First, it was Olivia Munn, then Kate Middleton. A rash of high-profile people under 50 have been getting cancer and many people are worried.
Is cancer becoming more common among younger adults? And if so, what’s causing the increase?
TOPICS (0:48) How worried should we be about an increased incidence of cancer among young people? (3:52) What are the causes of rising cancer rates? (5:52) What role do environmental factors play in cancer rates? (12:33) Opioids, addiction, and policy issues
🎙️⚕️ABOUT CARETALK CareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (Senior Advisor, Walgreens Health) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy.
First, it was Olivia Munn, then Kate Middleton. A rash of high-profile people under 50 have been getting cancer and many people are worried.
Is cancer becoming more common among younger adults? And if so, what’s causing the increase?
TOPICS (0:48) How worried should we be about an increased incidence of cancer among young people? (3:52) What are the causes of rising cancer rates? (5:52) What role do environmental factors play in cancer rates? (12:33) Opioids, addiction, and policy issues
🎙️⚕️ABOUT CARETALK CareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (Senior Advisor, Walgreens Health) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy.
First, it was Olivia Munn, then Kate Middleton. A rash of high -profile people under 50 have been getting cancer, and everyone is worried. Is cancer becoming more common among younger adults? And if so, what's causing the increase? you Welcome to Care Talk, America's home for incisive debate about healthcare business and policy. I'm David Williams, president of Health Business Group. And I'm John Driscoll, senior advisor at Walgreens Health. Come join the fast growing Care Talk community on LinkedIn, where you can dig deep into healthcare business and policy topics, access Care Talk content, and interact with the hosts and sometimes with our guests. Please be sure to leave us a rating on Apple or Spotify while you're at it. We love those ratings. So David, how worried should we be? about an increased incidence of cancer among young people. I mean, these famous cases, I know, you know, it's not just, you know, when you're coursing through People magazine and looking at famous people who are sadly suffering, but the numbers are up for kids in cancer. Shouldn't we all be worried? We should be somewhat worried, John. The latest statistics I've seen that there is about 103 cancer diagnosis for a hundred thousand people in the U .S. under age 50 in 2019 versus in 2010, there were only about a hundred. So it's a 3 % increase over, you know, over nine years. So any amount is worrying, especially when you see that cancer diagnoses in older people, which is who mostly get cancer. So those have dropped off a little bit. So you see at the same time, you know, cancer is coming under control more with the older, you seem to see some increase in the younger. And I think it's, It's concerning, John, because this is cancer is very serious, life -threatening for people. So any increase is a concern. You'd like to be able to see it going down. Of course, those numbers also mask individual cases, which is why these high-profile ones make an impact. But also, there are some areas where there seems to be a big increase. One is in colorectal and other gastrointestinal cancers that are diagnosed about twice as often now. among people under 50 as they were in the 90s. And then breast cancer too has been rising. Some people think at around a 4 % per year for people under 50. I mean, what's, what's interesting is people typically thought of cancer as an old person's disease. The two most likely killers of you in the industrialized world and in the U S would be heart disease and cancer. It just, it's jarring that kids have to deal with these kinds of challenges. Um, what do you think is kind of, underneath all of this? Well, John, I mean, it's I think it's not completely fair to say that sort of like the new emphasis on kids and we haven't thought about before. Certainly in the past, you had like childhood leukemia was a big deal. And there's actually a lot of work that was done to make that more treatable and people can live a more less normal life. I think what's happening now is you've got people that are really kind of in the in the heart of life, you know, like not even necessarily middle aged, you know, 30s, early 40s, who are looked to be like complete paragons of health and then coming down with cancer. And so it is a worry. And I think what it says to us is there's some other factors that are out there is what people are concerned about and there may well be something to it. Well, I think one of the things that people should remember that while pediatric cancers and cancer in young people that the rates are going up and we should dig into that next. but our ability to actually manage, cure, and end cancer for healthy young people is actually improving over time. And so we're actually getting better and better at solving this horrible problem. But let's go to the roots of it, David. Why is this happening? It seems to be kind of multifactorial. In the past, you could point to pretty direct link between some cancers and some behaviors, and the most notable one being cancer, lung cancer being caused by cigarette smoking. And of course, that's still happening. So there are some