{"id":51519,"date":"2026-04-15T15:06:40","date_gmt":"2026-04-15T15:06:40","guid":{"rendered":"https:\/\/foreignnewstoday.com\/?p=51519"},"modified":"2026-04-15T15:06:40","modified_gmt":"2026-04-15T15:06:40","slug":"early-onset-cancer-fuels-calls-for-wider-screening-but-at-what-cost","status":"publish","type":"post","link":"https:\/\/foreignnewstoday.com\/?p=51519","title":{"rendered":"Early-onset cancer fuels calls for wider screening \u2014 but at what cost?"},"content":{"rendered":"<p><br \/>\n<\/p>\n<div data-test=\"access-teaser\">\n<figure class=\"figure\"><picture class=\"embed intensity--high\"><source type=\"image\/webp\" srcset=\"https:\/\/media.nature.com\/lw767\/magazine-assets\/d41586-026-00687-6\/d41586-026-00687-6_52244392.jpg?as=webp 767w, https:\/\/media.nature.com\/lw319\/magazine-assets\/d41586-026-00687-6\/d41586-026-00687-6_52244392.jpg?as=webp 319w\" sizes=\"(max-width: 319px) 319px, (min-width: 1023px) 100vw,  767px\"\/><figcaption>\n<p class=\"figure__caption u-sans-serif\"><span class=\"mr10\">Some countries have lowered the recommended age for mammograms in response to rising rates of early-onset breast cancer.<\/span><span>Credit: Operation 2022\/Alamy<\/span><\/p>\n<\/figcaption><\/picture><\/figure>\n<p>The question of what age cancer screening should start is getting louder, as <a href=\"https:\/\/www.nature.com\/articles\/d41586-024-00720-6\" data-track=\"click\" data-label=\"https:\/\/www.nature.com\/articles\/d41586-024-00720-6\" data-track-category=\"body text link\">increasing numbers of people under 50 are being diagnosed<\/a>, often well before they are eligible for routine testing.<\/p>\n<p>\u201cThere is clearly something going on,\u201d says Yoanna Pumpalova, a medical oncologist who treats colorectal cancer at the Columbia University Irving Medical Center in New York. \u201cI see it every day. I have way too many patients who are my age \u2014 I\u2019m 37 \u2014 or even younger, and it\u2019s horrible. It\u2019s more than it was five years ago; there\u2019s no question about it.\u201d<\/p>\n<p>In addition to colorectal cancer, there also seems to be an uptick in other types of malignancies, including those affecting the breasts, stomach, kidney and pancreas (see \u2018Starting early\u2019). A <i>BMJ Oncology<\/i> study<sup><a href=\"#ref-CR1\" data-track=\"click\" data-action=\"anchor-link\" data-track-label=\"go to reference\" data-track-category=\"references\">1<\/a><\/sup> published in 2023 estimated that the global incidence of cancer in people under 50 will increase by more than 30% between 2019 and 2030, the authors citing diet, alcohol consumption and tobacco use as potential risk factors.<\/p>\n<p><iframe id=\"d84cfb6d-36a6-4b27-8693-4c08733379f1\" style=\"width: 100%;\" title=\"Interactive graphic: Starting early\" src=\"https:\/\/static-enhanced-content-live.storage.googleapis.com\/interactive\/2026\/index-cancer\/screening-starting-early.html\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/p>\n<p><iframe id=\"85130cb9-7163-4746-abec-b8dea500a096\" style=\"width: 100%;\" title=\"Interactive graphic: Additional cases\" src=\"https:\/\/static-enhanced-content-live.storage.googleapis.com\/interactive\/2026\/index-cancer\/screening-additional-cases.html\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/p>\n<p>Some countries have responded by lowering the screening age for certain cancers. In 2024, Australia lowered the recommended starting age for colorectal cancer screening from 50 to 45, and as of late last year, every province and territory in Canada, except Quebec, had lowered its minimum age for routine breast-cancer screening from 50 to 40 or 45. This year, South Korea launched its new <a href=\"https:\/\/www.nature.com\/articles\/d41586-026-00689-4\" data-track=\"click\" data-label=\"https:\/\/www.nature.com\/articles\/d41586-026-00689-4\" data-track-category=\"body text link\">national cancer control plan<\/a>, which states that from 2028, anyone aged 45 will be eligible for a national colonoscopy screening.