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Time of India
13-07-2025
- Health
- Time of India
Appendix cancer is no longer rare for millennials and Gen X: Study
Appendix cancer Once regarded as exceedingly rare, appendix cancer, specifically appendiceal adenocarcinoma (AA), is now rising sharply in younger adults, especially among Gen X and millennials. A new retrospective study conducted by researchers at Vanderbilt University Medical Center and published in the Annals of Internal Medicine has brought this unsettling trend to light. What is Appendiceal Adenocarcinoma Appendiceal adenocarcinoma is a rare form of gastrointestinal (GI) cancer that begins in the appendix, a small, finger-like pouch connected to the large intestine. While traditionally considered uncommon, affecting about 3,000 people per year in the U.S., AA now appears to be increasing at an alarming rate, especially among adults under 50. Study finds significant appendix cancer surge in post-1945 birth cohorts A study published in Annals of Internal Medicine examined birth cohort patterns across 21 overlapping generations using data from eight SEER cancer registries, examining 4,858 confirmed cases of primary AA in patients aged 20 and older from 1975 to 2019. Read the primary findings from the study: Individuals born in 1980 had a more than 3-fold increase in AA incidence compared to those born in 1945. For those born in 1985, the rates were over 4.5 times higher. This pattern shows that people born after 1945 are more likely to develop appendix cancer, possibly because of changes in lifestyle or the environment that have affected these generations differently. Possible reasons for rise in appendix cancer rates Dr. Andreana Holowatyj , lead researcher and assistant professor at Vanderbilt University Medical Center, stressed that the increase is not simply due to more appendectomies being performed. Surgical removal rates have remained relatively stable, indicating that external factors, not detection bias, are likely contributing to the surge. Although the exact cause remains undeciphered, professionals point to several potential causes: Increased consumption of ultra-processed foods, sugary drinks, and processed meats. Rising rates of obesity and metabolic syndrome both linked to cancer development. Environmental exposures, including pollutants, microplastics, and changes in gut microbiota. These lifestyle and environmental changes, especially among people born after 1945, are believed to be part of a wider pattern affecting GI health in younger populations. Why appendix cancer is so difficult to detect Diagnosing appendix cancer is quite difficult and often misdiagnosed because it often presents with non-specific symptoms and currently lacks reliable screening methods. At present, there are no blood or urine tests that can accurately detect it, making early identification difficult. In the majority of cases, appendix cancer is discovered incidentally, during surgery for other conditions such as appendicitis. In other situations, the disease may only be identified after it has spread to the abdomen, causing more visible symptoms like: Abdominal pain or bloating Fluid buildup (ascites) Unexplained weight loss Fatigue and digestive discomfort To confirm if someone has appendix cancer, doctors usually need to take a small tissue sample from the appendix, called a biopsy. Scans like CTs aren't always helpful in spotting this cancer early. That's because appendix cancer doesn't usually form a solid lump like other cancers. Instead, it spreads out in thin layers, making it harder to see. As Dr. John Paul Shen puts it, 'It's like painting the walls of a room with cancer. ' The difficulty in diagnosing is preceded by the early symptoms, like bloating, loss of appetite, or changes in digestion, that are vague and easy to overlook. Because of this, many people are diagnosed late, when treatment becomes more difficult. Potential causes under study Professionals, including Dr. Andrea Cercek from Memorial Sloan Kettering Cancer Center, suggest that environmental causes, such as: Food and water contamination Microplastics Sedentary lifestyle Highly processed diets As of now, the exact causes of appendix cancer remain unknown; scientists are urging further research into environmental exposures, genetic predispositions, and molecular changes that may play a role in its development because researching more into these factors could pave the way for earlier detection and help reduce the increasing risk among younger generations. Also read | The rise of colorectal and other GI cancers in young people
Medscape
24-06-2025
- Health
- Medscape
Amelanotic Melanoma Tied to Worse Survival
