Over four decades, cancer quietly became the leading disease-related killer of adolescents and young adults in the United States — a generation too often overlooked by medicine's traditional divisions between childhood and adulthood. Researchers tracking nearly half a million cases found a 30 percent rise in diagnoses between 1973 and 2015, with kidney, thyroid, and gastrointestinal cancers emerging where they were once rarely seen. The data asks a difficult question that science has not yet fully answered: what is changing in the world these young people inhabit, and why is their bodies beari
Cancer cases among teens and young adults surge 30% over four decades
Cancer is the leading cause of disease-related death in adolescents and young adults, with rising incidence rates creating increased mortality risk in this age group.
Cancer is the leading cause of disease-related death in this age group
Mark
Why does it matter that adolescents and young adults are treated separately from children or older adults?
Mimi
Because their bodies, their life circumstances, and their cancers are genuinely different. A 25-year-old with testicular cancer needs different counseling about fertility than a 65-year-old. The side effects that matter to someone starting a career are different from those that matter to a retiree. Right now, they're often squeezed into adult protocols designed for people 20 years older.
Mark
The data shows kidney cancer rising fastest. Do we know why?
Mimi
Not yet. That's the uncomfortable part. It could be environmental—something in the water or air. It could be dietary. It could be that we're just better at finding it now. But the fact that it's rising specifically in this age group, and not equally across all ages, suggests something is actually changing, not just our ability to detect it.
Mark
Is 30 percent over 40 years a dramatic increase?
Mimi
It depends on your baseline. If cancer was rare in this age group to begin with, even a 30 percent rise might still mean relatively few cases. But cancer is already the leading cause of disease-related death in teenagers and young adults. So yes, when the leading killer is getting more common, that's dramatic.
Mark
What would targeted screening look like?
Mimi
Right now, a 20-year-old with abdominal pain might not get screened for kidney cancer because doctors aren't trained to think of it in that age group. Targeted screening means teaching clinicians to recognize warning signs in younger people, and developing guidelines that say: watch for these symptoms in this population. It's about changing what doctors expect to see.
Mark
Could this trend reverse?
Mimi
Only if we understand what's driving it. If it's environmental, we'd need to identify and reduce the exposure. If it's dietary, prevention messaging could help. But right now, we're still in the dark. The research is a map of the problem, not yet a solution.
Il Polso
- Cancer diagnoses in 15-to-39-year-olds climbed from 57 to 74 per 100,000 over four decades — a 30 percent surge that has made cancer the top disease-related cause of death in this age group.
- Kidney cancer is rising faster than any other type in young people, while thyroid and gastrointestinal cancers — once considered rare in this population — are becoming measurably more common.
- A critical gap in care persists: adolescents and young adults are routinely folded into pediatric or adult treatment protocols that were never designed with their distinct biology and risk profile in mind.
- Researchers point to environmental exposures, dietary shifts, and evolving screening practices as possible drivers, but no single cause has been identified — leaving the trend without a clear intervention point.
- Penn State's Dr. Nicholas Zaorsky is calling for prevention, screening, and treatment guidelines built specifically for this age group, warning that without targeted action, the upward trajectory is likely to continue.
Over four decades, cancer quietly became the leading disease-related killer of adolescents and young adults in the United States — a generation too often overlooked by medicine's traditional divisions between childhood and adulthood. Researchers tracking nearly half a million cases found a 30 percent rise in diagnoses between 1973 and 2015, with kidney, thyroid, and gastrointestinal cancers emerging where they were once rarely seen. The data asks a difficult question that science has not yet fully answered: what is changing in the world these young people inhabit, and why is their bodies bearing the cost?
Between 1973 and 2015, researchers at Penn State College of Medicine tracked nearly half a million cancer cases in Americans aged 15 to 39, drawing on decades of data from the National Cancer Institute's surveillance program. Their finding was stark: new diagnoses rose 30 percent over that period, climbing from 57 to 74 cases per 100,000 people. Cancer has become the leading cause of disease-related death in this age group, and the trend shows no sign of reversing.
