A growing concern: What younger adults need to know about GI cancer

Cancer happens most often in adults — especially as people get older. That’s because, in general, it can take years for cancer to start.

But statistics show that cancer rates are going up in adults under 50. And 8 of 14 cancers have to do with the digestive system.

A study published in 2023 found that these cancers are twice or even three times higher in people born around 1990, compared to those born around 1955. Gastrointestinal (GI) cancers cited in the research include small intestine and pancreatic. For women in the younger age group, liver and bile duct cancer was higher.

Experts have a few ideas about why. But they say more research is needed to fully understand the reasons behind the increase in younger people.

“It’s alarming to see cancer rates in younger people go up — especially since this age group isn’t routinely screened for cancer,” says Emilie Regner, MD, a PeaceHealth gastroenterologist in Vancouver, Washington. “It’s all the more important to be aware of what you can do to lower your risk and take action if you see symptoms.”

Risk factors for GI cancer

Anyone can get cancer. But some things make it more or less likely to happen.

Here are the factors known to cause or increase the risk of cancer:

• Cigarette smoking and tobacco use. 
• Infections such as helicobacter pylori, a gut-based bacteria that can cause ulcers.
• Exposure to radiation, such as radon, a naturally occurring gas in rocks and soil. 
• Immunosuppressive medicines typically used after an organ transplant.

There are many other things that can increase the likelihood of developing cancer. Among them are:

• Poor diet, especially ultra-processed foods high in sugar or unhealthy fats. Read more in this study. 
• Alcohol. Learn more from this cancer report.
• Little or no physical activity. 
• Chronic inflammation, which can show up as pain, fatigue, digestive issues and infections.
• Carrying extra weight. 
• Diabetes, a condition that affects how the body turns food into energy.
• Exposure to toxins. These include things like asbestos, arsenic, soot, wood dust and many other substances in a work environment or home.
• Genetics. It’s good to be aware of cancers that run in your family — especially blood relatives.

There are some factors you can’t change such as genetics or past exposures. The American Association for Cancer research says that 40 percent of all cancers are associated with modifiable risk factors — in other words, things that you can change.

Common GI cancers and symptoms

Risk factors like those above can influence whether cancer develops. This includes cancers in parts of the digestive system such as the:

• Esophagus – the part of your body that helps you swallow and move food into the stomach.
• Stomach – where food starts to be broken down.
• Pancreas – the organ that produces fluids that help with digestion.
• Colon and/or rectum – the part of the digestive system that moves waste out of the body.

Tumors — cancerous or not — can grow slowly. You might not feel any symptoms. But if you do, they might include:

• Indigestion
• Heartburn
• Nausea and/or vomiting
• Pain or discomfort in the gut
• Loss of appetite
• Unexplained weight loss
• Blood in the poop
• Feeling full after eating a small amount of food
• Unexplained fever
• Choking or difficulty swallowing (esophagus)
• Sudden swelling of the abdomen (liver)
• Yellow skin and eyes (liver and pancreas)

If you have any of these, talk with your primary care provider. The symptoms might be caused by something other than cancer. But checking it out is the safest bet.

Diagnosing and treating GI cancers

Your PCP can run tests to see what’s going on. Or you might be referred to see a specialist called a gastroenterologist for follow-up. Here are common tools used to find signs of GI cancers:

• Imaging 
  • X-ray with barium (a fluid to help doctors see inside your body during the X-ray).
  • CT scans
  • MRI
  • Ultrasound
• Scope – a lighted, flexible camera inserted into the body.

Depending on the type, treatment for GI cancers typically include one or more of the following:

• Surgery, which involves physically removing the tumor, cancer cells or other affected parts.
• Chemotherapy, which uses medication to shrink cancer cells.
• Radiation therapy, which uses high-energy rays to stop cancer cells from growing.

Best plan of action

While improvements in cancer treatment have saved or extended many lives, it’s good to have a few strategies to protect yourself — no matter how old you are.

First, look at your personal risk factors and do what you can to counteract them. Here are a few simple steps that can reduce your risks:

• Eat a plant-rich diet of whole nutrient-dense foods, especially those that help you get the recommended daily amount of fiber.
• Limit your alcohol intake.
• Move or exercise regularly. Aim for 150 minutes of aerobic activity per week. Build muscle strength and flexibility.
• Lose a few pounds if you’re not at a healthy weight.
• Treat or manage conditions that may affect healthy habits. For example, arthritis or depression might keep you from feeling good enough to exercise. 
• Keep your home or work environment free of toxic products or items.

Second, pay attention to your body. Know what’s normal for you — especially when it comes to eating or using the restroom. Take note if something feels “off.” Symptoms of GI cancers can be very subtle and easy to dismiss. Don’t let symptoms go unchecked for long.

Third, talk to your PCP about getting screened. This may be based on your age and other risk factors. Let your doctor know if you have a family member who has or had cancer at a young age.

There’s not a screening test for every type of GI cancer. But consider the options available to spot the most common and most often fatal, colorectal cancer: 

• Fecal test – a noninvasive test done in the privacy of your home. It’s recommended every one to three years. Insurance often covers it. It finds 70% of cancers and 43% of large polyp (small growth in the colon). Learn more about this type.
• Blood test – a new test that could become part of routine blood work. It’s simpler than the other screenings. It’s not yet covered by insurance. In studies, it found 87% of cancers at an early, treatable stage. It found 13% of large polyps.
• Colonoscopy – a thorough preventive test that requires preparation and sedation. It’s recommended starting at age 45 if you are at average risk. It’s done every five to 10 years, depending on past results. Insurance often covers it. It finds 95% of cancers and 94% of large polyps.

“Your best odds to prevent cancer is to avoid anything that is known to cause cancer,” says Dr. Regner. Still, some things are unavoidable. “Don’t be afraid to ask your doctor for help to get screened and potentially catch concerns as early as possible.”