This is tricky business. Since 1992, the diagnoses of eight cancers in people under 50 has doubled in the U.S. Those cancers include thyroid, anus, kidney, small intestine, colorectum, endometrium (uterus), pancreas and myeloma (blood cancer). Breast cancer is also on the rise.
But here’s the thing: some cancer specialists say this surge
is the result of an “epidemic of detection”—finding cancers that wouldn’t have
killed patients. One doctor notes, “The epidemic narrative not only exaggerates
the problem, but may also exacerbate it. While more testing is often seen as
the solution to an epidemic, it can just as easily be the cause.” As another doctor
noted, “We are a very imaging-happy society.”
Not every cancer is dangerous. Some go away on their own;
others stop growing or pose no risk. Autopsy studies repeatedly find that many
people die with small cancers they were unaware of. Prostate cancer is one of
these; so is thyroid cancer. The problem is that it’s impossible to know if
someone’s cancer will be deadly or not, and if the cancer is gone after
treatment, there’s no way to know if it needed to be treated.
Other doctors believe the surge in cancer diagnoses is real and serious. While the death rates for six of the cancers mentioned in the first paragraph are flat or declining, the death rates of colorectal and endometrial cancers have increased. Some scientists attribute this increase to the obesity epidemic, or something amiss in people’s microbiomes, or toxins in the environment. They’re trying to figure it out.
For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.