The rise is not evenly distributed. Young men are most commonly diagnosed with testicular cancer, melanoma, and non-Hodgkin lymphoma; young women face higher rates of breast, thyroid, cervical, and uterine cancers. But the steepest climbs are happening in cancers once considered rare for this population — kidney cancer above all, followed by thyroid and gastrointestinal cancers. The reasons remain elusive, with researchers pointing to possible environmental exposures, dietary changes, and shifts in screening practices over the four decades studied.
At the center of the research is a structural problem in medicine itself. Adolescents and young adults occupy an awkward middle ground — no longer children, not yet older adults — and are routinely absorbed into clinical protocols designed for one group or the other. Dr. Nicholas Zaorsky, who led the study, argues this is a fundamental failure. Without guidelines built specifically for this population, diagnoses may arrive late and treatments may fall short of what these patients actually need.
Published in JAMA Network Open in December 2020, the study is a call to reorient how medicine sees this generation. Zaorsky urges clinicians to remain alert to these cancers in younger patients, and calls for dedicated research into why kidney and thyroid cancers are rising — and what environmental or dietary forces may be driving the shift. Until those answers emerge, the trend is likely to continue claiming young lives at a rate that few would have predicted a generation ago.
Between 1973 and 2015, cancer diagnoses among teenagers and young adults in the United States climbed steadily upward. Researchers at Penn State College of Medicine tracked nearly half a million cases in people aged 15 to 39, pulling data from the National Cancer Institute's long-running surveillance program. What they found was sobering: the rate of new diagnoses jumped from 57 cases per 100,000 people to 74 per 100,000—a 30 percent increase across four decades. For this age group, cancer has become the leading cause of death from disease, and the trend is accelerating.
The pattern is not uniform across cancer types. Among young men, testicular cancer, melanoma, and non-Hodgkin lymphoma remain the most frequently diagnosed. Young women face higher rates of breast, thyroid, cervical, and uterine cancers. But the most alarming shifts are happening elsewhere. Kidney cancer is rising faster than any other type. Thyroid and gastrointestinal cancers are climbing too. These are cancers that were once considered rare in this population, yet they are becoming measurably more common.
Dr. Nicholas Zaorsky, an assistant professor of radiation oncology and public health sciences at Penn State, emphasizes that adolescents and young adults occupy a distinct place in cancer medicine—neither children nor older adults, yet often lumped together with one group or the other in research and treatment protocols. "They are often grouped together with pediatric or adult patients in research studies," Zaorsky noted. "It is important to study how this group is distinct so that care guidelines can be developed to address the increase in cases." The problem is practical: if clinicians are not specifically trained to recognize and treat cancers in this age group, diagnosis may come late, and treatment may not be optimized for their particular needs.
The reasons for the increase remain unclear. Zaorsky points to several possibilities: environmental exposures, changes in diet, or shifts in screening practices over the four decades studied. Each of the rising cancer types has its own risk profile, making it difficult to pinpoint a single cause. What is clear is that the trend demands attention. "Our data reinforces the fact that clinicians should be on the lookout for these cancers in their adolescent and young adult patients," Zaorsky said.
The research, published in JAMA Network Open on December 1, 2020, calls for a fundamental shift in how medicine approaches this population. Rather than adapting pediatric or adult protocols, Zaorsky argues, the field needs prevention, screening, diagnosis, and treatment strategies built specifically for teenagers and young adults. That means understanding why kidney cancer is rising, why thyroid cancer is becoming more common, and what environmental or dietary factors might be driving these shifts. Until those questions are answered, the trend will likely continue—and young people will continue to face a disease that was once considered rare in their years.
Citazioni salienti
Adolescents and young adults are a distinct cancer population. But they are often grouped together with pediatric or adult patients in research studies.— Dr. Nicholas Zaorsky, Penn State College of Medicine
Our data reinforces the fact that clinicians should be on the lookout for these cancers in their adolescent and young adult patients.— Dr. Nicholas Zaorsky
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