Cancer: Rising Incidence Among Younger Adults
Health and data journalist. I cover a wide range of healthcare topics, from cutting-edge therapies to global health. My stories are often data-driven, and I strive to make complex issues clear and accessible. Before becoming a full-time journalist, I worked in communication, research, and data analysis for the UN and EU. In the private sector, I developed health economics models to inform policy and investment decisions. Originally from Italy, I am now based in Zurich.
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Samantha Weiss, a trained nurse, was diagnosed with an aggressive form of the blood cancer lymphoma in 2021, at the age of 35. The news was devastating.
“My world started to collapse,” she says.“One minute I am in the prime of my life – I have a good job, a successful career, I have just bought a house with my husband – the next, everything I have built is at risk.”
Although still rare, such cases are becoming increasingly frequent. Data showExternal link that, globally, the incidence of cancer among 14-49-year-olds is rising, while rates in many older age groups have stayed the same or even declined. In Switzerland, cancers such as colorectal and thyroid have become more common among 15-49-year-olds over the last 50 years.
For adults in their 20s or 30s, a cancer diagnosis often strikes at key moments in their lives – such as finishing education, entering the workforce, or starting a family.“It's a complete trajectory interruption,” says Christina Grivea, a counsellor at Cancer Support Switzerland (CASSExternal link ) who works closely with young adults who develop cancer.“The shock is huge, the disconnect from their peers is huge. They go out with their friends and see them having fun while they are confronting deep, existential questions.”
Cancer is devastating at any age, but for people who develop the disease at a relatively early age, are confronted with a distinct set of physical, psychological, and social challenges that differ from those faced by older patients. Fertility, for example, may suddenly become a concern.“Those under 25 aren't usually thinking about starting a family, it's not even on their radar,” says Grivea, but cancer forces them to make difficult choices.“It's a lot to process – physically and psychologically – while also dealing with treatment.”
Other side-effects from treatment can hit harder too: the physical toll of cancer – such as hair or weight loss, and surgical scars – can deeply impact body image, Grivea adds, at an age when they may still be still figuring out who they are.
Cancer cases diagnosed in people under 50 are often referred to as“early-onset”. This is because, statistically, cancer is a disease that mainly affects older adults, with most diagnoses occurring after age 50.
Depending on the study or health system, the early-onset category may start at 18, or include adolescents, covering ages 15 (or sometimes 14) to 49.
The term adolescents and young adults (AYA) is sometimes used interchangeably with early-onset, though its definition varies, most commonly spanning ages 15–39 or 18–39.
Adolescents and young adults (AYA) also experienceExternal link greater post-traumatic stress, anxiety, depression, and fatigue compared with long-term survivors of childhood cancer, and conventional care models are often unable to meet their needs, research shows. In Switzerland, support services tailored to them are fragmented and limited, according to a surveyExternal link conducted by the gfs research institute on behalf of the Swiss branch of the global pharmaceutical company MSD.
These psychological challenges are compounded by practical ones such as difficulty resuming their careers and discrimination in accessing supplementary health insurance, mortgages, and loans, including in Switzerland.
A disease of ageCancer is, in a sense, a disease shaped by time: the risk increases significantly with age, because typically it takes decades for harmful mutations to accumulate in a single cell, and even longer for that cell to develop into an invasive tumour.
Of the roughly 46,700 new cases of cancer diagnosed annually in Switzerland from 2017 to 2021, almost 90% were found in adults aged 50 or over, according to the latest data publishedExternal link by the Federal Statistical Office. This is why cancer diagnosed in 18–49-year-olds is referred to as early-onset: most cancer types remain statistically rare in this age group.
External ContentGrivea runs the under-45s support group at CASS.“We decided to launch a dedicated group this summer because in the last two years we have had so many younger patients,” she says. It's unclear whether this reflects a real increase in the number of cases or the greater reach of the organisation, she says. But data suggest that cancer before the age of 50 is becoming more common worldwide.
