Ellen Phiddian
Bowel cancer rates are on the rise among younger people in a number of high-income countries, including the USA, Australia, and several European nations.
A study predicting the rates of cancer across Europe for 2024 suggests that obesity and alcohol consumption may be the culprit.
The study, published in Annals of Oncology, predicts 1,270,800 deaths from cancer in the European Union (EU) during 2024.
The study, which looks at all 27 EU member countries and the UK, has predicted an increase in bowel cancer death rates among people aged 25-49 years for the first time. Bowel cancer mortality in general, however, is decreasing – meaning that people diagnosed with bowel cancer are less likely to die from it.
The greatest increase among young people is in the UK, where the researchers expect the ratio of bowel cancer in men to increase from an age-standardised rate of 3.7 deaths per 100,000 people in the late 2010s, to 4.7 deaths per 100,000 in 2024. The rate is increasing even faster for women, going from 3.3 to 4.6 deaths per 100,000.
Lead author Professor Carlo La Vecchia, an epidemiologist at the University of Milan in Italy, says that obesity and related health conditions like diabetes and high blood sugar levels are a key driver of this increase in bowel cancer.
“Additional reasons are increases in heavier alcohol drinking over time in central and northern Europe and the UK, and reductions in physical activity,” says La Vecchia.
“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.”
Death rates from all cancers are expected to fall from their 2010s levels, dropping from 132 to 123 deaths per 100,000 for men and from 83 to 79 deaths per 100,000 for women.
But, as Europe’s population ages, cancer deaths in total are expected to rise.
La Vecchia says that governments should consider strengthening policies designed to increase physical activity and lower alcohol consumption, both of which will likely bring cancer death rates down.
He also says that bowel cancer screening should be more widespread, pointing out that those who are diagnosed younger tend to have lower survival rates.
“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 Task Force to recommend lowering the age at which screening starts to 45 years.”
In Australia, bowel cancer screening tests are sent free to everyone aged between 50-74. In 2021, there were 21 deaths per 100,000 people from bowel cancer at an age-standardised rate. This has halved in the last 40 years, but rates among young people, while still rare, are rising.
Correction, 30 January 2024: An earlier version of this article stated incorrectly that bowel cancer screening tests are free for Australians aged 50 to 75. The correct age range for screening in Australia is 50 to 74. We have updated the article.
