Obesity and binge drinking driving up bowel cancer rates in young people in UK

Unhealthy lifestyles among younger people are contributing to cancer at an earlier age, a new study has warned as it called for earlier screening tests.

Obesity, alcohol and reduced physical activity are the main factors driving up bowel cancer cases among younger generations as lifestyle habits such as heavy drinking and less exercise worsened over the same period. The illness, usually diagnosed in people aged over 50, is now expected to affect younger people in the coming years.

The study also found concerns over bowel cancer death rates in women of all ages, which do not appear to be following the downward trend of many other cancers.

Published in the journal Annals of Oncology, it compared what death rates in 2024 could look like set against figures for 2018 across the UK and Europe. It found that the UK showed a massive jump compared to countries like Italy, Germany, Poland and Spain.

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Bowel cancer death rates for men and women aged 25 to 49 years are expected to rise in Italy (by 1.5 per cent in men and 2.6 per cent in women), in Poland (5.9 per cent) and among Spanish men (5.5 per cent), and German women (7.2 per cent).

The UK, on the other hand, has an expected 26 per cent rise in bowel cancer death rates among men, and a significant 39 per cent among women, far surpassing its European peers.

The researchers wrote: “In the UK, colorectal (bowel) cancer mortality decreased for all ages in the past decades. However, there was an increase for the 25 to 49 years age group since around 2000 in both sexes.”

Overall, death rates for all cancers when taken together are predicted to fall among both sexes in the UK, from 120.3 per 100,000 people to 103.7 per 100,000 people.

However, the report stressed concerns about younger people and women when it comes to bowel cancer, with bowel cancer death rates among women refusing to budge.

The researchers said: “In the UK, projected ASRs (age standardised rates) for (bowel cancer) at all ages are favourable for men (3.4 per cent versus 2018) but not for women (0.3 per cent).”

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Professor Carlo La Vecchia, from the University of Milan, said: “Key factors that contribute to the rise in bowel cancer rates among young people include overweight, obesity and related health conditions, such as high blood sugar levels and diabetes.

“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.”

He added that younger people are faced with lower survival rates: “Early onset bowel cancer tends to be more aggressive, with lower survival rates, compared to bowel cancer that is diagnosed in older people.”

He called on national governments to implement policies to promote healthier lifestyles including physical activity and reduced obesity and alcohol consumption. He recommended the extension of bowel cancer screening to younger ages starting at 45.

The World Cancer Research Fund said the new study was “alarming”, however, it added that the findings were not entirely surprising.

Dr Panagiota Mitrou, director of research at the WCRF, said: “Early onset of cancer in younger people is a concern, but not entirely surprising, given that young people are being exposed to risk factors early on in life, for example living with overweight and obesity.”

In England, people aged 60 to 74 are invited for bowel cancer screening and the programme is expanding to everyone aged 50 to 59.

But Professor Sir Mike Richards, former national cancer director at the Department of Health – who now advises NHS England, has said there is much work to do to improve diagnosis, treatment and survival.

The NHS has set the sensitivity threshold for the FIT stool test at 120 micrograms of blood per gram of faeces in England, but Prof Richards says this should be 80 and even lower.

A Department of Health and Social Care spokesperson said: “The independent UK National Screening Committee – which is made up of clinical experts – considers scientific evidence and makes a decision on age cohorts to ensure a programme does more good than harm.

“Harms from screening can occur through overdiagnosis. We are taking strong action to encourage healthier food choices and to tackle obesity, recognising that it increases the risk of a range of serious and chronic diseases and costs the NHS around £6.5bn a year.”