City of Hope Orange County Report Reveals Concerning Trends About Cancer in Younger Adults in Southern California

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City of Hope Orange County, the most advanced cancer research and treatment organization in Orange County with two locations in Newport Beach, has released a report that evaluates the cancer incidence rate in people ages 18 and 49 in Orange County and Southern California amid a national epidemic of early-onset cancer diagnoses.

“The Younger Face of Cancer” report reveals that Orange County — despite its reputation for healthy living — has the highest overall rate of cancer incidence in people under 50 compared to Los Angeles, Riverside, San Diego and San Bernardino Counties.

Across the United States, early-onset cancer, which is defined as disease occurring between ages 18 and 49, is on the rise for cancers of the uterus, colon and rectum, breast, pancreas, stomach, kidney and renal pelvis and cervix.

“This is a startling paradigm shift,” says Edward S. Kim, M.D., M.B.A, physician-in-chief, City of Hope Orange County. “We are seeing a deeply concerning rise in adult early-onset cancer. It is imperative to identify the reasons behind this trend, educate the public, advance prevention and early diagnosis and develop more effective treatments.”

A recent American Cancer Society report found that people under 50 were the only age group in the United States with an increase in overall cancer incidence from 1995 to 2020.

The incidence rates for cancer in people under 50 in Orange County are the most pronounced in breast, colon and lung cancer:

  • Breast cancer rates are increasing for women under 50 in Orange County. Orange County has the 13th highest incidence rate in the state with this disease type. By comparison, Los Angeles County ranked 26th in the state.
  • Orange County ranks 25th in the state for colon cancer incidence rates under 50, above Los Angeles, San Bernardino, and San Diego County. The rate of early onset colon cancer is rising and threatening to nudge Orange County even higher.
  • Orange County has one of the highest incidence rates of lung cancer in women under 50 in California, ranking fifth in the state — although data suggests a downward trend.

“Sedentary lifestyles and consumption of processed foods and alcohol are likely contributing factors,” said Misagh Karimi, M.D., a medical oncologist at City of Hope Orange County Lennar Foundation Cancer Center who specializes in colon cancer. “We see that about half of our younger patients diagnosed with colon cancer are overweight.”

Environmental carcinogens pose additional risk: The government’s most recent Report on Carcinogens lists 256 substances and exposure circumstances known or reasonably anticipated to cause cancer in humans.

“There is evidence that some toxic exposures happen as early as in the womb or even in preconception germ cells. However, we have reason to believe changes to diet and lifestyle, especially in youth and early adulthood, could make a significant difference,” Kim says.

Researchers point to the importance of taking care of the gut’s microbiome—the internal mechanism responsible for the absorption of vitamins, regulation of the immune system and assistance with food digestion. Microbiome health can improve by not eating ultraprocessed foods (now 60 percent of most American adult diets), exercising to prevent obesity and avoiding alcohol and smoking.

“This is a concern to all of us at City of Hope and it’s a concern to me as a member of this community and as a mother and a grandmother,” said Annette M. Walker, president, City of Hope Orange County.  “It is counterintuitive to our goal of reducing cancer risk for each successive generation. As the region’s most advanced cancer treatment and research organization, City of Hope is as focused on preventing cancer as we are on treating and curing it. We know the best way to treat cancer is to prevent it in the first place.”

Walker says she is encouraged by changes to screening guidelines that have lowered the recommended age for colon cancer screenings from 50 to 45 for people of average risk and mammograms from 50 to 40.

A cancer diagnosis is difficult, but it hits younger survivors especially hard.

“Younger people often face issues such as fertility preservation, managing employment and childcare duties, changes in physical function and body image,” says Irene Morae Kang, M.D., medical director of women’s health medical oncology at City of Hope Orange County. “These can be significant issues for our patients across the age spectrum but may specifically impact younger patients.”

Innovative treatments for early-onset cancers are also emerging from research at NCI-designated comprehensive cancer centers like City of Hope, including:

  • A simpler colorectal screening ¬- Fear of colonoscopy screenings can get in the way of early detection of colon cancer. New research by scientists at City of Hope may point to noninvasive and inexpensive methods to detect colorectal cancer at an earlier and more treatable stage.
  • Gut response – Recent insights into gut microbiome health are revolutionizing the approach to preventing and treating colorectal and other cancers. A healthy gut microbiome acts as a protective shield against intestinal infections and inflammation, potentially contributing to tumor development. Additionally, the gut microbiome plays a pivotal role in augmenting the effectiveness of cancer immunotherapy.
  • The investigational pill with enormous potential punch – An experimental pill that has eliminated malignant cancer cells and prevented their resurgence in laboratory and mouse models is in human safety testing in a Phase 1 clinical trial, according to City of Hope researchers. The newly-discovered, cancer-inhibiting investigational medicine known as AOH1996 has been shown in preclinical research to bring all cancer growth to an abrupt standstill. Its capabilities in humans will be discovered in later-stage clinical trials.

City of Hope is an NCI-designated comprehensive cancer center and one of the country’s largest cancer research and treatment organizations. City of Hope Orange County provides access to 600 physicians and more than 1,000 researchers and scientists who only focus on cancer and more than 800 clinical trials each year. City of Hope’s Orange County network includes City of Hope Orange County Lennar Foundation Cancer Center and four regional clinics including two in Newport Beach.


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