England has Europe’s steepest rise in under-50s with bowel cancer
Cases of bowel cancer in young adults are rising more sharply in England than anywhere else in Europe, according to a study that suggests our poor diet could be to blame.
Researchers looked at rates of the disease in 50 countries and found that bowel cancer in those aged 25 to 49 was rising rapidly, particularly in the West.
In England, rates increased by an average of 3.6 per cent every year in the decade to 2017 — the fourth steepest rise after Chile, New Zealand and Puerto Rico.
Experts said poor diet, consumption of more ultra-processed foods, obesity and a lack of exercise played a role.
The study, published in The Lancet Oncology, said: “A considerable shift from traditional diets, rich in low fat and high fibre foods, to increased consumption of red or processed meat, sugars and ultra-processed convenience foods has probably contributed, at least in part.”
Michelle Mitchell, chief executive of Cancer Research UK, said: “This flagship study reveals that increasing rates of early onset bowel cancer, affecting adults aged 25 to 49, is a global issue.
“Concerningly, this research has revealed for the first time ever that rates are rising more sharply in England than in many other countries around the world.
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“A cancer diagnosis at any age has a huge impact on patients and their families, so while it’s important to note that rates in younger adults are still very low compared to people over 50, we need to understand what’s causing this trend in younger people.”
Scientists believe “unknown” risk factors, beyond known risks such as smoking or obesity, are driving the increase.
Analysis by Cancer Research UK shows that bowel cancer incidence has risen by 52 per cent in adults aged 25 to 49 since the early 1990s.
There are about 2,600 new bowel cancer cases in people aged 25 to 49 in the UK every year and about 44,100 new cases among all ages. Victims include Dame Deborah James, the BBC presenter, who died of bowel cancer in 2022. She was 40 and had been 35 when diagnosed.
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The new study by the American Cancer Society said the rise in early onset cancers was a global phenomenon. Rates had increased in 27 of the 50 countries studied.
England had the highest statistically significant annual increase of all European countries. Cases were up by 3.6 per cent a year, compared with 2.1 per cent in France and 0.4 per cent in Italy. In Spain, rates fell.
Young women in England had faster increases in early bowel cancer rates than men. In older adults, in many countries including England, bowel cancer rates were falling, partly because of effective screening programmes.
The study called for “innovative tools to prevent and control cancers linked to dietary habits, physical inactivity and excess body weight”.
Prospect, a global study involving a team at King’s College London, is examining how dietary changes could reduce bowel cancer in younger adults.
Professor Tim Spector, who is leading the UK arm of Prospect, said: “Colon cancer in younger people is soaring — and the UK has some of the highest rates in Europe. While many factors are at play, diet is undoubtedly a major player.
“A shocking 60 per cent of our calories come from ultra-processed foods, whilst our fibre intakes are dismally low and consumption of sugary drinks and processed meats too high. Our kids’ ultra-processed foods intake is the worst in the world. Unless we can reverse our reliance on fake foods, this trend will continue. The government must act now to curb our ultra-processed food addiction.”
A separate study, by the University of South Florida, analysed tumour samples from patients with early onset bowel cancer and said that inflammation caused by ultra-processed foods and seed oils may be linked to the disease.
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Separately, an annual report by Professor Sir Chris Whitty, England’s chief medical officer, said that in cities, “healthy food deserts” and advertising for junk food was setting children up for “shorter and unhealthier” lives.
Whitty’s report urges the government and local policymakers to tackle the availability of junk and ultra-processed food.
Ultra-processed food in the dock
Limiting red meat and following a high-fibre diet is proven to cut the risk of bowel cancer (writes Eleanor Hayward). So it is perhaps not surprising that rates of the disease are rising steeply among young adults in the UK, because we eat more junk food than almost anywhere else in the world.
Research shows that 57 per cent of the typical UK daily diet is ultra-processed — that is, made by industrial processes — including sweets, some breakfast cereals and frozen ready-meals. The UK figure is just below the USA and higher than any other country in Europe. In Italy less than 20 per cent of the daily diet is ultra-processed.
These foods often contain additives that would not have been present 50 years ago, before the rise in early onset bowel cancers began. These include emulsifiers, which glue together ingredients that do not mix together naturally, and artificial sweeteners such as high-fructose corn syrup.
Scientists believe these additives may cause inflammation in the gut, which could in turn promote mutations in cells that lead to tumours. Research has suggested the microbiome — the community of trillions of bacteria in the gut — is key to explaining a link between diet and bowel cancer.
Patients with early onset bowel cancer have been shown to have more harmful gut bacteria, linked to highly-processed foods. These bacteria can lead to chronic inflammation or mutations in DNA and, in turn, cause tumours to form.
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