredient bisphenol A in popular music, Welles goes on, managing to rhyme microplastics and metastatic:
But it’s from the purple ketchup, the BPAs and microplastics
Just hope it don't go metastatic.
It's meaner than the meanest, meaner than the rumors
It's your own personalized "Bam! Pizza Hut", home-grown little tumor
Take it.
***
The statistics behind the lyrics reveal their truth.
Cancer rates are indeed rising among young adults, ages 18-49. As the most recent data reveal, this increased incidence is apparent across the board, striking both men and women and involving more than a dozen different cancers, including big-ticket malignancies, such as colon, prostate, and breast cancers, that we commonly think of as old-people problems. Worse, young adults are more often diagnosed with more aggressive forms of the disease.
Trends in colon cancer incidence rate among young adults. Credit: American Cancer Society, 2023
The latest report on nationwide cancer incidence from the American Cancer Society showed that while overall cancer mortality is falling, the number of new diagnoses is trending upwards. In 2022, 1.9 million Americans were told they have cancer. In 2023, over 2 million. And a disproportionate number of new cases involve young people. Indeed, adults under 50 are the only age group with an increase in overall cancer incidence between 1995 and 2020.
To put a sharper point on the data: every year since 1995, the U.S. cancer rate has risen by 1 to 2 percent, and young people with tumors are driving this trend. And of all the cancers now striking the young, gastrointestinal cancers, including colon cancer, are rising the fastest.
***
[pre-chorus] Well then, what causes it?
As someone who suffered two brushes with cancer by age 36 (bladder and colon) and went on to document the beginning of the above-described statistical trend in the book I first wrote in 1997 (and then updated in 2010), I have a keen interest in the answer. And I am unsurprised by the unresolved bewilderment over causality that was apparent to me as a young adult with cancer in the 1990s and also, apparently, continues to this day.
The term gas-lighting hadn’t yet entered the popular parlance when I first began my research. I think we can apply it now.
In popular news reporting, the question of how to prevent cancer is, once again, elided into how to detect it. Hence, young people are urged to seek cancer screenings at younger ages. But detecting a bad thing, no matter how early, is not the same preventing a bad thing, no matter how many times the cheerful cancer pamphlets intone “Early detection is your best protection!”
Young people are also exhorted to know their family medical history—even though inherited risk factors are responsible for only a small fraction of cancers and even though, clearly, Americans in the prime of life are not getting more cancer because they are sprouting new cancer genes.
The peer-reviewed literature is somewhat less obscure on these points, but it’s clear that the role of environmental carcinogens is just as obscure as it was three decades earlier. From the abstract of a recent paper in the Journal of the American Medical Association:
Cancer has traditionally been considered a disease of older individuals…but recent data suggest a marked increase in the incidence of cancer of various organs among patients younger than 50 years, collectively known as early-onset cancer. These cancers affect a variety of organ systems, including the breast, colon and/or rectum, pancreas, head and neck, kidney, and reproductive organs. The increase in early-onset cancers is likely associated with the increasing incidence of obesity as well as changes in environmental exposures, such as smoke and gasoline, sleep patterns, physical activity, microbiota, and transient exposure to carcinogenic compounds.
In my book Living Downstream, I quote from peer-reviewed abstracts that say basically the same thing, which is to say [waves hands in the air], “rising rates of cancer are attributable to some unknown combination of involuntary environmental exposures and your own bad lifestyle.”
This ongoing bafflement persists in spite of all the advances in epigenetics, biomonitoring, developmental endocrine disruption, and computational biology that have taken place during the last 30 years.
***
[pre-chorus] Well then, what causes it?
In April 2024, WRAL News in North Carolina reported that it had documented reports of cancer diagnoses among 150 former students who had spent time in a particular building that quartered the Education and Psychology Department on the campus of North Carolina State University.
That building, Poe Hall, was closed in November 2023. Renovations conducted in 2018 had uncovered cancer-causing PCBs in the window caulk, at levels 340 times what the EPA considers “hazardous special waste.” PCBs have been banned from use since the 1980s.
