Global trends in incidence, death, burden and risk factors of early-onset cancer

Having read the study, it does have a major flaw in its risk attribution approach, but the global data is pretty interesting, in particular this:<p>&gt; &quot;In 2019, after breast cancer, the digestive and respiratory systems of early-onset cancer were mainly responsible for the deaths.&quot;<p>However, it&#x27;s risk conclusion is that &quot;Dietary risk factors (diet high in red meat, low in fruits, high in sodium and low in milk, etc), alcohol consumption and tobacco use are the main risk factors underlying early-onset cancers.&quot; - but, they don&#x27;t even mention industrial and secondary exposures to carcinogenic chemicals, even though this has been a well-described cause of early-onset cancer for over 100 years, and of course the respiratory and digestive tract - which is where early-onset cancers are showing up - are obvious immediate targets for carcinogenic environmental pollutants. E.g.:<p>&quot;Outdoor air pollution and cancer: an overview of the current evidence and public health recommendations&quot; (2022)<p>&quot;Cumulative risk analysis of carcinogenic contaminants in United States drinking water&quot; (2019)<p>Any study that chooses to <i>completely ignore</i> this factor in favor of blaming the rising rates of early-onset cancer on &#x27;personal dietary choices&#x27; should be tossed in the trash, it&#x27;s the kind of thing an industrial PR group would generate in an effort to stop clean air&#x2F;water&#x2F;food regulations from being implemented.

I really appreciate the &quot;what was already known, what this study adds&quot; summary about a page down in this.

High BMI and high fasting glucose are a main risk factor, they write. Well what about reducing sugar and carbs altogether instead of promoting whole grains as they do?

The gorilla question: what has changed in the past 33 years to cause this increase? I&#x27;d look first at confounding variables like 33 years of improved methods to detect cancer earlier: the rise of MRI, screening for chemical signatures of cancer (like PSA), etc.<p>The abstract didn&#x27;t suggest the authors filtered out more recent methods of detection from their data (i.e. detections based only on 1990-era tests like physical exam, 2D X-Ray, etc).

Sort of surprising to see the main factor being dietary and only calling out some specific things but not others. No mention of hormones (or chemicals that act like them), toxins, etc as risks.

Under “what this study adds”:<p>&gt; <i>Dietary risk factors (diet high in red meat, low in fruits, high in sodium and low in milk, etc), alcohol consumption and tobacco use are the main risk factors underlying early-onset cancers.</i>

One key paragraph: Since 1990, the incidence and deaths of early onset cancers have substantially increased globally. Early-onset breast, tracheal, bronchus and lung, stomach and colorectal cancers showed the highest mortality and burden in 2019. Countries with a high-middle and middle Sociodemographic Index and individuals aged 40–49 years were particularly affected. Dietary risk factors (diet high in red meat, low in fruits, high in sodium and low in milk, etc), alcohol consumption and tobacco use are the main risk factors underlying early-onset cancers.

I bet this can all be explained by the negligence of government to protect the public against dangerous chemicals in the water, food, and consumer products because of lobbying by private industry.

At least from my view as a young millennial, drinking culture among gen x and younger boomers is enormous. Wouldn&#x27;t be surprised if that plays a role here.