The U.S. Preventive Services Task Force has been in the news a lot lately. These same organizations reduced the recommended age for breast cancer screening from 50 to 40. This momentous shift comes in the wake of a 2021 ruling. This decision was a big win for advocates because it lowered the screening age for colon cancer from 50 to 45. These developments represent a paradigm shift in cancer diagnostics. They shine a light on the need for access to early intervention and recent technological strides that allow for tumor detection at earlier stages.
These recommendations have caused an increase in breast and kidney cancer cases. Younger populations are especially vulnerable to this rise. Despite this rise, mortality rates across all age groups have notably declined in recent years, prompting discussions among medical professionals about the implications of these findings.
Dr. H. Gilbert Welch, a well-known curiosity contrarian in the cancer research realm, instilled doubt about why incidence rates should matter just because they are increasing. He remarked, “There really isn’t much more cancer out there. We’re just finding stuff that’s always been there. That’s particularly true in things like the thyroid and the kidney.” His statement raises questions about whether increased screening merely uncovers pre-existing conditions rather than indicating a true rise in cancer prevalence.
In a study published in JAMA Internal Medicine, researchers analyzed new cancer diagnoses over the past three decades alongside mortality rates for the fastest-rising cancers in adults under 50. In fact, their findings showed that among eight cancers studied, only colorectal and endometrial cancers were on the rise in death rates. We know that detection rates are increasing. While these data are not yet definitive, they suggest that the real risk from these cancers is less than what was previously estimated.
Colorectal cancer is a particularly striking example of this trend. From 2012 to 2021, the incidence rates for adults younger than 50 increased by an average of 2.4% per year. In comparison, adults aged 50 to 64 saw much more modest increases averaging just 0.4%. Mortality rates for colorectal cancer in people aged 45 to 49 have been cut in half. This exceptional progress is largely the result of major improvements in prevention, early detection and treatment.
On this issue, APC’s Cancer Prevention and Control Director Dr. Ahmed Jemal remarked that this increasing incidence cannot be explained away by better screening methods. He stated, “You create not only cost burden, but you create anxiety,” highlighting the concerns over unnecessary stress and financial implications associated with increased cancer diagnoses.
The psychosological fallout from cancer detection is another major factor in this important question. Dr. Philippe E. Spiess from the University of South Florida explained that often just the knowledge of an unknown diagnosis can incur major stressors on patients. He stated, “Once a patient physically knows they have a mass, there is a significant burden that you have related to knowing that.” This highlights the need for much more critical thinking when deciding whether aggressive screening strategies are needed.
All medical professionals can certainly agree that it is important to determine if the cancers we are finding at all are actually dangerous to our patients. Dr. Spiess noted, “As long as the patient is committed to observation and surveillance, I think the consideration there is that you’re really not losing anything,” suggesting that a cautious approach may benefit younger patients faced with newly identified masses.