things on the lifestyle side. And then there's some things on the environmental side. Believe it or not, John, obesity, which we know has been rising a lot. We've had, you know, recent shows about that is a is a contributor toward cancer and something like 40 % of adults under 40 have obesity now, coupled with lack of exercise. Percent. Yeah, you know how John they have George. They sometimes have these lists, you know, 40 under 40. Well, this is 40 % of people under 40 with obesity. Yeah, that's what's just happened over time. It's not. So, so you see more obesity. One of the things where I've obviously learned over time is that, you know, cancer loves sugar. Like often people who are going through cancer treatments are trying to suppress it will actually go off of sugar. And so a lot of the food, the, the industrial food machine that feeds our system, that's, that's sugar focused. corn and sugar focused is probably feeding the beast here. I don't know whether we can make draw that conclusion yet, but certainly I'd be digging in there. What do you think of that? I think it's one of the factors, you know, so processed foods, like that process, you know, ultra process. That's kind of the new term. Lack of exercise, drinking alcohol, believe it or not. Another one is giving birth earlier actually seems to be protective against cancer to some extent for women. And so with with women giving birth, later or not at all, that may also be a factor. So John, there's a lot of different things. And I think it would be a mistake to point just like at one thing and say, that's the problem. So there's these lifestyle issues. Then there are, is this other one that I actually get concerned more about in a sense, because it's harder to control as an individual, which is environmental exposure. So we talked about air pollution, microplastics, you know, which is what happens when you've got all these plastic containers and they get into tiny pieces in the ocean and then into our foods. Different food. What could, I mean, in micro and nanoplastics, do you really think that, can we really tie those to cancer? I know I'm gonna disappoint you, John, by not being able to put my finger at one particular thing. These are all items that are kind of introduced into the environment that are likely to play a role. It's hard to say how big of a role. And when you take an individual person, you're not gonna say it. So, you know, the examples we gave of people that got cancer, they're not obese. So, you know, you wouldn't just point to that. So yeah, I mean, I think these things are factors. And one of the scary things about it, and one of the reasons it's getting attention is there's some sense that, you know, something is going wrong. Why are more, you know, younger people getting cancer? I would say in a way, the cancer part, it's very dramatic and people talk about it. There are some other things that are increasing a lot faster and where you can definitely, where it's more certain even to point to the environmental factors. So one that I'm familiar with is, you know, in autoimmune diseases. So if you take, uh, inflammatory bowel disease, which is like Crohn's or ulcerative colitis. That's tripled in the past 20 years or so among younger people. And you've seen it everywhere where there's been industrialization that happens quickly. It's hard to say exactly what the cause of it is, but that's something that's affecting younger people where it's not like a 3 % increase. You know, it's a huge difference and where it seems quite likely that there's some environmental trigger. I mean, it's certainly worth, I mean, I know that you're afraid to take on the plastics industry, but one of the things that we're finding is there are micro plastics everywhere and that they take forever to kind of deteriorate and little pieces of them, including nanoplastics ones that are really quite small, less than one nanometer can get really embedded in people's or just be part of people's diet. And the challenge with a lot of plastics is that they can contain not by choice, just by accident, a lot of cancer causing elements like PCBs. I mean, what we're finding is plastic, because it doesn't go away, is sort of everywhere. And I suspect it could be causing one of our challenges. But I would guess that, to your point, it's macro factorial, multi and macro factorial. If the food you eat is processed or the air you... breathe is toxic, that's all going to play in. It's striking to me that the children are being struck more frequently as adults actually are moderating their lifestyles in a way that clearly is creating a better outcome. So what do we do about this, David? I think generally what we see is that these are ways to reinforce things that we should be doing anyway. So there's some things on the individual level and there's some things on the societal level. So... We talked about population health and the need to, you know, we talked about obesity kind of in general. When it's tied to cancer, then people might say, huh, okay, maybe that gives a new emphasis about what we're going to try to do about it. So it is about improving the diet, about enabling communities where it's easy to exercise, having that happen in school, maybe less alcohol would be good. I don't want to make the point too strongly because I don't think there's any particular evidence for it, but. There's a lot of interest now