Unexpected Cause of the Scary Cancer Surge — Transcript

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1. 0:00Cancer rates appear to be skyrocketing
2. 0:01in people under the age of 50. So, Gen
3. 0:04X, millennials, even Gen Z, they're
4. 0:06being diagnosed at significantly higher
5. 0:07rates than previous generations were at
6. 0:09the same age. So, what in the world is
7. 0:11going on? Well, a new study has provided
8. 0:13us with some tantalizing answers, and
9. 0:15the story turns out to be quite nuanced,
10. 0:17and experts are divided about how to
11. 0:19account for what we're seeing. But,
12. 0:20there's one thing that they all agree
13. 0:21upon that's absolutely vital to know in
14. 0:24order to manage and lower your cancer
15. 0:26risk. So, how bad are the numbers when
16. 0:27it comes to cancer in young people?
17. 0:29Well, a massive analysis in 2023 in the
18. 0:32British Medical Journal analyzed data on
19. 0:3429 cancers across 204 countries.
20. 0:38Overall, early onset cancers jumped by
21. 0:4079.1%
22. 0:42between 1990 and 2019. For this study,
23. 0:45early onset cancer means cancer
24. 0:47diagnosed in someone between the ages of
25. 0:4914 to 49 years, and they found that the
26. 0:52most damaging cancers in terms of deaths
27. 0:54were early onset breast, tracheal, lung,
28. 0:56stomach, and colorectal cancers. And
29. 0:58this certainly isn't the direction that
30. 1:00we want to be moving in. And it raises a
31. 1:01critical question, what is driving the
32. 1:04increase? Several theories have emerged
33. 1:06and they've led to an unexpected turn.
34. 1:08So, one highlights the role of the gut's
35. 1:10microbiome. So, in recent years, we've
36. 1:12grown increasingly aware of the
37. 1:13microbiome's importance, and it's
38. 1:15central to our health. So, when it gets
39. 1:17out of balance, it can be a driver of
40. 1:19disease. And some changes in the
41. 1:20microbiome, they have been linked to
42. 1:22increases in inflammation and the
43. 1:24development of cancer. And there's
44. 1:25evidence that early onset colorectal
45. 1:27cancer in particular is associated with
46. 1:29changes in the gut microbiome. And a key
47. 1:31driver of the changes in the microbiome
48. 1:33is diet. And the modern Western diet
49. 1:35appears to trigger specific changes in
50. 1:37the bacterial populations in the gut.
51. 1:40And if we try and narrow down what is it
52. 1:41about the typical Western diet that
53. 1:43drives these changes, it seems to be
54. 1:45about red meat and highly processed
55. 1:47foods. So, this might be in part because
56. 1:49highly processed foods, they strip away
57. 1:51fiber, and fiber is so critical to feed
58. 1:53the good bacteria and maintain gut
59. 1:55microbiome diversity. Its absence
60. 1:57appears to promote inflammatory
61. 1:58environment. That's the exact opposite
62. 2:00of what we want when it comes to
63. 2:02avoiding cancer. Other research has
64. 2:03identified chronic stress, exposure to
65. 2:06antibiotics, exposure to a group of
66. 2:07chemicals called PFAS, so those are
67. 2:10forever chemicals that your body can't
68. 2:11get rid of and slowly build up over
69. 2:13time, to microplastics, and even lower
70. 2:15rates of breastfeeding. And finally,
71. 2:17some people have pointed to sedentary
72. 2:19lifestyles as a key risk factor. So, for
73. 2:21instance, one population study found a
74. 2:23pronounced association between being
75. 2:25inactive and higher risks of both
76. 2:27getting cancer and dying from it. But
77. 2:29while some researchers have tried to pin
78. 2:31down the drivers of rising rates of
79. 2:32cancer, other people have been asking a
80. 2:34different question. What if the data
81. 2:36isn't telling us what we think it is?
82. 2:38So, consider the story of South Korea.
83. 2:40After 1999, rates of thyroid cancer,
84. 2:43they shot through the roof. And this
85. 2:44prompted the same question that we've
86. 2:46been looking at. What is driving this?
87. 2:48And it turned out that the answer was
88. 2:49that people probably weren't getting
89. 2:51more thyroid cancer. Instead, there was
90. 2:53a massive push to do more thyroid cancer
91. 2:55screening. So, they were just finding
92. 2:56more cases that had been there all
93. 2:58along. So, when we see a rise in cancer
94. 3:00diagnoses, it's important to ask, is the
95. 3:02rise real, or is this just a reflection
96. 3:05of more and perhaps better screening?
