https://www.nature.com/articles/s41571-022-00672-8 Skip to main content Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript. Advertisement Advertisement Nature Reviews Clinical Oncology * View all journals * Search * My Account Login * Explore content * About the journal * Publish with us Subscribe * Sign up for alerts * RSS feed 1. nature 2. nature reviews clinical oncology 3. review articles 4. article * Review Article * Published: 06 September 2022 Is early-onset cancer an emerging global epidemic? Current evidence and future implications * Tomotaka Ugai ORCID: orcid.org/0000-0003-0182-5269^1,2^ na1, * Naoko Sasamoto^3,4^ na1, * Hwa-Young Lee ORCID: orcid.org/0000-0003-2591-1436^5,6^ na1, * Mariko Ando^7^ na1, * Mingyang Song^2,8,9,10, * Rulla M. Tamimi^11, * Ichiro Kawachi^7, * Peter T. Campbell^12^ na2, * Edward L. Giovannucci^2,8^ na2, * Elisabete Weiderpass^13^ na2, * Timothy R. Rebbeck ORCID: orcid.org/0000-0002-4799-1900^2,14,15^ na2 & * ... * Shuji Ogino ORCID: orcid.org/0000-0002-3909-2323^1,2,16,17^ na2 Show authors Nature Reviews Clinical Oncology (2022)Cite this article * 719 Accesses * 684 Altmetric * Metrics details Subjects * Cancer epidemiology * Cancer prevention * Pathogenesis * Risk factors * Scientific community Abstract Over the past several decades, the incidence of early-onset cancers, often defined as cancers diagnosed in adults <50 years of age, in the breast, colorectum, endometrium, oesophagus, extrahepatic bile duct, gallbladder, head and neck, kidney, liver, bone marrow, pancreas, prostate, stomach and thyroid has increased in multiple countries. Increased use of screening programmes has contributed to this phenomenon to a certain extent, although a genuine increase in the incidence of early-onset forms of several cancer types also seems to have emerged. Evidence suggests an aetiological role of risk factor exposures in early life and young adulthood. Since the mid-20th century, substantial multigenerational changes in the exposome have occurred (including changes in diet, lifestyle, obesity, environment and the microbiome, all of which might interact with genomic and/or genetic susceptibilities). However, the effects of individual exposures remain largely unknown. To study early-life exposures and their implications for multiple cancer types will require prospective cohort studies with dedicated biobanking and data collection technologies. Raising awareness among both the public and health-care professionals will also be critical. In this Review, we describe changes in the incidence of early-onset cancers globally and suggest measures that are likely to reduce the burden of cancers and other chronic non-communicable diseases. Key points * The incidence of cancers of various organs diagnosed in adults <=50 years of age has been rising in many parts of the world since the 1990s. * Evidence suggests an aetiological role for risk factor exposures in early life and young adulthood, although specific effects of individual exposures remain largely unknown. * The early life exposome (including, among other factors, diet, lifestyle, obesity, environmental exposures and the microbiome) has changed substantially, with variable trends observed around the world since the mid-20th century. * The early-onset cancer epidemic might be one manifestation of increasing trends in the development of many chronic diseases in young and future generations. * Prospective cohort studies using electronic health records and/or early-life biospecimen collection would enable the detailed investigation of early-life factors in relation to many future health outcomes, including cancer. * Raising awareness of the early-onset cancer epidemic and improving the early-life environment should be our immediate goals: these are likely to reduce the burden of both early-onset and later-onset cancers. Access through your institution Buy or subscribe Your institute does not have access to this article Access options Access through your institution Access through your institution Change institution Buy or subscribe Subscribe to Nature+ Get immediate online access to the entire Nature family of 50+ journals $29.99 monthly Subscribe Subscribe to Journal Get full journal access for 1 year $99.00 only $8.25 per issue Subscribe All prices are NET prices. VAT will be added later in the checkout. Tax calculation will be finalised during checkout. Buy article Get time limited or full article access on ReadCube. $32.00 Buy All prices are NET prices. Additional access options: * Log in * Learn about institutional subscriptions Fig. 1: Trends in incidence of selected early-onset cancers. [41571_2022_672_Fig1_HTML] Fig. 2: Individual life-course exposures and their relationship with the development of early-onset cancers. 