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last mo.

Major Reviews Highlight Surge in Early-Onset Gastrointestinal Cancers and Screening Shortfalls

Experts warn low screening rates for adults under 50 risk missing early cases, prompting calls for expanded detection guidelines, lifestyle interventions, genetic testing

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Demonstrators protest funding cuts outside of the National Institutes of Health (NIH) in Bethesda, Maryland, on March 8, 2025.
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Overview

  • Two major July reviews in JAMA and the British Journal of Surgery report a 14.8% global increase in early-onset GI cancers between 2010 and 2019, with notable rises in colorectal, pancreatic, gastric and esophageal tumors.
  • Colorectal cancer accounts for over half of early-onset GI cases worldwide, with U.S. incidence in 20–24-year-olds jumping 185% and European rates in 20–29-year-olds rising 7.9%.
  • Fewer than one in five U.S. adults aged 45–49 underwent recommended colorectal screening in 2021, and no routine screening protocols exist for other gastrointestinal cancers.
  • Key drivers include modifiable risks—obesity, poor diet, sedentary lifestyle, smoking and alcohol—and pathogenic germline variants present in 15–30% of early-onset patients.
  • Health authorities are urging broader screening criteria beyond age 45, targeted prevention campaigns and universal genetic testing for patients diagnosed before 50 to improve early detection and outcomes.