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When should you get screened for cancer? Are cancer rates increasing or decreasing? Why is cancer increasing in young adults?
Barbara McAneny, MD, CEO of New Mexico Oncology Hematology Consultants, and a past president of the AMA, joins us to discuss the rising rates of cancer in younger generations. Dr. McAneny also discusses our current approach to cancer screenings and shares ways that people can reduce their cancer risk. AMA Chief Experience Officer Todd Unger hosts.
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Speaker
- Barbara McAneny, MD, CEO, New Mexico Oncology Hematology Consultants
Transcript
Unger: Hello and welcome to the AMA Update video and podcast. Today, we're talking about the rising rates of cancer in young people, including the trends we're seeing, what might be causing them and what we can do about them. Our guest today is Doctor Barbara McAneny, CEO of New Mexico Oncology Hematology Consultants and a past president of the AMA in Albuquerque, New Mexico. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. McAneny, it's a pleasure to have you with us today.
Dr. McAneny: Thank you for inviting me.
Unger: Well, over the last couple of years, there have been a number of studies showing that rising rates of cancer in younger generations. Why don't we just start by having a brief recap of some of the major trends that we're seeing?
Dr. McAneny: Well, as people may know, the American Cancer Society tracks this every year. And this year, they reported that half of the cancers that they track are increasing in younger and younger people. And that is really alarming because those cancers are also more aggressive than they are when they occur in the older people.
The JAMA Network, also published from a National Cancer Institute study and noticed that when Gen-Xers turned 60, which starts next year, that they're more likely to have an invasive cancer than boomers were when we turned 60. So this is something that we need to put on everyone's radar screen.
Unger: Now, this is pretty alarming in terms of those trends. Do we have any idea what is causing them?
Dr. McAneny: Well, the short answer is that we don't know yet. There's going to need to be a lot of research to figure out what is causing it. And because cancer is so many different diseases, there will not be just one cause. Some of it is going to be genetic. We know that when people have certain cancer predisposition genes, those cancers tend to show up at an earlier rate.
We're also a little concerned about the rising obesity rates because obesity is correlated with cancer incidence. People aren't eating as well as they used to, their sedentary lifestyles. And there are a lot of environmental factors that we're concerned about. There's more pollution in our atmosphere than there was many years ago, and it will take a lot of study to figure out, is that a contributor, and if so, which pollutants, and if so, what can we do about it.
Unger: Dr. McAneny, given all this, how do we need to be rethinking our approach to cancer screenings going forward, given that we're seeing at younger generations. Well, the U.S. Preventive Services Task force, which sets up the appropriate screening recommendations for the United States and is the one that U.S. insurance companies pay for, lowered mammogram screening age from 50 to 40. And I think that's well overdue.
Also, they lowered the recommended age for colorectal screening from 50 to 45. So we need to make sure that people get those screenings. It makes sense to do that because with more aggressive, faster growing cancers in younger people, I have always thought that it makes more sense to screen the younger patients than the older ones, where the cancer is going to be more indolent and slow growing, and we have more time to catch it. In younger people, we want to catch those cancers as quickly as we can.
However, there's a lot of cancers that do not have any approved screening tests. There are some interesting studies going on with the GRAIL test to look at blood tests to screen cancer, and we're really watching that development very carefully. Because while quite expensive, it may give us a new option we've never had before to find these cancers early.
Unger: Yes, that would be a pretty significant advance. Dr. McAneny, you talked about cancer screenings, but you also mentioned a number of—I'll call them more lifestyle-oriented issues that would probably be heavily related to prevention. What advice should physicians be sharing with their patients along these lines?
Dr. McAneny: So, Todd, I don't think my suggestions are going to be any surprise to anyone. Having a healthy diet, making sure you get some exercise and try to limit how many days you're just sedentary will help a lot.
However, there are other things one can specifically do. The first one and the most important one remains don't smoke. Just don't do that. Tobacco causes cancer, and we just don't need more of those.
The second thing I would encourage everyone to do is to get the vaccinations like human papillomavirus. That's key for head and neck cancer, cervical cancers and anal cancers. I think that limiting your sun exposure is important. Melanoma can be a very deadly cancer, and it is definitely related to sun exposure, particularly, sunburns. So there are a lot of things that one can do.
I want to add one more suggestion for everyone, which is next Thanksgiving dinner discuss your family history with everyone. We need to know what did your great aunt die of. Do you know? Because if you do, that can sometimes give us a clue as to what kind of risks you have or your children have or your siblings have. So family history is increasingly important.
Unger: Absolutely. And even with a rise in cancer rates, there is one encouraging trend, and that is that survival rates are continuing to improve. Well, tell us more about that.
Dr. McAneny: Well, first of all, because of screening, we're finding a lot of cancers earlier. But a lot of the things are just the improvement in therapies. Immunotherapy and the targeted therapies that we use, that we refer to as personalized medicine can make a huge difference. Not only can we cure more cancers with more aggressive treatments, but we can keep people alive, even if their cancer has spread, with excellent quality of life, often for many years.
And a new drug is released by the FDA more than once a week. So that really gives us a huge amount of tools to use to make sure that people who do have a cancer can live a good life.
Unger: Well, Dr. McAneny, before we go, there's one other thing I wanted to talk with you about. And that's the Lifetime Achievement Award that you recently received from the Greater Albuquerque Medical Association. I wanted to say congratulations. What was your reaction when you found out about that?
Dr. McAneny: Well, thank you very much for that. I was very flattered to be recognized by my peers. The first thing I did was to check the obituaries and make sure I wasn't in them. Because you worry about Lifetime Achievement awards, meaning that you're now gone. And when I wasn't in that, I just made sure from my practice I still had a job.
So once I got over those two hurdles, I was very flattered that my peers would give me that Lifetime Achievement Award. So, thank you for asking.
Unger: Well, congratulations. And for those of you that were listening, you can have a very interesting Thanksgiving conversation that'll probably be better than talking about politics and learning about your family's health history. So important as we see these trends, especially among younger people.
If you found this discussion valuable, you can support more programming like it by becoming an AMA member at ama-assn.org/join. That wraps up today's episode, and we'll be back soon with another AMA Update. Be sure to subscribe for new episodes and find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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