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Benefits and adverse events in younger versus older patients receiving adjuvant chemotherapy for colon cancer: findings from the adjuvant colon cancer endpoints data set. J. Clin. Oncol. 30, 2334-2339 (2012). PubMed PubMed Central Article Google Scholar Download references Acknowledgements The work of S.O. is supported in part by the U.S. National Institutes of Health grants (R35 CA197735 and R01 CA248857) and the Cancer Research UK Cancer Grand Challenge Award (6340201/A27140). The work of T.U. is supported by grants from the Prevent Cancer Foundation, Japan Society for the Promotion of Science, and the Mishima Kaiun Memorial Foundation. Author information Author notes 1. These authors contributed equally: Tomotaka Ugai, Naoko Sasamoto, Hwa-Young Lee, Mariko Ando. 2. These authors jointly supervised this work: Peter T. Campbell, Edward L. Giovannucci, Elisabete Weiderpass, Timothy R. Rebbeck & Shuji Ogino. Authors and Affiliations 1. Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA Tomotaka Ugai & Shuji Ogino 2. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA Tomotaka Ugai, Mingyang Song, Edward L. Giovannucci, Timothy R. Rebbeck & Shuji Ogino 3. Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, USA Naoko Sasamoto 4. Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA, USA Naoko Sasamoto 5. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA Hwa-Young Lee 6. Institute of Convergence Science, Convergence Science Academy, Yonsei University, Seoul, Republic of Korea Hwa-Young Lee 7. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA Mariko Ando & Ichiro Kawachi 8. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA Mingyang Song & Edward L. Giovannucci 9. Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA Mingyang Song 10. Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA Mingyang Song 11. Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA Rulla M. Tamimi 12. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA Peter T. Campbell 13. International Agency for Research on Cancer, Lyon, France Elisabete Weiderpass 14. Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA Timothy R. Rebbeck 15. Zhu Family Center for Global Cancer Prevention, Harvard T.H. Chan School of Public Health, Boston, MA, USA Timothy R. Rebbeck 16. Broad Institute of MIT and Harvard, Cambridge, MA, USA Shuji Ogino 17. Cancer Immunology and Cancer Epidemiology Programs, Dana-Farber Harvard Cancer Center, Boston, MA, USA Shuji Ogino Authors 1. Tomotaka Ugai View author publications You can also search for this author in PubMed Google Scholar 2. Naoko Sasamoto View author publications You can also search for this author in PubMed Google Scholar 3. Hwa-Young Lee View author publications You can also search for this author in PubMed Google Scholar 4. Mariko Ando View author publications You can also search for this author in PubMed Google Scholar 5. Mingyang Song View author publications You can also search for this author in PubMed Google Scholar 6. Rulla M. Tamimi View author publications You can also search for this author in PubMed Google Scholar 7. Ichiro Kawachi View author publications You can also search for this author in PubMed Google Scholar 8. Peter T. Campbell View author publications You can also search for this author in PubMed Google Scholar 9. Edward L. Giovannucci View author publications You can also search for this author in PubMed Google Scholar 10. Elisabete Weiderpass View author publications You can also search for this author in PubMed Google Scholar 11. Timothy R. Rebbeck View author publications You can also search for this author in PubMed Google Scholar 12. Shuji Ogino View author publications You can also search for this author in PubMed Google Scholar Contributions T.U., N.S., H.-Y.L., M.A. and S.O. researched data for the article and wrote the manuscript. All authors made a substantial contribution to discussions of content, and edited and/or reviewed the manuscript prior to submission. Corresponding authors Correspondence to Tomotaka Ugai or Shuji Ogino. Ethics declarations Competing interests E.W. is an employee of the IARC/WHO. The authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy or views of the IARC/WHO. 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Reprints and Permissions About this article Verify currency and authenticity via CrossMark Cite this article Ugai, T., Sasamoto, N., Lee, HY. et al. Is early-onset cancer an emerging global epidemic? Current evidence and future implications. Nat Rev Clin Oncol (2022). https://doi.org/10.1038/s41571-022-00672-8 Download citation * Accepted: 22 July 2022 * Published: 06 September 2022 * DOI: https://doi.org/10.1038/s41571-022-00672-8 Share this article Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. 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