97. 3:07So, one way we could try and answer this
98. 3:08question is to look at death statistics.
99. 3:11So, a certain percentage of people who
100. 3:13have cancer, they will die from the
101. 3:14disease. If we're seeing a true uptick
102. 3:16in cancer cases, not just an increase in
103. 3:18spotting them, we would expect to see a
104. 3:20corresponding rise in deaths, all things
105. 3:22being equal. So, what does the data look
106. 3:24like here? Well, a study just published
107. 3:27examined the numbers in the US, and it
108. 3:29paints a different picture compared to
109. 3:30the data on rising cancer rates. There's
110. 3:32been a 44% decline in cancer-related
111. 3:35deaths between 1990 and 2023. Yes, a
112. 3:39decline, which is the exact opposite
113. 3:41from what we would expect if cancer
114. 3:42rates were truly exploding in young
115. 3:44people. So, this lends some weight to
116. 3:46the theory that the rise we're seeing
117. 3:47may not necessarily reflect a true rise
118. 3:50in cancer rates. It suggests that we're
119. 3:51doing a better job of finding them, and
120. 3:54many of these would not have caused any
121. 3:55problems anyway had we not detected
122. 3:57them. But, there is an alarming
123. 3:59exception, colorectal cancer. It's the
124. 4:01only leading cause of cancer death in
125. 4:03this demographic that saw an increase.
126. 4:05It's grown by 1.1% annually since 2005.
127. 4:08It's now become the leading cause of
128. 4:10cancer death in the under 50 age group.
129. 4:12So, in this case of colorectal cancer,
130. 4:14all of the indicators agree. Here, it
131. 4:16looks like we are seeing a genuine rise
132. 4:18in the number of cancers with deadly
133. 4:20consequences. But, there is reason to
134. 4:22think that we're witnessing a real rise
135. 4:24in other gastrointestinal types of
136. 4:25cancer, too. For one thing, with many of
137. 4:27the cancers where we're seeing
138. 4:28increases, we don't screen for them in
139. 4:30young adults. So, this would include
140. 4:32things like pancreatic cancer and
141. 4:33stomach cancers, for instance. So, we
142. 4:35can't be finding more of those because
143. 4:36we're doing a better job at looking.
144. 4:38Instead, we're probably finding more
145. 4:40because more patients are showing up in
146. 4:41doctor's offices with symptoms of
147. 4:43cancer. And, there's another reason to
148. 4:45suspect that there's a real rise in
149. 4:47gastrointestinal cancers. So, medical
150. 4:49technology is not standing still. We're
151. 4:50getting better at finding cancer, but
152. 4:52we're also getting better at treating
153. 4:54the cancer that we do find. So, death
154. 4:56rates might still be falling even if
155. 4:58more people are actually getting sick
156. 5:00because we're catching it earlier, and
157. 5:01treatments are more effective. So, for
158. 5:03instance, with pancreatic cancer, the
159. 5:055-year survival rates have gone up
160. 5:07dramatically. So, in 2000, only 16.5% of
161. 5:10those diagnosed with pancreatic cancer
162. 5:12would still be alive at the 5-year mark.
163. 5:14In 2016, that number had risen to just
164. 5:17over 37%, and the global numbers provide
165. 5:20some additional evidence for this
166. 5:21perspective. So, remember the British
167. 5:23Medical Journal study that looked at 204
168. 5:25countries. They found it wasn't just
169. 5:27early-onset cancer diagnoses that were
170. 5:29rising. Death rates were also rising,
171. 5:31too, by about 28% during the same
172. 5:33follow-up period of between 1990 to
173. 5:362019. So, that's in contrast to what's
174. 5:38happening in the US, where the rates of
175. 5:40cancer-related deaths is falling. So,
176. 5:43this might be because the US and other
177. 5:44wealthy countries, they invest massive
178. 5:46resources into health care that helps to
179. 5:48offset the impact of growing numbers of
180. 5:50cases. So, in many other countries, that
181. 5:53level of investment just isn't
182. 5:54available. So, a rise in the number of
183. 5:56cancers isn't masked by improvements in
184. 5:59the ability to treat the disease. So,
185. 6:00the two graphics from the British
186. 6:02Medical Journal study, they help to
187. 6:03illustrate this idea. So, in the first
188. 6:05one, we can see that the rates of cancer
189. 6:07diagnoses across the world in 2019, the
190. 6:10highest is in red, followed by orange.
