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Why are more young people like Kate Middleton being diagnosed with cancer?

The American Cancer Society says people under 50 were only one of three adult age groups with an increase in overall cancer incidence.

A photo of King Charles (left) and Princess Kate (right).
King Charles III and the Princess of Wales. Photo by YUI MOKADRIAN DENNIS/POOL/AFP/AFP via Getty Images

Princess Catherine’s announcement Friday that she has been diagnosed with cancer at age 42 makes her part of a troubling trend in which there’s a rising rate of early onset cancer among young adults.

In fact, people under age 50 were the only one of three adult age groups with an increase in overall cancer incidence from 1995 to 2020, the American Cancer Society said in a January report.

The phenomenon has left public health experts and researchers searching for answers — and calling for expedited cancer screenings and increased awareness among young people about their potential risks.

“The data has been showing for the last several years there’s been an increase in cancers we don’t usually see in young people,” including colorectal, cervical, breast and endometrial cancers, says Neil Maniar, director of Northeastern University’s Master of Public Health Program.

Headshot of Bryan Spring.
Northeastern assistant professor of physics and bioengineering Bryan Spring. Photos by Alyssa Stone/Northeastern University

“What we’re seeing with Kate Middleton is one of the highest-profile cases (concerning) cancer occurring among young people,” says Maniar, who previously worked as vice president of health systems for the American Cancer Society for the New England region.

“It really should be a wake-up call for anyone who is due, or overdue, for a cancer screening to get screened and take all the prevention measures necessary,” he says.

Scientists don’t yet understand the cause of the cancer surge in young adults, says Bryan Spring, a cancer researcher and Northeastern associate professor of physics.

“It makes you wonder what’s going on,” he says. “We’re getting wiser about carcinogens in technology and the food industry. There’s a potential for unknown factors we haven’t discovered.” 

Cancer is most likely to be diagnosed in adults 65 years and older, which is why people  were saddened but not shocked when 75-year-old King Charles III announced in early February that he had been diagnosed with an unspecified cancer. 

But Kate’s video announcement that she has started preventive chemotherapy after testing positive for cancer came as a bombshell. 

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Married to Prince William, heir to the British throne, Kate has enjoyed the image of being a healthy, happy working royal and the mother of three young children: Prince George, 10, Princess Charlotte, 8; and Prince Louis, 5.

A cancer diagnosis at any age is devastating whether it is the age 50-64 group, the 65 and older group or the 18-49 group studied by the American Cancer Society.

Those in the youngest adult group traditionally are considered to be in the prime of their lives — either newly entering adulthood as students, establishing careers and often becoming parents or making plans to have children.

“Not every symptom is cancer, but it’s important if you’re not feeling well to see your healthcare provider,” Maniar says. “There is an increase in cancer risk for younger populations. That is absolutely clear.” 

He says young people should get screened as soon as they are able, which in the case of a colonoscopy has been changed to age 45 after being age 50 for years.

“There’s a reason for that,” Maniar says. “There was an increase in colorectal cancer incidence in individuals under age 50.”

According to the American Cancer Society, there’s been a notable rise in colorectal diagnoses among people younger than 50, with it now being the leading cause of cancer death in men younger than 50 and the second cause in women that age. 

Developing liquid biopsies and other non-invasive approaches that can indicate when it’s time to get a colonoscopy or other major screening could benefit time and cash-strapped young people, Spring says.

“We really do need something that’s cheap and that you can do at home,” he says.

People under the age of 45 usually can get a colonoscopy referral if there’s a family history of cancer. And the worried well under 45 can have an at-home Cologuard test that would indicate the need for a colonoscopy followup, Maniar says.

“Early detection is key,” Maniar says. “It’s important to have conversations with health care providers.”

Middleton has not specified what type of cancer she has, saying that tests following abdominal surgery in January ended up showing she had a malignancy and that she is in the early stages of preventive treatment.

“The best-case scenario is they are just being cautious” and the chemotherapy is a precaution and the cancer was confined to the organ that was operated on, Spring says. 

“The good news is she is young and seems healthy. If she can endure the chemotherapy, hopefully that will prevent any further development of the disease,” he says.

Given the statistics, a youthful sense of invincibility is no longer appropriate, Maniar says. “Younger people may be more likely to attribute pains or other symptoms to other causes or activities. They may feel that cancer is just not something they need to worry about in their age group.”

“You do want to know and you want to know as early as  you can. Cancer risk is something young people need to be aware of, particularly if you are between the ages of 18 and 49,” Maniar says.

He advises people of any age to eat healthily, exercise and to stop smoking if they are smokers.

And “please get screened,” Maniar says. “This is a serious issue.”