Cancer’s New Generation: Why Are Younger People Getting Sick?

Oh, that can’t be good.

Shelby Bennoit’s heart sank when the iPhone in her server’s apron vibrated during a busy August afternoon shift at The Choptank in Annapolis. Seconds before, her Apple Watch had pinged with a message notification from Advanced Radiology. It was clear someone needed to get in touch with her, and Bennoit was filled with dread.

A few weeks earlier, Bennoit felt a lump in her right breast while folding her arms across her chest. She had just graduated from the University of Maryland College Park and was standing in front of the pantry in her childhood home looking for a snack. The lump was cause for concern, but Bennoit wasn’t overly worried. It was probably a cyst or maybe a swollen lymph node.

Still, just to be sure, she scheduled an appointment with her gynecologist, who immediately ordered an ultrasound test to check if the lump was a fluid-filled cyst or a solid mass. Two days later, Bennoit underwent a needle biopsy to check for cancer cells. Two days after that, her phone vibrated at work. Bennoit excused herself from the table of Choptank customers and hurried to a back corner of the restaurant’s kitchen to take the call from Ascension, even as her self-preservation instincts urged her to ignore it.

“Hello?”

Breast cancer. It was all Bennoit heard. The room started spinning. Her legs gave out. She felt her knees hit the floor as she sobbed. The diagnosis seemed impossible. Bennoit was only 22. She had no family history of cancer. She played field hockey and lacrosse in high school, ate healthy foods, worked out constantly, and didn’t party in college. By all accounts, she was the picture of health. Until now.

The drive home was a blur for Bennoit, who called ahead to marshal her parents and boyfriend. They were all confused. Scared. Helpless. And Bennoit began to spiral under the devastation of the news. Her phone vibrated again. This time, with a lifeline.

“Hello, Shelby? This is Dr. Fernandez at Ascension. Let’s talk.”

Dr. Kristen Fernandez, surgical director of the Ascension Saint Agnes Breast Center, called as soon as Bennoit’s test results hit her inbox. Bennoit was diagnosed with stage 2B triple-negative breast cancer, an aggressive form of the disease that occurs in only about one percent of women younger than 25.

“At that age, you’re supposed to be finishing college, finding your first job, and deciding what to wear out on a Friday night,” says Fernandez. “That’s the kind of stuff you should be worrying about—not cancer.”

Bennoit is part of an alarming increase in cancer diagnoses in patients younger than 50. Incidence rates for early-onset cancer among Americans increased 22 percent between 2000 and 2023, according to the National Cancer Institute, and researchers predict the global number of early-onset cancer cases will increase by 31 percent by 2031. The troubling numbers have grabbed the attention of cancer researchers and frontline physicians.

Celebrities are also bringing attentionto the cause. Chadwick Boseman, star of Black Panther, waged a private battle with colorectal cancer before his shocking death at 43. James Van Der Beek, 48, former Dawson’s Creek heartthrob, talked about coming to grips with gradually succumbing to colorectal cancer in social media posts that were as heartbreaking as they were inspirational.

Angelina Jolie brought worldwide attention to genetic testing for breast cancer when she underwent a prophylactic double mastectomy in 2013 when she was 37 to significantly reduce her cancer risk. Olivia Munn publicly advocated for screening in 2023 while battling and surviving aggressive breast cancer. The courage and vulnerability they showed likely saved countless lives. She was 42 when she was diagnosed.

For every brave celebrity, there are tens of thousands of patients like Bennoit whose personal battles are waged away from the spotlight. Data from the American Cancer Society (ACA) indicates that cancer diagnoses among those under age 50 remain rare, but a major NCI analysis published in 2025 shows that the rates of cancer are trending upward.

After examining 33 cancers, the researchers discovered that 14 types had increasing incidence in at least one younger age group between 2010 and 2019. ACA statistics from 2025 show the incidence of early onset cancer, that is, a diagnosis between the ages of 18 49 is rising one to two percent annually.

Dr. Meredith Shiels, of NIH’s National Cancer Institute in Rockville, was the lead investigator on the NCI study. Her team wanted to better understand what the data signified. Shiels and her research team analyzed more than 2 million cases of early-onset cancer diagnosed between 2010 and 2019.

The greatest absolute increases in the number of cases in 2019 relative to what was expected based on 2010 rates were female breast cancer, colorectal cancer, kidney cancer, and uterine cancer, which together accounted for more than 80 percent of additional diagnoses during the study period.

“For at least a subset of these cancers, whatever is driving the increase at younger ages is likely also contributing to increases in older age groups,” she says. “That could be a risk factor, an environmental exposure, or even something that is increasing detection across different age groups.”

Shiels believes her high-level research provides a starting point for understanding what’s causing the rise of early-onset cancers and could translate to effective cancer prevention and early detection efforts. She says ongoing funding of detailed epidemiologic and molecular cancer research will provide a greater understanding of disease drivers among young adults.