TOPLINE: Patients with amelanotic melanoma showed poorer disease-specific survival (DSS) than those with melanotic melanoma in a Surveillance, Epidemiology, and End Results (SEER) database analysis. METHODOLOGY: Researchers analyzed data on patients with invasive cutaneous amelanotic melanoma (n = 1598) and melanotic melanoma (n = 417,974) from the SEER 17 database between 2000 and 2021. Patients with amelanotic melanoma were older at diagnosis and presented with more advanced-stage disease than those with melanotic melanoma (regional/distant stages: 26.8% vs 12.4%), ulceration (35.6% vs 13.1%), and Breslow thickness > 2 mm (42% vs 17%). The primary outcome was DSS. TAKEAWAY: Five-year DSS was significantly lower in patients with amelanotic melanoma (78.6%) than in those with melanotic melanoma (91.3%; P < .001). Patients with amelanotic melanoma carried a 31% higher risk for mortality after adjusting for sex, age, and stage (P < .001). Among those with amelanotic melanoma, men (hazard ratio [HR], 1.38; P = .014 vs women) had a higher disease-specific mortality, and mortality was higher among adults aged 85 years and older (HR, 1.86; P = .002 vs patients aged 45-64 years). Amelanotic melanoma diagnoses made 2011 onward were associated with a lower mortality risk (HR, 0.55; P < .001) than those diagnosed before 2011, with 2-year DSS for distant metastases more than doubling from 26.4% during 2000-2005 to 58.8% during 2016-2021. IN PRACTICE: 'This study underscores the poorer survival outcomes associated with AM [amelanotic melanoma] compared to MM [melanotic melanoma] and highlights a potential survival improvement following the availability of immunotherapy,' the study authors wrote. They called for prospective trials 'to validate these findings and guide tailored management strategies for AM.' SOURCE: The study was led by Trang M. Nguyen, MD, National Hospital of Dermatology and Venereology, Hanoi, Vietnam, and was published online on June 12 in Journal of the American Academy of Dermatology. LIMITATIONS: Limitations included selection bias and limited follow-up for recent cases. DISCLOSURES: The authors reported having no funding sources or relevant conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
17-06-2025
- Health
- Medscape
CRC Outcomes Better When First of Multiple Cancers
Colorectal cancer (CRC) survival is longer when it's the first of multiple primary malignancies than when it's the second or solo, new data suggest. The findings came from a retrospective analysis of data from the Surveillance, Epidemiology, and End Results (SEER) database of more than half a million people in the US with primary CRC. They were divided into three groups: Group A, with CRC as their only malignancy; group B, with CRC as the first with one or more subsequent primary malignancies; and group C, with CRC as the second of multiple primary malignancies. The finding that Group B had the highest 5-year survival of the three groups is novel and surprised the authors, but they have some theories to explain it. 'We potentially thought group A would do the best, seeing as they only had one type of cancer. But what we found…is that [group B] actually had the best survival outcome. It could have something to do with the tumor characteristics at a molecular biological level, or potentially because of increased surveillance from having colorectal cancer first,' first author Anjelli Wignakumar, MD, told Medscape Medical News . On the other hand, those in group A tended to be younger and to present with more aggressive disease, although they still fared better than did those in group C. 'There are lots of potential explanations,' said Wignakumar, a clinical research fellow in Colorectal Department, Cleveland Clinic, Weston, Florida. Clinically, the takeaway is for comprehensive screening for other types of cancer in people with primary cancers, and in particular screening for CRC in people with other primary cancers. 'Depending on the patient's family history and other things, increasing that screening hopefully increases our risk of picking up something earlier,' she said. Of the total 592,063 patients with CRC in SEER from 2000-2020, 71.8% were in group A, 11.9% in group B, and 16.3% in group C. Group B included a higher proportion of men (57.1% vs 51.8% and 53.1% for A and C, respectively; P < .001). Group A was significantly younger at CRC presentation (65.7 years vs 67.3 years and 72.6 years, for B and C, respectively; P < .001). Those in group A were more likely to have elevated pretreatment tumor marker carcinoembryonic antigen (49.7% vs 43.2% and 46.9%, in B and C, respectively; P < .001) and presented more often with liver metastases (17.5% vs 7.4% and 12.1%, respectively; P < .001) or lung metastases (6.3% vs 2.5% and 4.2%, respectively, P < .001). Right-sided CRC, which has been associated with worse survival compared to left-sided, was more common in group C (38.6%), while left-sided colonic cancer, associated with better survival, was more common in group B (37.9%). Both were significant compared to the other groups ( P < .001). Surgical treatment was recommended significantly ( P < .001) more often for group B (20.5%) than for groups A (13.0%) or C (14.3%), while systemic adjuvant therapy was given significantly ( P < .001) more often to those in group A (29.0%) than groups B (27.8%) or C (21.3%). Compared to group B, overall 5-year mortality hazard ratios were 1.26 for group A, which could be attributed to their more advanced disease, the authors said. Those in group C also had higher 5-year mortality (1.66). Those were both statistically significant, with similar trends for cancer-specific mortality. Mean 5-year survival was 50.4 months for group B, significantly ( P < .001) longer than the 41.8 months for group A and 39.2 months for group C. In their discussion in the paper, Wignakumar and colleagues presented a variety of hypotheses about the findings, including that group B might have a distinct immune profile that 'enhances their ability to survive multiple cancers and potentially improve their responsiveness to treatment.' Alternatively, 'Patients who develop a second primary cancer have already demonstrated resilience, having endured the physical and emotional challenges of their initial cancer treatment. This experience may reflect a stronger baseline health status and the benefits of previous successful interventions, contributing to potentially better survival outcomes compared with those facing cancer for the first time.' Wignakumar had no disclosures.
Arab Times
15-06-2025
- Health
- Arab Times
Rare appendix cancer increasing in younger adults, research shows
NEW YORK, June 15: Though still extremely rare, appendix cancer is becoming more common, particularly among younger generations, according to a new study published in the Annals of Internal Medicine. An analysis of data from the National Cancer Institute has revealed that rates of appendix cancer have tripled among Generation X and quadrupled among millennials when compared to older generations. 'There is a disproportionate burden of appendix cancer among young individuals,' said Dr. Andreana Holowatyj, the study's lead author and assistant professor of hematology and oncology at Vanderbilt University Medical Center and Vanderbilt Ingram Cancer Center. Holowatyj noted that earlier research had already shown that one in three appendix cancer cases occurs in adults under 50, a significant contrast to colorectal cancer, where only one in eight cases affects those under 50. Appendix cancer remains extremely rare, with the National Cancer Institute estimating an annual incidence of only 1 to 2 cases per million people in the U.S. To examine trends over time, Holowatyj and her team analyzed data from the Surveillance, Epidemiology, and End Results (SEER) program, which covers nearly half of the U.S. population. Between 1975 and 2019, a total of 4,858 appendix cancer cases were recorded. The generational increase in younger patients diagnosed with appendix cancer highlights the urgent need to investigate underlying causes, Holowatyj said. 'It's important that we find the causes underpinning these statistics in order to reverse this trend and reduce the disease burden.' Experts say this pattern reflects a broader rise in gastrointestinal cancers among younger adults. Dr. Andrea Cercek, co-director of the Center for Early Onset Colorectal and GI Cancers at Memorial Sloan Kettering Cancer Center, emphasized that while the exact cause remains unclear, environmental and lifestyle factors may be playing a role. 'It's likely that there are environmental causes, including exposures through food, water, and microplastics, as well as lifestyle and dietary changes,' Cercek said. 'It's probably not one single factor but multiple contributing elements since 1945.' The appendix, a small pouch attached to the large intestine, is best known for causing appendicitis. Unlike other gastrointestinal cancers, appendix cancers are harder to detect on scans or through colonoscopy. Dr. Deborah Doroshow of the Icahn School of Medicine at Mount Sinai noted that most appendix cancers are not identified until after a patient undergoes surgery for appendicitis. 'About 95% of appendix cancers are discovered only after removal and pathological examination of the appendix,' Holowatyj added. This typically results in later-stage diagnoses and poorer outcomes. Doroshow, who was not involved in the study, stressed the importance of paying attention to subtle symptoms, especially among younger people. Persistent fatigue, unexplained pain, or weight loss should not be overlooked. 'If a person feels something is wrong, it's always best to seek a medical opinion,' Doroshow said. 'We've seen young patients with cancer who were initially dismissed because of their age.' She also urged women and people of color to advocate for themselves, as their concerns are more likely to be underestimated. Still, Doroshow cautioned against overreacting to occasional discomfort. 'Not every abdominal pain is a cause for concern,' she said. 'It's the persistent or unusual symptoms that should prompt evaluation.'