From 1990 to 2019, global cancer diagnoses in adults under 50 rose by79%, and deaths by 28%, according to a studyExternal link published in the journal BMJ Oncology in 2023. The sharpest increases were observed in the Gulf region, where incidence in countries including the UAE and Qatar rose tenfold, although this was partly due to greater screening uptake and better testing. The highest rates, however, have consistently been found in North America, Oceania, and Western Europe.
Cases are expected to continue growing: the BMJ study forecast a 30% increase in early-onset cancer cases worldwide from 2019 to 2030.
In Switzerland, the picture is mixed. While overall cancer incidenceExternal link among 18-49 year olds has remained broadly stable since the 1990s (with small increases among women in their 30s and modest declines among men), certain conditions – particularly colorectal, thyroid, and breast cancer – have been rising in adults under 50.
External ContentResearchers have not been able to pinpoint the reasons for the increase in early-onset cancer. In the absence of a clear understanding of the underlying causes that could guide targeted prevention strategies, some experts are turning their attention to screening.
“Cancers in younger patients often present in more aggressive forms,” says Dr Michael Scharl, Chief Physician at the Department of Gastroenterology and Hepatology at the University Hospital of Zurich. Hence,“early detection becomes even more important to improve survival outcomes.”
Doctors and researchers do not have a definitive answer on what is causing the increase in early-onset cancer, but they believe it's a complex mix of lifestyle, environmental, and biological factors.
They have identified a series of risk factors – including alcohol consumption, smoking, lack of physical activity, and diets high in red or processed meat and low in fibre – that have become more common in recent decades and may explain why cancer is increasing faster among people born after 1950.
Yet statistical analyses suggest that such risk factors cannot fully account for the rise. Some scientists are investigating whether early-onset cancers have different genetic or molecular features compared with those diagnosed later in life. Other research focuses on the link between certain cancers and disruptions to the body's microbial balance – especially in the gut. Studies have already linked exposure to certain chemicals during pregnancy, such as the synthetic hormone DES, with higher cancer risks later in life; some scientists suspect that similar, as yet unidentified, substances could be contributing to the increase in cancer incidence recorded in the past decade.
Understanding the trend will take time and, above all, data: long-term studies that follow people for decades are needed to reveal meaningful patterns over time, researchers say. But these are costly and difficult to run, requiring multi-country effort and coordination.
Fragmented support, uneven reachIn the clinical setting, international best practice increasingly pointsExternal link to the need for dedicated AYA teams: typically oncology units or multidisciplinary teams that bridge pediatric and adult care, combining oncologists, psychologists, fertility specialists, and social workers.
Countries such as the US, Canada and Australia offer established, coordinated AYA programs. In Europe, the AYA Working group was launched in 2015 as a joint initiative by the European Society for Medical Oncology and the European Society for Paediatric Oncology. The group publishedExternal link a position paper in 2021 defining the minimum requirements for an AYA center and highlighted the inequitable access to services for this age group across different European countries.
In Switzerland, there is as yet no formal programme targeting the AYA age group nor any dedicated AYA wards. However, pilot initiatives have begunExternal link at some hospitals, where interdisciplinary teams address the specific needs of younger patients.
International cancer trials and treatment protocols largely focus on paediatric or older patients, while adolescents and young adults are typically underrepresented. This sometimes leaves patients like Weiss without tailored treatment plans.
“The cancer I had is usually seen in children and teenagers, and then in people over 60. There is limited clinical experience with patients in my age group” Weiss explains.
“So they treated me as they would treat an adolescent, with a really high dose. Sometimes it felt like they were testing how much my body could take.”
Read more on why treating cancer is so expensive in Switzerland:
More More Why Switzerland pays more for cancer care than SwedenThis content was published on Apr 1, 2025 More money is spent on cancer in Switzerland per capita than any other country in Europe, but this doesn't translate to higher survival rates.
Read more: Why Switzerland pays more for cancer care than S
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