<\/p>\n<p>In the United States, recommendations for lowering the screening age are also gaining traction. In 2024, the US Preventive Services Task Force (USPSTF) \u2014 an independent panel of medical experts \u2014 lowered its recommended starting age for routine mammograms from 50 to 40<sup><a href=\"#ref-CR2\" data-track=\"click\" data-action=\"anchor-link\" data-track-label=\"go to reference\" data-track-category=\"references\">2<\/a><\/sup>. The group cited data from the US National Cancer Institute that showed that breast cancer rates among women in their 40s had risen by an average of 2% per year between 2015 and 2019.<\/p>\n<p>The decision to lower the age for routine screening programmes requires a complex assessment of risks, benefits and individual circumstances. The challenge, says Robert Smith, a cancer epidemiologist at the American Cancer Society, a non-profit cancer advocacy and research organization headquartered in Atlanta, Georgia, is weighing the potential gain in lives saved versus the potential harms. Not only is it \u201cvery expensive\u201d, Smith says, but broadening eligibility would expose more people to the risks of physical injury and false-positive results. \u201cThere really does need to be a certain prevalence of cancer in the population to justify inviting asymptomatic individuals to undergo screening,\u201d he says.<\/p>\n<h2><b>A delicate balance<\/b><\/h2>\n<p>It\u2019s not clear why some cancers are becoming more prevalent in people under 50. Mark Ebell, a primary care epidemiologist at Michigan State University in East Lansing, suspects that a combination of improved screening technologies and expanded screening programmes is a major factor. \u201cDetection of more cancers in younger persons may just be a consequence of more sensitive and widely used imaging rather than a real increase in incidence.\u201d<\/p>\n<p>Other researchers, including the authors of the <i>BMJ Oncology<\/i> study, argue that routine screening for under-50s remains too limited to fully explain the trend. Data from the Australian Institute of Health and Welfare show that in 2025, around 7.2% of colorectal cancers in the country were diagnosed in people aged under 40 \u2014 a group that would not have been routinely screened \u2014 up from 2.2% in 2000.<\/p>\n<p><article class=\"recommended pull pull--left u-sans-serif\" data-label=\"Related\"><a href=\"https:\/\/www.nature.com\/collections\/beeeifffhh\" class=\"u-link-inherit\" data-track=\"click\" data-track-label=\"recommended article\"><img decoding=\"async\" class=\"recommended__image\" alt=\"\" src=\"https:\/\/media.nature.com\/w400\/magazine-assets\/d41586-026-00687-6\/d41586-026-00687-6_52283576.jpg\"\/><\/p>\n<p class=\"recommended__title u-serif\">Nature Index 2026 Cancer<\/p>\n<p><\/a><\/article>\n<\/p>\n<p>Regardless of what\u2019s behind the increase in early-onset cancers, calls from patient advocacy and support groups to lower the screening ages for certain cancers are intensifying, and some researchers are concerned that it\u2019s being done before the risks are fully understood. Ebell, who served on the USPSTF from 2012 to 2015, says the organization\u2019s decision to lower the recommended screening age for some cancers is being \u201cmade in the absence of any new evidence regarding the benefits and harms of screening in younger persons\u201d.<\/p>\n<p>Barron Lerner, a physician and medical historian at the New York University School of Medicine in New York, agrees, and says the USPSTF should evaluate more data to decide whether the changes were really warranted. \u201cIt\u2019s a teachable moment for the public about screening,\u201d Lerner says. \u201cWhile there is an assumption that screening should find every case of cancer at its earliest stage\u201d, achieving this would require expanding testing in ways that would cause unacceptable levels of harm, he adds.<\/p>\n<p>About 10% of mammograms performed in the United States between 2005 and 2017 produced false-positive results that led to additional imaging or biopsy<sup><a href=\"#ref-CR3\" data-track=\"click\" data-action=\"anchor-link\" data-track-label=\"go to reference\" data-track-category=\"references\">3<\/a><\/sup>, for example, and although rare, bowel perforations \u2014 when a colonoscopy punctures the wall of the large intestine \u2014 can require emergency surgery. \u201cThe more you screen, the more people that have the procedure, the more they\u2019re going to have those complications,\u201d Pumpalova says.