New York Post
11-06-2025
- Health
- New York Post
Rare cancer diagnoses surge dramatically among millennials, Gen X
A rare type of cancer is growing among millennials and members of Generation X, new research shows. Diagnoses of appendix cancer have tripled in the US for people born between 1976 and 1984 — and it has quadrupled for those born between 1981 and 1989. Advertisement The study was published on Monday in the Annals of Internal Medicine. Researchers from the Vanderbilt University Medical Center analyzed data from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) Program to arrive at these findings. 'When you take these alarming rates that we are seeing for appendiceal cancer across generations, together with the fact that one in every three patients diagnosed with appendiceal cancer is diagnosed under the age of 50, these point to a timely need for everyone to be aware of the signs and symptoms of appendix cancer,' said lead author Andreana Holowatyj, PhD, assistant professor of Medicine at Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, in a press release from the university. Cancer of the appendix is rare, affecting only about one or two people per million each year in the US, according to the National Cancer Institute (NCI). Even so, doctors emphasize the importance of seeking medical attention if symptoms emerge. Advertisement 3 Appendix cancer has been rising among members of Generation X and millennials. Chinnapong – 'Ruling out the possibility of an appendix cancer diagnosis, or diagnosing it early, is important for this cancer as we continue to learn what factors may be contributing to this worrisome trend,' Holowatyj said. Appendiceal cancer forms in the appendix, which is a small organ located in the lower right abdomen. There are two main types: epithelial appendiceal cancer, which involves the cells of the lining of the appendix, and neuroendocrine appendiceal cancer, which results from the growth of neuroendocrine (carcinoid) tumors of the appendix, the NCI states. Advertisement In early stages of the disease, most people do not notice symptoms. 3 The rates have tripled in the US among people born between 1976 and 1984 — while quadrupling for those born between 1981 and 1989. Peakstock – As the cancer progresses, common symptoms include pain, a bloated feeling, a mass in the abdomen, nausea and vomiting, and sudden feelings of fullness while eating, according to the above source. Common treatments for this type of cancer include surgery to remove the appendix and any other affected organs, as well as chemotherapy to kill any metastasized cancer cells. Advertisement Based on the study findings, the researchers are calling for increased awareness among both the public and the medical community. 'As incidence rates in younger generations are often indicative of future disease burden, these results support the need for histology-specific investigations of appendiceal adenocarcinoma, as well as increased education and awareness of appendiceal adenocarcinomas among healthcare providers and the public,' the study stated. 3 Annals of Internal Medicine published the study on Monday, as researchers from Vanderbilt University Medical Center analyzed data from the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) Program. charnsitr – There are no standard screening guidelines or risk factors for appendix cancer, which means up to half of diagnoses occur after the disease has already spread, according to the researchers. Five-year survival rates for appendix cancer range from 10% to 63%. The new study received funding from the Appendix Cancer Pseudomyxoma Peritonei (ACPMP) Research Foundation and the National Institutes of Health.
