It’s not a well-known cancer. And it strikes an organ most of us don’t think about and many of us don’t even have anymore. But cancer of the appendix is on the rise among younger people.
A study published this month in the Annals of Internal Medicine found that among the Gen X and millennial generations, the rate of appendiceal cancer is “anywhere between triple and quadruple the rates” of baby boomers, says Dr. Alexander Jow, a gastroenterologist at Kaiser Permanente.
That’s the latest in a string of cancers affecting younger generations, Jow says. “Colon cancers being a very well-known one that we’re seeing, but even breast cancers and kidney cancers and gastric cancers.”
Potential Risk Factors of Cancer of the Appendix
What’s going on? Jow isn’t sure. But he says researchers are looking for correlations. “We do know that potential risk factors really fall on the diet and microbiome and some reversible lifestyle risk factors.” Highly processed foods such as processed meats are considered carcinogens. And obesity, insulin resistance, and diabetes have been associated with increased risks of gastrointestinal cancers as well, Jow says.
One obvious factor: People are more likely to hold on to their appendices. “I think the appendix is kind of this under-appreciated organ,” Jow says. It was long considered an organ that had no real function. So as soon as someone got an attack of appendicitis, out it went. But over the past few decades, Jow says, “It’s been recognized to be a more important potential organ that can be part of the immune system.” And appendicitis is more often treated with antibiotics and a wait-and-see approach.
That increase of the rate of cancer of the appendix is even scarier than it sounds, Jow says, because lots of cases were detected when the appendix was removed. “Fewer people are actually getting their appendixes removed, but we’re still seeing an increased rate of diagnosis of appendix cancer. We’re not necessarily detecting more cancers because we’re doing more appendectomies; we’re actually seeing it despite the fact that we’re doing fewer appendectomies nowadays.”
Early Detection Matters
Like any cancer, appendiceal cancer has a high survival rate if it’s detected early. “It gets more concerning,” Jow says, “if this is detected when it’s already more advanced and spread outside of the colon, or, say, for example, your appendix bursts. In certain types of appendiceal cancers, those cells can spread into the peritoneum, and it can be very difficult to treat. So it can be a difficult cancer and something that is important to recognize early.”
Unfortunately, there’s bad news there as well. While doctors advise patients to start getting regular colonoscopies at age 45, “there really is no screening tool for detection of appendiceal cancers,” Jow says. So it’s more important than ever, he adds, that “If you see something, say something.” Bloating and abdominal pain lasting weeks or months is a serious red flag. “And certainly, changes of bowel habits or digestion, bring that up to your doctor. It may warrant kind of delving into more workup if everything else comes back negative,” Jow says.
Healthy Habits Are Key
The good news? This cancer is still extremely rare, with about 3,000 cases diagnosed in the U.S. in a year, versus, for example, 150,000 cases of colon cancer. “So it’s still a very small subset of cancers in the gastrointestinal tract. But it is something that I think researchers are now interested in looking at,” Jow says.
It’s all going to take more research, but in the meantime Jow emphasizes that the usual healthy habits are only going to help.
“I always say this is a good time to look at your diet, so making sure that you’re eating a diet rich in vegetables and fruits and legumes and whole grains; really limiting processed foods, especially processed meats, sugary beverages, and refined grains; maintaining a healthy weight and staying active, and then really avoiding known toxins” such as tobacco and alcohol.
“And seeing your doctor.”
