Cancer is surging, bringing a debate about whether to look for it

Summary

The statistics are incontrovertible: Since 1992, the diagnoses of eight cancers has doubled in the United States in patients under age 50, including cancers in the thyroid, anus, kidney, small intestine, colorectum, endometrium and pancreas, as well as the blood cancer myeloma. Other types, including breast cancer, also are on the rise.“The magnitude and speed at which early onset cancer incidence has increased is unlike most cancer trends ever observed (the possible exception being cigarette smoking and lung cancer),” the American Association for Cancer Research said in its announcement of a special conference being held this week that will explore the rise in cancers among younger people.The sharp uptick has been agonizing for these younger patients and many of their doctors.The patients wonder: Why did I develop cancer? And how will my life be transformed by potentially excruciating treatments?Their doctors share these questions, and some have additional concerns: What if these cancers had never been detected? Are doctors offering treatments to younger patients with early-stage diseases that may do as much harm as good?Outside exam rooms and clinics, many medical experts are debating the culprits of the spike. They are looking at toxins in the environment, the obesity epidemic and changes in peoples’ microbiomes, perhaps from diets heavy in ultraprocessed foods. With rates rising so swiftly, they say, there is a compelling reason to find out why.Some cancer specialists counter these concerns, saying the surge in diagnoses is primarily a surge in detecting cancers that did not need to be found, or did not need to be found so soon. They would not have killed patients if they had not been detected, or if they had been detected later in life.It has been known for decades that not every cancer is dangerous. Some go away on their own. Others stop growing or pose no risk — they cause no symptoms and do not spread.The idea that finding a cancer early is not always a good...