One important consideration is the lifestyle factors that might contribute to increased cancer risk including smoking and alcohol use, poor diet, physical inactivity, and obesity. Research conducted at Johns Hopkins estimated that about 42 percent of all cancers in U.S. adults older than 30 can be attributed to potentially preventable causes.

“It’s a three-legged stool: diet, physical activity, and obesity are closely interconnected,” says Dr. Otis Brawley, oncologist at the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center. “Obesity alone accounts for approximately 15 percent of all cancers in the
United States.”

Brawley, a world-renowned expert on cancer screening and prevention, says the obesity problem in the United States began to accelerate in the late 1960s. A decade later, roughly 16 percent of U.S. adults were obese. Today, that figure is close to 40 percent, and, according to Brawley, the obesity epidemic could approach 50 percent by 2030, though the use of GLP1s (and relapse after GLP1 use stops) complicates the projection data.

“Obesity is not just a public health issue,” he says. “It’s one of the leading preventable contributors to cancer in the United States. When we look at the rise in obesity alongside the rise in certain cancers, we need to take that connection seriously.”

For example, it’s known that higher body fat in young girls is associated with earlier puberty and menarche, which has been linked to an increased risk of breast cancer later in life. The thinking is that earlier puberty means breast tissue is exposed to ovarian hormones, particularly estrogen, for longer periods.

“The rise in childhood obesity may be one piece of the puzzle,” says Brawley. “What happens to a girl’s health early in life can have consequences for her cancer risk when she’s in her 40s, 50s, and 60s.”

Women who have children after 30 are also at increased overall risk of breast cancer, according to Fernandez. With more women focusing on their careers or waiting to start families, this certainly could be a factor in the increased incidence of early-onset breast cancer.

“Experts theorize that the surge of hormones occurring during pregnancy have a different effect, depending on a woman’s age,” says Fernandez. “If that surge happens when the breasts are younger—say, before age 30—it may be less likely to cause problems. But if it happens when a woman is in her 30s or early 40s, the hormones stimulate breast tissue and breast cells that may have developed abnormalities as they’ve aged.”

But data, stats, and theories can’t always explain why cancer strikes someone like Bennoit, who’s young, in shape, and has never been pregnant. Fernandez sees a gap in preventative care for healthy young women like her who are more likely to see gynecologists for annual check-ups than they are to have a dedicated primary care physician.

“We need an easy tool that GYNs can use to assess individuals for breast cancer risk factors,” she says. “They could then educate high risk women about the importance of screenings and direct them to local options.”

Breast cancer is not the only cancer on the rise. The ACS reports that an estimated 158,850 new cases of colorectal cancer will be diagnosed in the U.S. in 2026, and 55,230 people will die from the disease. The incidence is rising by three percent each year in people 20 to 49.

“When you see those numbers quantified, they’re astonishing,” says Dr. Ekta Gupta, chief of the division of gastroenterology at the University of Maryland Medical Center Midtown Campus. “The continued rise in that age group is concerning and underscores the
need to understand why it’s happening and, more importantly, what we can do about it.”

“The continued rise in that age group is concerning and underscores the need to understand why it’s happening…”

That “why” is the tricky part. The fact is, there are multiple contributing factors, including genetics, gut microbiome, obesity, metabolic health, physical activity, and diet. “There’s no smoking gun,” says Gupta.

In response to this increase, in 2018, the ACS lowered the recommended starting age for colorectal screening for individuals at average risk from 50 to 45, and the U.S. Preventive Services Task Force followed suit in 2021. The policy shift was intended to identify and remove precancerous growths and catch colorectal cancer in the early stages, when it’s easier to treat.

Shifting the recommended screening age by five years made good sense because, according to the ACS, half of colorectal cases diagnosed before age 50 occur in 45- to 49-year-olds and it is in this younger age bracket that colorectal cancer rates are increasing.

When it comes to colorectal cancer, recent research has focused on the gut microbiome—the bacteria lining the digestive track—and its role in the onset of the disease. Brawley points to increasing evidence that younger people who develop the colorectal cancer have less diversity in their colon bacteria.

One theory is that the overuse of antibiotics among children may contribute to changes in gut microbiome that, in turn, increase the colorectal cancer risk in young adults. But researchers need to study more, ever mindful of the question: Is the lack of diversity contributing to the development of colorectal cancer? Or is the cancer changing the microbiome make-up?

“That’s how science progresses,” says Gupta. “Once we identify one clue, researchers latch onto it, investigate it from different angles and try to build the larger story and connect the dots to understand what’s really driving this trend.”

Understanding new screening recommendations and tools is critical to detecting cancers early. Take, for example, cervical cancer, which is on the rise in millennial women. A study published in the Journal of the American Medical Association showed that the disease has risen by 2.5 percent per year among women who are between 30 and 34 years old.

