Introduction to Appendix Cancers
Although they are very rare, cancers of the appendix are on the rise, a new study finds.
An analysis of a National Cancer Institute database found that compared with older generations, rates of appendix cancer have tripled among Gen X and quadrupled among millennials, according to the report, published Monday in the Annals of Internal Medicine.
The Disproportionate Burden of Appendix Cancer
“There is a disproportionate burden of appendix cancer among young individuals,” said the study’s lead author, Andreana Holowatyj, an assistant professor of hematology and oncology at the Vanderbilt University Medical Center and Vanderbilt Ingram Cancer Center.
Holowatyj’s earlier research was “the first to show that 1 in every 3 appendix cancers is diagnosed among adults younger than age 50,” she said in a phone interview. “That’s compared to 1 in every 8 colorectal cancers diagnosed among adults younger than age 50.”
Rarity and Prevalence of Appendix Cancers
Still, appendix cancers are extremely rare: According to the National Cancer Institute, they occur at a rate of 1 to 2 per million people in the United States a year.
To see whether rates of the cancer had changed over time, Holowatyj turned to the Surveillance, Epidemiology and End Results program, which includes data from nationally representative cancer registries that cover about 45.9% of the U.S. population.
Overall, there were 4,858 cases of appendix cancer from 1975 through 2019.
Understanding the Rise in Appendix Cancers
When the large proportion of patients diagnosed between ages 18 and 49 is combined with the new finding of a generational rise in Gen X and millennials, it’s “important that we find the causes underpinning these statistics in order to reverse this trend and reduce the disease burden,” Holowatyj said.
The new study further confirms that there is a trend toward younger and younger patients from recent generations being hit with gastrointestinal cancers, said Dr. Andrea Cercek, a medical oncologist and a co-director of the Center for Early Onset Colorectal and GI Cancers at Memorial Sloan Kettering Cancer Center in New York City.
Causes of the Rise in GI Cancers
In particular, rates of colorectal cancer in younger adults have been rising for several decades. The cause for the rise in such GI cancers needs more research.
“It’s likely that there are environmental causes, which include exposures to food, water and micro plastics or lifestyle or dietary changes,” said Cercek, who wasn’t involved with the new research. “You can’t really pin it down to one thing or another. It’s likely multiple factors causing this rise after 1945.”
Characteristics of Appendix Cancers
The appendix is a small pouch that hangs off the large intestine on the lower right side of the abdomen. A blockage can lead to infection and inflammation, called appendicitis, which needs emergency treatment.
Unlike other cancers of the GI tract, appendix cancers aren’t easily found because they’re not as easy to see on abdominal scans and won’t be picked up by colonoscopies, said Dr. Deborah Doroshow, an associate professor of medicine at the Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai in New York City. “So it’s not easy to detect or screen for them.”
Detection and Diagnosis of Appendix Cancers
In fact, Holowatyj said, about 95% of appendix cancers aren’t spotted until after a person has appendicitis and the appendix is removed and examined by pathologists. As a result, the cancers tend to be at a late stage with poorer long-term prognoses, she added.
Doroshow, who wasn’t involved with the new study, said it’s essential for patients and their doctors to be more aware of subtle symptoms. Symptoms such as changes in energy level, a new persistent pain or unexplained weight loss in a young person shouldn’t be ignored, she said.
Conclusion
The rise in appendix cancers among younger generations is a concerning trend that requires further research to understand its causes and develop effective prevention and detection strategies. It is crucial for individuals, especially those in younger age groups, to be aware of the symptoms and to consult with healthcare professionals if they experience any unusual or persistent abdominal pain.
FAQs
Q: What is the current rate of appendix cancer in the United States?
A: According to the National Cancer Institute, appendix cancers occur at a rate of 1 to 2 per million people in the United States per year.
Q: Why are appendix cancers difficult to detect?
A: Appendix cancers are not easily found because they are not as easy to see on abdominal scans and won’t be picked up by colonoscopies.
Q: What are the common symptoms of appendix cancer?
A: Symptoms such as changes in energy level, a new persistent pain or unexplained weight loss in a young person can be indicative of appendix cancer.
Q: What can individuals do to reduce their risk of appendix cancer?
A: While the exact causes of the rise in appendix cancers are not known, maintaining a healthy lifestyle, including a balanced diet and regular exercise, may help reduce the risk of developing gastrointestinal cancers.
