Cancer Rates in the Appendix on the Rise Among Younger Generations

Although rare, cases of appendix cancer are increasing, according to a new study.

The analysis of a National Cancer Institute database indicates that appendix cancer rates have tripled in Gen X and quadrupled among millennials compared to earlier generations. This report was published recently in the Annals of Internal Medicine.

Andreana Holowatyj, an assistant professor specializing in hematology and oncology at Vanderbilt University Medical Center, noted, “There is a disproportionate burden of appendix cancer among young individuals.” In a phone conversation, she remarked that her earlier research indicated that one in three appendix cancer diagnoses happens in adults under 50 years old. In contrast, only one in eight colorectal cancers are diagnosed in the same age group.

Still, it’s crucial to emphasize that appendix cancers are quite rare, occurring at a rate of 1 to 2 per million people annually in the United States, as stated by the National Cancer Institute.

In assessing trends over time, Holowatyj examined data from the Surveillance, Epidemiology and End Results program, which collects information from cancer registries covering around 45.9% of the U.S. population.

From 1975 to 2019, there were a total of 4,858 documented cases of appendix cancer. The significant number of cases in patients aged 18 to 49, combined with the generational rise, highlights the need to explore the root causes of these increases and work towards reversing the trend, Holowatyj emphasized.

This study reinforces the observation that younger patients are increasingly diagnosed with gastrointestinal cancers, noted Dr. Andrea Cercek, a medical oncologist at Memorial Sloan Kettering Cancer Center in New York. Particularly troubling is the rise in colorectal cancer rates among young adults over recent decades. The precise reasons for this increase warrant further investigation.

“It’s likely that environmental factors are involved—these could range from what we consume to broader lifestyle changes,” Cercek, who did not participate in this study, explained. “It’s complicated; you can’t really attribute it to a single cause.”

The appendix is a small pouch connected to the large intestine; blockages here can result in appendicitis, which requires immediate care.

Detecting appendix cancers is more challenging than other gastrointestinal cancers, as these tumors aren’t easily visible on scans and typically are not discovered during colonoscopies, according to Dr. Deborah Doroshow from the Icahn School of Medicine at Mount Sinai in New York City. “Detection and screening is difficult,” she said.

Holowatyj added that around 95% of appendix cancers are found after a person experiences appendicitis and has the appendix removed for examination. Unfortunately, this often means the cancers are at an advanced stage, leading to worse long-term outcomes.

Doroshow highlighted the importance of being aware of subtle symptoms; changes in energy, persistent pain, or unexplained weight loss in younger individuals shouldn’t be overlooked. “If something feels off, it’s wise to seek medical advice,” she advised. “Young patients with cancer have sometimes not been taken seriously by healthcare providers.”

She also mentioned that women and people of color might need to be more vocal in advocating for themselves.

While it’s normal to have occasional abdominal discomfort, persistent pain is more concerning, Doroshow noted.