Cancers among the former students included lymphoma, breast, and thyroid cancers.
After Poe Hall closed, the North Carolina Department of Health and Human Services recommended that the university conduct a health hazard evaluation. Typically, such requests are forwarded to the National Institute of Occupational Safety and Health, which is tasked with conducting medical exams and epidemiological analyses, reviewing reports, and collecting samples when questions about cancer clusters in workplaces are raised.
According to WRAL, “In January 2024, the investigation was called off. Who is responsible for that decision is in dispute.”
Also according to WRAL, “The university has a Poe Hall Updates page but is not actively notifying people who previously spent time in Poe Hall that cancer-causing chemicals were found inside. Because of this, many alumni and former workers learned about the situation through WRAL reports.”
***
[pre-chorus] Well then, what causes it?
F Minus is a non-profit research team that has compiled a database of state-level lobbyists for oil, gas, and coal interests to demonstrate the extent to which these same lobbyists are also representing people, schools, communities, and businesses being harmed by the climate crisis.
Among these clients are cancer advocacy organizations.
In March 2024, F Minus documented that anti-cancer organizations, including the American Cancer Society, employ lobbyists who also advocate for fossil fuel companies, “despite these organizations’ own warnings that fossil fuels and the climate crisis are increasing Americans’ exposure to carcinogens.”
The F Minus researchers note that employing gas lobbyists to advocate for cancer policies is especially problematic because of all the emerging studies showing living in proximity to gas extraction operations, gas transmission projects (including compressor stations), and gas-burning stoves raises risks for cancer.
Furthermore, climate change is, all by itself, already increasing cancer risk through increased exposure to carcinogens after extreme weather events such as hurricanes and wildfires. As revealed in a 2020 study published in the American Cancer Society’s own flagship journal, CA, fossil fuel-driven climate change not only increases cancer risk, it is also dragging down cancer survival as when extreme weather events impede patients' access to cancer care and the ability of cancer treatment facilities to deliver care.
Are the lobbyists who count both the fossil fuel industry and the cancer advocacy community as their clients representing this evidence to lawmakers, policymakers, and political leaders?
With fossil fuel-created air pollution and fossil fuel-created petrochemicals among the leading sources of involuntary carcinogenic exposures, how does one lobby both for fossil fuels and against cancer?
As F Minus points out, it’s hard to overestimate the outsized role that fossil fuels plays in the story of human cancer. Most stunningly: a 2021 Harvard study attributed fossil fuel air pollution to 18 million deaths per year. That’s one in every five deaths. These deaths could indeed be prevented if the transition from fossil fuels to renewables were fast-tracked.
But, in the United States, “this transition is being impeded by thousands of fossil fuel lobbyists, many of whom also represent clients being harmed by the climate crisis. This dynamic is particularly dangerous for people in frontline communities in places like…Pennsylvania, where anti-cancer groups continue to hire some of the state’s leading champions of fracking as their own lobbyists.”
F Minus concludes: “It is time for anti-cancer organizations to stop working with lobbyists for fossil fuels, in the same way they avoid working with lobbyists for tobacco.”
***
[pre-chorus] Well then, what causes it?
In July 2023, a team of researchers in New Zealand published a paper that investigated whether rising exposures to microplastics could be contributing to rising rates of colon cancer among young adult via damage to the mucosal layer of the colon.
Their conclusions:
The epidemiology of increase in [early onset colo-rectal cancer] suggests an environmental driver. This increase in [incidence] matches the time sequence in which we could expect to see an effect of rapid increase of microplastics in the environment and, as such, we have explored possible mechanisms for this effect. We suggest that it is possible that the microplastics damage the barrier integrity of the colonic mucus layer, thus reducing its protective effect. Microplastics in in colo-rectal pathogenesis warrants further investigation.
“Cancer” by Welles, last verse:
It'll make an atheist plead with God
Hardcore bumper sticker Christian give up
Monsanto Clause is checkin' his list and the cancer don't give a f**k