<\/p>\n<p>There\u2019s also the issue that young bodies can sometimes be less suited to the tests that are used in standardized screening programmes. Smith notes that it can be challenging to spot breast cancer in women in their 30s and early 40s, because they tend to have denser breast tissue, which is difficult for the radiological equipment to see through. After women undergo menopause in their mid-40s to mid-50s, that dense tissue is gradually replaced by fat tissue, which is easier to image, he says.<\/p>\n<h2><b>Rethinking the strategy<\/b><\/h2>\n<p>Some researchers want to see more <a href=\"https:\/\/www.nature.com\/articles\/d41586-025-01153-5\" data-track=\"click\" data-label=\"https:\/\/www.nature.com\/articles\/d41586-025-01153-5\" data-track-category=\"body text link\">personalized screening<\/a> replace a \u2018one-size-fits-all\u2019 approach. Instead of recommending the same annual screening test for everyone above a certain age, clinicians could assess individual risk factors to determine how and when they are screened.<\/p>\n<p>Research seems to support this idea: a randomized clinical trial involving more than 28,000 women in the United States<sup><a href=\"#ref-CR4\" data-track=\"click\" data-action=\"anchor-link\" data-track-label=\"go to reference\" data-track-category=\"references\">4<\/a><\/sup> found that when mammography frequency is tailored to an individual\u2019s risk profile, it results in some women undergoing screening less often than they would under a routine annual schedule.<\/p>\n<figure class=\"figure\"><picture class=\"embed intensity--high\"><source type=\"image\/webp\" srcset=\"https:\/\/media.nature.com\/lw767\/magazine-assets\/d41586-026-00687-6\/d41586-026-00687-6_52244394.jpg?as=webp 767w, https:\/\/media.nature.com\/lw319\/magazine-assets\/d41586-026-00687-6\/d41586-026-00687-6_52244394.jpg?as=webp 319w\" sizes=\"(max-width: 319px) 319px, (min-width: 1023px) 100vw,  767px\"\/><img decoding=\"async\" class=\"figure__image\" alt=\"In the foreground, a woman lying on her back with one hand above her head, the other hand placed on her torso. In the background, an CT scanner is seen, out of focus.\" loading=\"lazy\" src=\"https:\/\/media.nature.com\/lw767\/magazine-assets\/d41586-026-00687-6\/d41586-026-00687-6_52244394.jpg\"\/><figcaption>\n<p class=\"figure__caption u-sans-serif\"><span class=\"mr10\">Some countries use low-dose computed tomography scans as part of their routine screening programmes for lung cancer.<\/span><span>Credit: Kristian Thacker\/The New York Times\/Redux\/eyevine<\/span><\/p>\n<\/figcaption><\/picture><\/figure>\n<p>Sanjay Shete, a population health scientist at the MD Anderson Cancer Center in Houston, Texas, is investigating the use of genetic risk factors, rather than age, to inform patient screening routines. \u201cBelow a certain age group, I think we should start looking into more risk-based screening as opposed to simply age-based screening,\u201d he says. \u201cThere are several calculators now coming up, which show that maybe one person is, say, 35, but their risk is the same as a 55-year-old because they have strong family history and they have some other risk factors.\u201d<\/p>\n<p>Some researchers are using what\u2019s known as a polygenic risk score to estimate the combined effect of many gene variations in a given patient, and say it could be used to inform a more personalized approach to cancer screening. A study last year<sup><a href=\"#ref-CR5\" data-track=\"click\" data-action=\"anchor-link\" data-track-label=\"go to reference\" data-track-category=\"references\">5<\/a><\/sup> found that a polygenic risk score was better than the <a href=\"https:\/\/www.nature.com\/articles\/d41586-020-01037-w\" data-track=\"click\" data-label=\"https:\/\/www.nature.com\/articles\/d41586-020-01037-w\" data-track-category=\"body text link\">standard prostate-specific antigen blood test<\/a> in identifying men who benefitted from prostate cancer screening using magnetic resonance imaging.