191. 6:12Yellow is in the middle, while green and
192. 6:14then blue are the lowest rates. So,
193. 6:16notice the pattern here. The highest
194. 6:18rates are in North America, Western
195. 6:20Europe, Australia, and New Zealand, all
196. 6:22relatively wealthy places with large
197. 6:24investments in health care. Rates are
198. 6:26much lower in Africa and throughout much
199. 6:28of the developing world. But, in many of
200. 6:30these places, health care spending is
201. 6:32low. Now, look at what happens and how
202. 6:34the picture changes when we move to a
203. 6:36graph showing how many people are dying
204. 6:38from cancer. The colors essentially
205. 6:40flip. Those places that had higher rates
206. 6:42of cases had lower death rates. Those
207. 6:44places with lower rates have relatively
208. 6:46higher numbers of deaths. So, the
209. 6:48pattern seems to fit. In wealthy
210. 6:50countries, people are less likely to die
211. 6:52from cancer if they have it. So, if we
212. 6:54just look at the US, diagnoses are going
213. 6:56up, but death rates seem to suggest that
214. 6:58cancer rates must not really be rising.
215. 7:00But, globally, there's an increase in
216. 7:02early onset diagnoses that's matched by
217. 7:05an increase in deaths. So, it looks like
218. 7:07here, the rise is real. So, overall,
219. 7:10yes, there is still debate about whether
220. 7:11we are seeing a true rise in cancer
221. 7:13rates or whether we're just detecting it
222. 7:15earlier because of advanced cancer
223. 7:16screening programs. We do need more
224. 7:18data, but again, what is not debated is
225. 7:21that colorectal cancer rates are
226. 7:22genuinely rising and it's taking an
227. 7:24increasing toll in terms of lives. So,
228. 7:27what can we do about it? Well, the first
229. 7:29place to start is our diet. As we've
230. 7:31already seen, the standard Western diet
231. 7:32with its abundant intake of highly
232. 7:34processed foods is a risk factor. It
233. 7:36just strips away all of that fiber. Red
234. 7:38meat is also linked to colorectal cancer
235. 7:40as well. Instead, so long as we don't
236. 7:42have irritable bowel syndrome or
237. 7:43inflammatory bowel disease, we want to
238. 7:45make sure that we're getting plenty of
239. 7:46fiber from fresh fruits and non-starchy
240. 7:49vegetables, and also plant-based
241. 7:50proteins, like things like chickpeas and
242. 7:53lentils and beans. Looking at fiber
243. 7:55specifically, some research has linked a
244. 7:5710 to 17% reduction in colorectal cancer
245. 8:00with each 10 g per day of fiber intake.
246. 8:02Next, we have to prioritize exercise,
247. 8:04and even if it's hard to find time to
248. 8:06head to the gym, exercise snacks
249. 8:08throughout the day can help us add
250. 8:10movements that make a definite
251. 8:11difference to our health for the long
252. 8:13term. And after getting these lifestyle
253. 8:14factors in order, we have to consider
254. 8:16screening. So, the current guidelines
255. 8:18say that for most people, regular
256. 8:20colorectal screenings should start from
257. 8:21the age of 45 and continue to the age of
258. 8:2475 if we're in good health. And there's
259. 8:26a positive change here that many of my
260. 8:27patients don't yet know about. So, in
261. 8:29the past, the standard screening
262. 8:31approach was a colonoscopy, but in
263. 8:33recent years, we've developed highly
264. 8:35sensitive tests that can detect signs of
265. 8:37colorectal cancer from a simple stool
266. 8:39sample. So, personally, I go a bit
267. 8:41beyond recommendations here. So, I plan
268. 8:43to do my first stool-based screening
269. 8:45from the age of 35. Again, because we
270. 8:47are seeing this rise in young people
271. 8:49getting colorectal cancer. Now, this
272. 8:50isn't something based on research or
273. 8:52something that I recommend to my
274. 8:53patients. Again, for me though, the test
275. 8:55is so simple that I don't mind taking
276. 8:57this extra precaution. And finally, we
277. 8:59have to be aware of the warning signs
278. 9:01for colorectal cancer. So, if we spot
279. 9:03blood in the stool, or if we experience
280. 9:05abdominal pain, or we see sudden shifts
281. 9:06in our bowel habits, it is time to see
282. 9:08your doctor. And earlier, we did look at
283. 9:10the theory cancer rates and how it might
284. 9:13be linked to changes in the gut
285. 9:14microbiome due to shifting dietary
286. 9:15habits. And one of the new element in
287. 9:18the modern diet is artificial
288. 9:19sweeteners. So, what type of impact do
289. 9:21they have on the microbiome? Well, make
290. 9:23sure to check out this next video here
291. 9:25to learn the surprising results from a
292. 9:26recent study.