Obesity and alcohol ‘driving up bowel cancer cases among young people in UK’

Obesity study

Obesity and alcohol are driving up bowel cancer cases among young people in the UK, researchers have warned.

Unhealthy lifestyles are contributing to cancer at an earlier age, they said, as they called for people to undergo screening sooner.

The new study also found concerns over bowel cancer death rates in women of all ages, which do not appear to be following the downward trend of many other cancers.

The research, published in journal Annals of Oncology, looked at European cancer death rates and those it the UK, comparing what death rates in 2024 could look like set against figures for 2018.

It found bowel cancer death rates for men and women aged 25 to 49 years would rise in Italy (by 1.5% in men and 2.6% in women), in Poland (5.9%) and among Spanish men (5.5%), and German women (7.2%).

It is alarming to see the high predicted rises in bowel cancer death rates, especially in younger people in the UK.

Dr Panagiota Mitrou

However, the UK showed a massive jump compared to these other countries, with a 26% expected rise in men and a 39% rise in women.

The researchers wrote: “In the UK, colorectal (bowel) cancer mortality decreased for all ages in the past decades.

“However, there was an increase for the 25 to 49 years age group since around 2000 in both sexes.”

Overall, death rates for all cancers when taken together are predicted to fall among both sexes in the UK, from 120.3 per 100,000 people to 103.7 per 100,000 people.

However, there are concerns about younger people and women when it comes to bowel cancer, with bowel cancer death rates among women refusing to budge.

The researchers said: “In the UK, projected ASRs (age standardised rates) for (bowel cancer) at all ages are favourable for men (3.4% versus 2018) but not for women (0.3%).”

We are taking strong action to encourage healthier food choices and to tackle obesity

DHSC

“Additional reasons are increases in heavier alcohol drinking over time in central and northern Europe and the UK, and reductions in physical activity.

“Alcohol consumption has been linked to early onset bowel cancer, and countries where there has been a reduction in alcohol consumption, such as France and Italy, have not experienced such marked rises in death rates from this cancer.

“Early onset bowel cancer tends to be more aggressive, with lower survival rates, compared to bowel cancer that is diagnosed in older people.

“National governments should consider strengthening policies to encourage increased physical activity, a reduction in the number of people who are overweight or obese, and a reduction in alcohol consumption.

“In terms of prevention, governments should consider the extension of screening for bowel cancer to younger ages, starting at ages 45 years.

“Screening programmes vary across Europe, but an increase in the incidence of bowel cancer among young people in the US has prompted the US preventive service task force to recommend lowering the age at which screening starts to 45 years.”

In England, people aged 60 to 74 are invited for bowel cancer screening and the programme is expanding to everyone aged 50 to 59.

But Professor Sir Mike Richards, former national cancer director at the Department of Health – who now advises NHS England, has said there is much work to do to improve diagnosis, treatment and survival.

He has said there is a need to reduce the threshold at which people are sent to have a colonoscopy diagnostic test for bowel cancer.

The NHS has set the sensitivity threshold for the FIT stool test at 120 micrograms of blood per gram of faeces in England, but Prof Richards says this should be 80 and even lower.

The lower the threshold, the more sensitive the test will be and the more cases of cancer can be picked up.

The FIT screening threshold is 80 micrograms of blood per gram of faeces in Scotland.

Dr Panagiota Mitrou, director of research, policy and innovation at the World Cancer Research Fund, said of the new study: “It is alarming to see the high predicted rises in bowel cancer death rates, especially in younger people in the UK.

“Early onset of cancer in younger people is also a concern, but not entirely surprising, given that young people are being exposed to risk factors early on in life, for example living with overweight and obesity.

“The reasons for the sex differences are unclear but need to be investigated in more detail.

“Promoting healthy habits such as a balanced diet low in fat sugar and salt, having a healthy weight from early on in life, and avoiding alcohol, as well as early detection, should be central to UK Government health policy and a comprehensive national cancer plan, which includes a strong focus on prevention, is of utmost importance.”

A Department of Health and Social Care spokeman said: “The independent UK National Screening Committee – which is made up of clinical experts – considers scientific evidence and makes a decision on age cohorts to ensure a programme does more good than harm.

“Harms from screening can occur through over-diagnosis…

“We are taking strong action to encourage healthier food choices and to tackle obesity, recognising that it increases the risk of a range of serious and chronic diseases and costs the NHS around £6.5 billion a year.”

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