Five theories about the staggering rise of cancer in the under-50s ...Middle East

One evening in late 2016, I found myself staring at Facebook in a state of shock. During my university years, I’d spent much of my time gigging my way around the pubs and clubs of Bristol as part of a jazz ensemble known as the Hornstars. One of my fellow bandmates was a highly talented trombonist called Oli, a keen triathlete and qualified diving instructor who was also one of the most athletic people I knew.

We’d lost touch since university, but on that night, I was curiously browsing social media to see what he was up to when I discovered that his page had become a “memorialised account”. Oli had died that summer from an aggressive neuroendocrine cancer [originating from hormone-producing cells] at the age of just 33. I was stunned, not only by the news of his death, but by the sheer speed of his demise – he died just five months after being diagnosed.

In recent years, I’ve been reminded of Oli’s story time and again when reading reports of the alarming rise of cancers in the under-50s. On 6 October, new research from the World Cancer Research Fund revealed that cases of seven types of cancer have risen sharply among younger people in England. It found that the number of people under 50 diagnosed with prostate cancer had quadrupled since 2011, while cancers of the bowel, kidney, and womb had doubled.

One major epidemiological study carried out by Chinese researchers using data from the Global Burden of Disease database, an international data collection summarising the leading causes of death and ill health across 204 countries, concluded that there has been a 79 per cent rise in so-called “young onset cancers” [defined as under 50] between 1990 and 2019. The cancers responsible for the most deaths and long-term disability were those of the breast, oesophagus, lung, bowel and stomach.

A paper by epidemiologists at the Institute of Cancer Research in London (ICR) found that this pattern is most evident when it comes to the rapidly rising cases of bowel cancer in young people. While bowel cancer has traditionally been a disease which occurs in people in their sixties and seventies, another study found that nearly 10 per cent of new cases of the disease are now occurring in people under 50.

This trend has been noted by NHS specialists up and down the country and is another that I have personal experience of – a journalist friend in his early forties was diagnosed with bowel cancer in 2024. “We’re definitely seeing an effect on the front line,” says Sofoklis Panteleimonitis, a NHS consultant colorectal surgeon at University Hospitals Birmingham. “I’ve treated numerous patients under 50 with bowel cancer now. It’s become a hot topic. I’ve only been a consultant for three years, but as a registrar, I don’t remember seeing so many young people with colorectal cancer.”

Panteleimonitis (pictured with his colleagues) says: ‘I’ve treated numerous patients under 50 with bowel cancer now. It’s become a hot topic’

Panteleimonitis looked into his records and since 2023, 10 per cent of the colorectal cancer patients he has operated on have been under 50. He is keen not to alarm the public, and stresses that these are not vast numbers, but they are notable as bowel cancer used to be vanishingly rare in younger age groups. He says that cases in the under-50s also tend to be much more aggressive and detected at a later stage, as screening is currently only carried out in the 50-74 age range.

Why is this happening? By and large, the rising trend of young-onset cancers is a mystery, one which oncologists around the world are scrambling to try and understand, but when it comes to bowel cancer at least, a handful of clues are starting to emerge. Here are the most common working theories.

Gut toxins and antibiotics

According to Professor Trevor Graham, director of the ICR’s Centre for Evolution and Cancer, the leading explanation for around half the cases of early-onset bowel cancer relates to something going wrong in the gut microbiome, the complex ecosystem of microorganisms that resides in our intestines.

In particular, certain strains of invasive gut bacteria, for example E.coli, Klebsiella pneumoniae and Citrobacter koseri, can produce a toxin called colibactin, which is capable of inflicting significant DNA damage on cells in the colon, making the development of cancer more likely.

Professor Trevor Graham says the leading explanation for around half the cases of early-onset bowel cancer relates to something going wrong in the gut microbiome

Last year, researchers at the University of California, San Diego published a study where they showed that signs of colibactin-related DNA damage are 3.3 times more common in bowel tumours found in patients under the age of 40, compared with older patients. This seemingly tell-tale finding suggests that in recent decades, colibactin-producing bugs have become more adept at taking residence in the human gut, and much earlier in life.

How are they getting there? One theory relates to the increasing use of antibiotics in childhood, with data indicating that the doses of antibiotics consumed by children under the age of five increased from 9.8 per 1,000 people in 2,000 to 14.3 in 2018. While antibiotics are life-saving drugs, they can also drastically reshape the gut microbiome by destroying swathes of resident species in a single swoop, making it easier for opportunistic pathogens to take hold.

“There’s evidence with these so-called bad bugs that if people are infected with them, that infection may well occur during childhood,” says Graham. “There has been increased use of antibiotics early in life, and it’s plausible that antibiotic use could deplete the microbiome a little bit and allow these bugs to invade.”

Graham is hoping to shed more light on this mysterious trend through his own research, utilising a unique archive of decades-old bowel tumour samples stored in the basement of St Mark’s Hospital in west London, dating from the 50s onwards. “We’re treating it like a time machine,” he says.

