Appendix cancer is on the rise among young people: What symptoms should you watch out for?

Appendix cancer is a disease that, until recently, was so rare that most people didn't even consider it. For decades, it was the type of disease doctors might encounter only once or twice in their careers, and it was almost always found in older adults.

But now a surprising and worrying trend is emerging: appendix cancer is being diagnosed more frequently, increasingly affecting people in their 30s, 40s, and even younger. This shift has left many experts perplexed and searching for answers.

The appendix is ​​a small, finger-shaped pouch attached to the large intestine. Its function in the body is still a matter of debate, but it is best known for causing appendicitis , a painful inflammation that often requires urgent surgery. What is less well known is that cancer can develop in the appendix, usually without any warning signs.

A new study, published in the Annals of Internal Medicine , has shown that the number of appendix cancer cases has increased dramatically among people born after the 1970s. In fact, the incidence has tripled or even quadrupled in younger generations compared to those born in the 1940s .

Although the overall numbers remain low (appendix cancer affects only a handful of people per million each year), the rapid increase is striking. Even more remarkable is that one in three cases occurs in adults under 50, a much higher proportion than that seen with other types of gastrointestinal cancer.

What is causing this increase? No one knows for sure, but one of the prime suspects is the drastic change in lifestyle and environment in recent decades . Obesity rates have skyrocketed since the 1970s, and being overweight is a known risk factor for many cancers, including those of the digestive system.

At the same time, diets have shifted toward more processed foods, sugary drinks, and red or processed meats, all of which have been linked to an increased risk of cancer in other parts of the gut.

Physical activity has also declined, with more and more people spending long hours sitting at desks or in front of screens.

Another possibility is that we are exposed to new environmental factors that previous generations did not face. The industrialization of food production, the widespread use of plastics and chemicals, and changes in water quality could all play a role. However, evidence is still in its early stages.

Appendix cancer is particularly difficult to detect. Unlike colon cancer, which can sometimes be detected early through screening colonoscopies, appendix cancer often goes undetected .

Symptoms, if they appear, are vague and easy to dismiss. Mild abdominal pain, bloating, or changes in bowel habits may be experienced, which are common symptoms of many benign conditions. Therefore, most cases are only discovered after surgery for suspected appendicitis, when it is often too late for early intervention.

Despite the increase in cases, there is no routine screening test for appendix cancer. The disease is too rare to warrant widespread screening, and the appendix can be difficult to visualize with standard imaging or endoscopy. Therefore, both patients and physicians must be extremely vigilant.

If someone experiences persistent or unusual abdominal symptoms, especially if they are under 50, it's important not to ignore them. Early investigation and prompt treatment can make a significant difference in outcomes.

The increase in appendix cancer among younger adults is part of a broader trend seen in other gastrointestinal cancers, such as colon and stomach cancers. These cancers are also diagnosed more frequently in people under 50, suggesting the existence of shared risk factors.

The reasons for this change are complex and likely involve a mix of genetics, lifestyle, environment , and perhaps even changes in our gut microbiome—the bacteria that live with us.

In recent decades, antibiotics have become more prevalent in both medicine and agriculture. This widespread use can alter the balance of bacteria in our gut, which could influence cancer risk. Some recent research suggests that exposure to antibiotics in early life may have long-term effects on the digestive system, but more studies are needed to confirm this relationship.

For now, the best advice is to focus on prevention and awareness. Maintaining a healthy weight, eating a balanced diet rich in fruits, vegetables, and whole grains, and staying physically active are all measures that can reduce the risk of many types of cancer .

It's also important to avoid tobacco and limit alcohol consumption. Although these measures can't guarantee protection against appendix cancer, they are proven strategies for overall health.

Researchers are working to unravel the mystery of why appendix cancer is increasing so rapidly among younger generations. Understanding the causes will be crucial to developing better ways to prevent, detect, and treat this rare but increasingly important disease.

In the meantime, raising awareness among healthcare professionals and the general public is essential. By recognizing the signs and taking action when symptoms appear, we can improve the chances of detecting appendix cancer early and offering patients the best possible outcomes.

The story of the rise of appendix cancer reminds us that even rare diseases can become more common when our environment and lifestyles change . It's also a call to action for further research and for all of us to pay attention to our bodies, see a doctor when we feel something unusual, and support efforts to understand and combat this disconcerting trend.

Professor of Biomedical Sciences, Anglia Ruskin University