And yet, nearly 1 in 3 women between 21 and 29 in 2023 had never received cervical cancer screening, notes a new study published in the journal JAMA Network Open. That’s an improvement over the 1 in 8 women who hadn’t been screened in 2005, but there’s clearly still a need to increase preventative tests among young women.

“The good news is that we have effective tools available to help prevent these cancers,” says Dr. Beman Khulpateea, a board-certified OBGYN and fellowship-trained gynecologic oncologist in The Gynecologic Oncology Center at Mercy Medical Center. “Research shows that one of the biggest reasons women aren’t getting screened is simply that they don’t know they should be.”

Pap smear tests, which detect precancerous changes to cells in the cervix and allow physicians to intervene early, remain the gold standard screening tool. The American College of Obstetricians and Gynecologists (ACOG) updated its cervical cancer screening guidance this year, recommending Pap smear testing every three years for women in their 20s. For women between 30 and 65 who are at average risk, ACOG suggests human papillomavirus (HPV) testing every five years. The ACOG also added patient-collected HPV testing (done easily at home with a swab) every three years as an option for women 30 to 65 who are at average risk.

“Self-collected HPV testing is still relatively new, having been FDA-approved within the past couple of years,” says Khulpateea, “but it could be an important way to reach women who might otherwise miss routine screenings.”

The HPV vaccine, which the CDC officially recommended in 2006, is effective at preventing infections with HPV types that are responsible for most cervical cancers and is recommended by the American Academy of Pediatrics for all children starting between ages 9 and 12.

But Khulpateea notes that vaccination does not protect against every HPV-causing cancer type and therefore doesn’t eliminate the need for regular screening. Also, “The vaccine was initially recommended at younger ages, so if you go back 20 years, girls who were around 9 years old at the time are now in their late 20s,” he says. “Because vaccine uptake was lower during the early years of its use, some of those patients are now reaching the age group in which we’re seeing cervical cancers.”

When patients have access to high-quality preventative care, the tumors are smaller and the disease is more localized, meaning it can be treated with surgical interventions.

“The earlier we identify these cancers, the more treatment options we have and, ultimately, the better the outcomes,” says Khulpateea. “It’s very rare for a woman who is current with her screenings to develop cervical cancer. In many ways, it’s a very preventable disease.”

Research shows that one of the biggest reasons women aren’t getting screened is simply because they don’t know they should be.

Preventing early-onset cancers remains the goal. Although more research is needed to pinpoint the exact causes of disease among younger individuals, doctors say there are practical ways to lower one’s risks. Minimize alcohol and tobacco consumption. Maintain a healthy weight and stay physically active. Cut back on processed foods and red meat, which have been associated with an increased risk of colorectal cancer. Increase fiber intake and incorporate more plant-based, natural foods into diets.

Understanding personal risk is equally important. Gupta encourages patients to talk with family members about their medical histories. “Family history is not just small talk—it can be preventative medicine,” she says.

Of course, regular screening tests remain key to preventing cancer or catching it in its earliest stages. Young adults may feel invincible, but they still need to seek care at the first inkling of concern.

Bennoit is proof that paying attention when your body says there’s something wrong can be a life-saving choice. That’s the first step. What comes next demands an inspiring level of personal inner strength.

“Shelby is really a unique person,” says Fernandez. “She’s very positive, very optimistic, and tough—tough as can be.”

In February 2025, one week after her double mastectomy and seven months after her diagnosis, Bennoit’s pathology report showed negative lymph nodes and no residual cancer in her breast. She was officially cancer free. Bennoit was driving with her grandparents when her phone vibrated. This time, with a life renewed.

“When Shelby’s nurse navigator, Stephanie, and I saw the pathology results, we FaceTimed her immediately to share the news,” says Fernandez. “There was a lot of joyous screaming. We were so over-the-moon happy because we’ve stood by so many women who have gone through these treatments. It’s physically, mentally, and emotionally devastating, and we knew how much Shelby had pushed through incredible challenges.”

On a picture-perfect morning in August, Bennoit sits in Ascension Hospital’s main atrium. She’s steps away from where she suffered through 16 rounds of chemotherapy and doses of immunotherapy. The hellish treatments didn’t break her spirit, but there were dark days when she wondered if she’d make it to her next birthday.

“I want to be a beacon of light. Cancer care is so advanced, and I want patients to be optimistic and have hope.”

That’s in the past, though. Today Bennoit is fresh off a week “down the ocean.” She’s tanned, healthy, and happy. Her bright smile and innate positivity are infectious.

“Sharing my story is a way to give back to the cancer community,” says Bennoit. “I want to be a beacon of light. Cancer care is so advanced, and I want patients to be optimistic and have hope.”

Before heading home, Bennoit catches up with members of the Ascension team, their affection for her obvious. The team offers heartfelt congratulations on her recent engagement and asks if she has any big plans for the rest of the summer. In other words, the kinds of things a 25-year-old woman with the rest of her life ahead of her should be looking forward to.