“We’re going to look for evidence of DNA damage caused by bad bugs in the gut, and what we expect to find is that this is almost never present in tumours from the 1950s, compared with roughly half of bowel tumours collected from young people today. If that is true, it will give some causative evidence that the bugs really are part of the cause.”

An archive bowel tumour set in wax

Different types of birth

The antibiotic theory is just one of many. Another is the increasing number of births by C-section, something which is thought to reduce gut microbiome diversity due to babies not being exposed to the ​​beneficial maternal vaginal and faecal bacteria in the vaginal canal.

One study in Sweden did identify an association between C-section birth and greater vulnerability to early-onset bowel cancer. However, far more research is still needed before firm conclusions can be drawn on this theory.

Ultra-processed foods (UPFs)

Some scientists have suggested that pesticides in our food may be to blame, while ultra-processed foods (UPFs), which have become steadily more abundant in our diets since the 1980s, have also been implicated as having a detrimental effect on the gut microbiome.

UPFs make up over half (approximately 53–57 per cent) of the daily calorie intake for the average adult in the UK. In 2025, researchers funded by the non-profit Cancer Grand Challenges published a study describing how people who consume up to 10 portions of UPFs a day – for example, through snacks, packaged breakfast cereals, fizzy drinks and ready meals – are more likely to develop bowel polyps, abnormal growths in the intestinal lining, which can progress into cancer.

“It may be that ultra-processed food influences the gut microbiome and its ability to maintain a healthy intestinal lining,” says Andrew Chan, a gastroenterologist and professor at Harvard Medical School, who led the study.

Forever chemicals

Some scientists have linked young-onset breast cancers to so-called forever chemicals or PFAS, the thousands of synthetic compounds found in everything from cosmetics to food packaging, which help make products resistant to water, stains and heat.

But as well as being useful in creating everyday items, these chemicals can also disrupt critical hormonal systems in the body by mimicking the hormone oestrogen.

Charity Breast Cancer UK says: “A large study that has looked at all the available evidence on PFAS to date has found that exposure to some PFAS (PFOA and PFHxS) may increase breast cancer risk, whilst the chemical PFNA may reduce risk. Another forever chemical, PFOS, currently has no link with breast cancer. It is important to note that most PFAS have never been tested, and their effects on human health are unknown.”

Technology and artificial light

Other researchers speculate that some of these cancers may be linked in part to another technology which has increasingly transformed society in recent decades – our constant exposure to sources of artificial light in the evening through smartphone and tablet screens.

Shuji Ogino, professor of pathology and epidemiology at Harvard University, describes this as a potentially novel carcinogen because it disrupts the body’s biological clock and impairs our sleep quality, something which has been linked to breast, colon, ovarian and prostate cancer.

“We are exposed to light a lot at night, even from when we’re babies, and that can have an adverse effect,” says Ogino.

What you can do

Of course, some early-onset cancers have a genetic component. Research suggests that 20 per cent of cancers diagnosed under the age of 35 are in some way linked to genetic predisposition, but this still leaves 80 per cent remaining.

Researchers are keen to emphasise that all of the above theories remain speculative, and so far, there is little concrete evidence linking anything to this trend.

Fast facts

Cancer rates in 25- to 49-year-olds in the UK increased by 24 per cent between 1995 and 2019, according to a 2024 analysis by Cancer Research UK.  Around nine in 10 cancer cases still happen in people over 50, but the under-50s are growing relatively, with around 35,000 under-50s diagnosed every year in the UK. That means approximately 100 younger adults were diagnosed every day between 2017 and 2019, says Cancer Research UK.  The percentage change is more than twice the 10 per cent rise in cancers in the over-75s, the group most at risk of the disease.

However, given the link Chan has identified between a high UPF diet and bowel polyps, it may be wise to cut down on UPFs and follow a diet rich in fermented foods and plant fibre, which can help restore microbiome diversity and nourish beneficial species.

Studies have repeatedly shown that rates of bowel cancer are lower in communities that consume more dietary fibre. Consuming more fibre is also beneficial for other reasons, for example, if you have antibiotics to treat a nasty infection, studies suggest that this kind of diet can help your gut to recover faster, repopulate lost species and be more resilient to pathogenic invaders.

As Graham points out, if his research does indeed confirm the “bad bug” theory, it would suggest that it’s all the more important to ensure that children are getting a healthy diet, especially if they’re exposed to antibiotics at a young age. “In terms of the bad bug idea, it could be about thinking about how to improve and maintain microbiome health, particularly early in life, so maybe kids should eat more yoghurt, that kind of thing.”

It’s now a decade on from Oli’s passing, and the terrifying rise of early-onset cancers has only become more starkly apparent to me. Not only through the stories of celebrities like van der Beek, but through other friends and acquaintances. Understanding exactly how and why this is happening to younger people, and how we can prevent it, will be one of the great public health challenges of the next decade.

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