New Cancer Cases Will Top 2 Million This Year

Diagnoses down for older adults, but up among the middle-aged and young

Rachel Nania,

AARP

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En español

Published January 17, 2024

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The risk of dying from cancer continues to fall in the U.S., a new report from the American Cancer Society finds. But this win, which health experts say is a testament to declines in smoking and newer, more effective treatments, is being threatened by a rise in new cancer cases.

Incidence is increasing for six of the top 10 cancers, and for the first time ever, the projected number of new diagnoses will top 2 million this year, according to research published Jan. 17 in CA: A Cancer Journal for Clinicians. More often, these new cancers are occurring in young and middle-aged adults.

Obesity may play role

Some of these new cancer diagnoses may be due to incidental screening, for example when a cancer is picked up on an imaging test that was ordered for another reason. Health experts also suspect environmental and lifestyle factors could be playing a role.

While it doesn’t explain all cases, “some of this may be a window into what's happening with the obesity epidemic,” says William Dahut, M.D., chief scientific officer at the American Cancer Society.

In the U.S., roughly 2 out of 3 adults are overweight or have obesity. And though it’s not typically thought of as a risk factor, excess weight is linked to 13 cancers that make up 40 percent of all cancers diagnosed in the U.S. each year, according to the Centers for Disease Control and Prevention (CDC).

“We live in an obesogenic environment [an environment that promotes gaining weight] with ultra-processed foods and declining levels of physical activity,” says Neil Iyengar, M.D., a breast oncologist at Memorial Sloan Kettering Cancer Center in New York. In 2020, less than 25 percent of U.S. adults met the physical activity guidelines. Meanwhile, research shows that roughly 60 percent of our calories come from ultra-processed foods — your packaged snacks, frozen dinners and sugary beverages.

“And this directly impacts the risk of metabolically driven cancers, which are the cancers that are rising in incidence,” Iyengar says.

Cancers influenced by obesity, such as pancreatic cancer, kidney cancer, postmenopausal breast cancer and liver cancer, are increasing, Dahut said at a news briefing. So is colorectal cancer — especially among young and middle-aged adults. Colorectal cancer is now the leading cause of cancer death in men under 50 and the second in women of the same age group.

Cancer on the rise among young, middle-aged

More generally, the burden of cancer is shifting to younger age groups. The American Cancer Society report found that while the overall proportion of cancer diagnoses has decreased for adults 65 and older over the last three decades (from 61 percent to 58 percent), it’s increased for those ages 50 to 64 (from 25 percent to 30 percent).

“The shift toward more middle-aged patients likely in part reflects steep decreases in incidence of prostate and smoking-related cancers among older men and increased cancer risk in people born since the 1950s associated with changing patterns in known exposures, such as higher obesity, as well as others yet to be elucidated,” the authors of the report write.

Incidence rates increased by 1 to 2 percent annually for cervical cancer among people 30 to 44 years old and for colorectal cancer for people under 55, according to the report.

“I think we're all grappling with what is the broadly spoken environmental factor which is changing the cancer incidence and mortality amongst the young,” Dahut said.

Small changes can make a big difference

Cancer Disparities Persist

The 2024 American Cancer Society report highlights prevailing disparities in cancer mortality. Compared to white people in the U.S.:

The risk of cancer death is 33 percent higher in Black people and 51 percent higher in Native Americans/Alaskan Natives.

Mortality rates in Black people are double for prostate cancer, stomach cancer and uterine corpus cancer (also called endometrial cancer).

Mortality rates in Native Americans/Alaskan Natives are double for liver cancer, stomach cancer and kidney cancer.

Mortality rates for Black women with breast cancer are 40 percent higher.

Source: Cancer Statistics 2024, American Cancer Society

Health experts say the report’s findings highlight the need for preventive measures, one of which is screening. “The cancers that do have screening tests need a much more active uptake,” says Dahut, who adds that screening participation for some cancers, like lung cancer, is “abysmal in many parts of the country.” Screening tests are available and recommended for cervical, breast, colorectal, prostate and lung cancers.

Beyond screening, Iyengar says “daily, small behaviors add up to have a huge impact on cancer risk.” Research suggests that about 42 percent of cancers are preventable through lifestyle changes.

Even a few minutes of daily physical activity can have an impact on your risk for certain cancers, Iyengar says. The same goes for diet. Start small — maybe pick one day a week to cut out red meat and focus on fruits and vegetables.

“For many of my own patients, what I find is that these small tweaks in diet and physical activity actually motivate folks to make bigger changes in their lifestyle, because I think it helps to lower the barriers or the mental expectation that it takes a lot of effort to change someone's lifestyle. When in fact, it's really these kind of small changes in the beginning that have the most impact,” Iyengar says.

Quitting smoking and limiting alcohol can also lower your cancer risk; both are linked to multiple cancers.

“It's never too late to implement prevention strategies,” Iyengar says. “A lot of folks will oftentimes think, ‘Well, you know, I've spent the majority of my life not eating well or not being active.’ There are several studies now which indicate that even folks who implement lifestyle modification later on in their lives do experience a benefit in terms of lowering the risk of several of these cancers.”

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