<\/p>\n<p>More comprehensive screening tests \u2014 such as a test that can detect multiple cancers at once \u2014 would be a game-changer, Pumpalova says, because it would not only expose people to fewer complications less often, but could potentially give them better coverage. Several <a href=\"https:\/\/www.nature.com\/articles\/d41586-025-00530-4\" data-track=\"click\" data-label=\"https:\/\/www.nature.com\/articles\/d41586-025-00530-4\" data-track-category=\"body text link\">multi-cancer detection tests<\/a> now in development aim to spot abnormal DNA, proteins and other markers in the blood, with the potential to identify more cancers than the handful that most countries routinely screen for \u2014 namely breast, cervical, colorectal, prostate and, for smokers, lung cancer.<\/p>\n<p><iframe id=\"746489aa-e772-4d6e-82e3-83d1383fb925\" style=\"width: 100%;\" title=\"Interactive graphic: Cancer output\" src=\"https:\/\/static-enhanced-content-live.storage.googleapis.com\/interactive\/2026\/index-cancer\/screening-cancer-output.html\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/p>\n<h2><b>Expanding access<\/b><\/h2>\n<p>Such technologies are at a very early stage of development, and if they were to be rolled out at a population level sometime in the future, wealthy countries would undoubtedly be the first to do it.<\/p>\n<p>Meanwhile, in low- and middle-income countries, which account for the majority of new cancer cases and deaths worldwide, resources for cancer screening are often extremely limited, even for the most at-risk patients. According to a study<sup><a href=\"#ref-CR6\" data-track=\"click\" data-action=\"anchor-link\" data-track-label=\"go to reference\" data-track-category=\"references\">6<\/a><\/sup> on the CanScreen5 project, a global cancer-screening data repository run by the International Agency for Research on Cancer, the World Health Organization\u2019s cancer branch, there are major gaps in screening rates between countries.<\/p>\n<p>According to the data set, which includes information on national screening programmes up to September 2022, the proportion of eligible people who received screening in Bangladesh for breast cancer was 1.7%, compared with 85.5% in England, for example. In C\u00f4te d\u2019Ivoire, the screening coverage for cervical cancer was 2.1%, and in Sweden, 86.3%. And for colorectal cancer, coverage was 0.6% in Hungary, compared with 64.5% in the Netherlands. Countries with strong policy and funding commitment, either from the government or from health-insurance providers, were more likely to have good coverage, the authors conclude.<\/p>\n<\/div>\n<p><br \/>\n<br \/><a href=\"https:\/\/www.nature.com\/articles\/d41586-026-00687-6\">Source link <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Some countries have lowered the recommended age for mammograms in response to rising rates of early-onset breast cancer.Credit: Operation 2022\/Alamy The question of what age cancer&hellip;<\/p>\n","protected":false},"author":1,"featured_media":51520,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[35],"tags":[],"class_list":["post-51519","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-science"],"_links":{"self":[{"href":"https:\/\/foreignnewstoday.com\/index.php?rest_route=\/wp\/v2\/posts\/51519","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/foreignnewstoday.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/foreignnewstoday.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/foreignnewstoday.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/foreignnewstoday.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=51519"}],"version-history":[{"count":0,"href":"https:\/\/foreignnewstoday.com\/index.php?rest_route=\/wp\/v2\/posts\/51519\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/foreignnewstoday.com\/index.php?rest_route=\/wp\/v2\/media\/51520"}],"wp:attachment":[{"href":"https:\/\/foreignnewstoday.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=51519"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/foreignnewstoday.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=51519"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/foreignnewstoday.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=51519"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}