Appendix cancer: the rare tumor that has quadrupled its incidence among young people

An unprecedented rise in appendix cancer among millennials and Generation X has experts alarmed; a Vanderbilt University study published in the Annals of Internal Medicine says the incidence has tripled, or even quadrupled , among those born after 1975 .

Although it remains a rare disease, affecting just over one or two people per million per year, researchers analyzed 4,858 cases diagnosed between 1975 and 2019 and found that one in three patients is under 50 years old , a much higher proportion than for other gastrointestinal tumors .

The study, led by epidemiologist Andreana Holowatyj and her team in Nashville, compared 21 birth cohorts using the National Cancer Institute's SEER registries.

The rates were calculated against the 1941-1949 cohort , taking as a reference the periods in which cases were hardly seen in clinical practice.

What's behind the increase?

"Such an effect lends credence to the idea that people born after a certain period had similar exposures to something that is increasing their cancer risk more than among people born decades earlier," oncologist Andrea Cercek told The Conversation .

Among the usual suspects are the obesity epidemic and metabolic disorders. "Rates of metabolic disorders such as obesity and diabetes , both associated with colon and stomach cancers, have increased over time. Young people, in particular, may be increasingly exposed to the negative effects of obesity and diabetes at a life stage when they are possibly more susceptible to developing cancer ," gastroenterologist Andrew T. Chan noted in the same publication.

Overconsumption of ultra-processed foods , continued exposure to plastics and chemicals , increased use of antibiotics , and changes in the gut microbiome complete the list of hypotheses. "Scientists don't yet know if any of these environmental factors specifically influence appendix cancer," Holowatyj admits.

Unlike the colon or stomach, the appendix does not have a screening program and, because it is poorly located for standard imaging techniques, most tumors are discovered unexpectedly after appendicitis .

The initial symptoms (diffuse abdominal pain, bloating, or changes in bowel habits) are so common that they are often mistaken for minor discomfort , delaying medical consultation and increasing the likelihood of diagnoses in advanced stages.

Maintaining a healthy weight, moving daily, and monitoring any persistent pain is, for now, the best way to buy time against this silent adversary.

Holowatyj points out that 77% of patients presented with some abdominal symptoms months before the tumor was discovered and insists: "There is an opportunity and a window for intervention there." Maintaining a healthy weight, exercising daily, and monitoring any persistent pain remains, for now, the best way to buy time against this silent adversary.