in experimenting with these weight loss drugs. We've already seen they have an impact most likely on cardiovascular health, a positive impact. Maybe you're going to see even the same thing with cancer or other things where obesity might be a factor. So you've got some things at the individual level that people can do differently. And then from a societal point of view, sometimes these environmental discussions can get fairly political, like it's a left versus a right point of view. But if you looked at, let's say, electric cars from the standpoint of, is it going to make the air cleaner and you're going to have fewer pollutants around because that might help to reduce cancer, maybe that's a good reinforcing argument for them. Well, I think it's a little bit easier if you can tie it to kids. Everybody wants to protect their children. And then I think hopefully it gets a little less political. The challenge with a lot of these public health arguments that affect, that drive to... recommendations on policy is you can't tie necessarily the specific thing you want to restrict control, regulate to the killing of a child or the illness of a child. But our kids are getting sicker and we've got to be paying attention to these trends because they're growing. I mean, look at some of the incidents of autoimmune disease. It's hard to argue that some of the same multifactorial inputs aren't creating the massive increase in autoimmune diseases across the population. John, I think I'm going to, again, kind of make the distinction between the kids, adolescents maybe, and young adults or people that are really in their prime. I don't think anybody actually cares about kids. When you look at it from a kind of a policymaking standpoint, there's a lot of talk about save the children, et cetera. But really, they don't vote. And they don't actually get that much attention, that much resources. Just what they should. I'm just, I'm just a reflection of the society in which I exist, John. But I think that when you've got people in their thirties or forties who are really kind of right out there, they are voting, they have economic power, uh, they have influence. Then there's actually, I actually think that this is going to be more effective than the kids thing. We say, Oh, I'm doing something for the kids. That's nice. You know, as opposed to, Hey, I'm doing something for myself. That's actually going to be more powerful. I think there's a chance. I'm gonna call BS on that one, David. I think people do care about kids and even if they don't vote, our hearts are with them and it's a nonpartisan issue. I think this is a call to action that we need to look at what's going wrong because ultimately our children are our future. It's where our hearts are. Even though they don't vote, I think they do matter. I see that their kids are always the only future we ever have, but it doesn't mean that we care about them. Let's talk about one other one I wanted to bring up. You know, I was doing some research for this episode and was looking at the the incidence of opioid use and addiction seems to be actually dropping among maybe overall, but among younger people as well. And we think about like what have been the big rise in deaths? You know, opioids has been a big factor over the past decade or so. Do you have hope that, you know, I'm not sure it's tied in with, I don't think it's tied in with cancer diagnosis, but how do you think about things like the opioid epidemic or behavioral health epidemic impacting and kind of crossing over with the thinking about the policy issues here? I think the challenge, I break it into two different pieces. One, we've got a foreign policy problem of controlling our borders regarding fentanyl and opioids. We need to do a better job at, I mean, the amount of controlling. the amount of illegal supply of, you know, mortally damaging drugs from our borders. But I think that the issues of addiction, again, are a little bit more complicated. I'm actually hoping that drugs like Wigobi might be able to help cut the cycle of addiction. But the implicit tolerance of a growing drug -addled of youth and adult population, I think is something that's really dangerous. I don't think you can sort of understand it unless you tolerate and first come to understand why people are becoming addicts. But I do think that the opioid and dental mess is one that we could control through foreign policy. The other a little bit like alcohol is something that is a public health issue that we have to be honest about and offer people better ways to manage their lives. and drugs and not just, I don't think the just say no works. We need to find out why people are getting hooked on drugs and staying on it and give them off -ramps. I mean, the vast majority of anti-addiction centers have a very high failure rate. I just don't think we've spent enough time trying to figure out how people get hooked and how we help them get unhooked once they've made that decision. Well, that's it for yet another episode of Care Talk. We've been talking about the growing prevalence of cancer in younger adults, whether anybody cares about children and about opioids. I'm David Williams, president of Health Business Group. And I'm John Driscoll, senior advisor at Walgreens. And I do care about children. But whether you liked what you heard or you didn't, we'd love it if you subscribe on your favorite service.