Appendix cancer is no longer rare for millennials and Gen Xers: Study |

Once regarded as exceedingly rare, appendix cancer, specifically appendiceal adenocarcinoma (AA), is now rising sharply in younger adults, especially among Gen X and millennials. A new retrospective study conducted by researchers at Vanderbilt University Medical Center and published in the Annals of Internal Medicine has brought this unsettling trend to light.

What is Appendiceal Adenocarcinoma

Appendiceal adenocarcinoma is a rare form of gastrointestinal (GI) cancer that begins in the appendix, a small, finger-like pouch connected to the large intestine. While traditionally considered uncommon, affecting about 3,000 people per year in the U.S., AA now appears to be increasing at an alarming rate, especially among adults under 50.

Study finds significant appendix cancer surge in post-1945 birth cohorts

A study published in Annals of Internal Medicine examined birth cohort patterns across 21 overlapping generations using data from eight SEER cancer registries, examining 4,858 confirmed cases of primary AA in patients aged 20 and older from 1975 to 2019. Read the primary findings from the study:

This pattern shows that people born after 1945 are more likely to develop appendix cancer, possibly because of changes in lifestyle or the environment that have affected these generations differently.

Possible reasons for rise in appendix cancer rates

Dr. Andreana Holowatyj, lead researcher and assistant professor at Vanderbilt University Medical Center, stressed that the increase is not simply due to more appendectomies being performed. Surgical removal rates have remained relatively stable, indicating that external factors, not detection bias, are likely contributing to the surge.Although the exact cause remains undeciphered, professionals point to several potential causes:

These lifestyle and environmental changes, especially among people born after 1945, are believed to be part of a wider pattern affecting GI health in younger populations.

Why appendix cancer is so difficult to detect

Diagnosing appendix cancer is quite difficult and often misdiagnosed because it often presents with non-specific symptoms and currently lacks reliable screening methods. At present, there are no blood or urine tests that can accurately detect it, making early identification difficult.In the majority of cases, appendix cancer is discovered incidentally, during surgery for other conditions such as appendicitis. In other situations, the disease may only be identified after it has spread to the abdomen, causing more visible symptoms like:

To confirm if someone has appendix cancer, doctors usually need to take a small tissue sample from the appendix, called a biopsy. Scans like CTs aren’t always helpful in spotting this cancer early. That’s because appendix cancer doesn’t usually form a solid lump like other cancers. Instead, it spreads out in thin layers, making it harder to see. As Dr. John Paul Shen puts it, “It’s like painting the walls of a room with cancer.”The difficulty in diagnosing is preceded by the early symptoms, like bloating, loss of appetite, or changes in digestion, that are vague and easy to overlook. Because of this, many people are diagnosed late, when treatment becomes more difficult.

Potential causes under study

Professionals, including Dr. Andrea Cercek from Memorial Sloan Kettering Cancer Center, suggest that environmental causes, such as:

As of now, the exact causes of appendix cancer remain unknown; scientists are urging further research into environmental exposures, genetic predispositions, and molecular changes that may play a role in its development because researching more into these factors could pave the way for earlier detection and help reduce the increasing risk among younger generations.