Rising Early-Onset Cancers: The Vital Role of Family History in Detection

Listen in and play along as hosts Cara Anthony and Blake Farmer test their knowledge with a HealthQ quiz on detecting early-onset cancers.

Bryce Ramsey of Madison, Mississippi, was 33 when she was diagnosed with colorectal cancer. Upon noticing blood in her stool, she blamed the hemorrhoids she’d developed after delivering her son eight years earlier.

Ramsey didn’t initially link her symptoms to cancer.

“But I had just kind of made a deal with myself because the blood was starting to become more frequent,” she said. “I was like, ‘If this happens the next time I go to the bathroom, I’m going to make a call.’”

She saw more blood, and she reached out to a gastrointestinal clinic to get it checked out, just in case. Her doctor said she normally wouldn’t scope someone Ramsey’s age, “‘but something in my gut is just telling me I need to do so,’” Ramsey recalled. “And thank God she did because she found a 5-centimeter polyp.”

Ramsey had surgery, endured chemotherapy, and survived stage 3 colon cancer. Now 40, she volunteers for the Colorectal Cancer Alliance, a nonprofit advocacy group, to raise awareness of early-onset colorectal cancer.

Stories like hers are becoming increasingly common: In the U.S., more than a dozen kinds of cancer are on the rise in adults under 50. Among these early-onset cancers, colorectal and breast cancers have increased the most, and colorectal cancer is now the deadliest cancer for Americans ages 18 to 49.

Here’s what to know about detecting early-onset cancers.

1. Family history is one of the most important risk factors.

Researchers have not been able to find a single cause for the rise in early-onset cancers. Instead, research suggests a myriad of factors play a role, including obesity, heavy alcohol use, environmental factors such as microplastics, and disruptions to gut health.

Doctors generally follow population-level guidelines for routine screenings — such as recommending mammograms starting at age 40 to screen for breast cancer — but physicians might recommend some patients get screenings as early as in their 20s. Doctors weigh a patient’s personal risks, including their family history of cancer.

Ramsey learned only after her diagnosis that her grandfather previously had colorectal cancer. “If I would’ve known that I had a significant family history, I would’ve been scoped a lot younger,” she said. “My doctor said my tumor had probably been growing for seven to 10 years.”

After her diagnosis, she encouraged her father, aunt, and brother to get screened. All three were diagnosed with colon cancer, too, and survived after receiving treatment.

Ramsey said it can be uncomfortable to urge family members to get tested or to talk with them about private health information, but those conversations are worth having to save a life.

“Just ask the question or make a joke about it. And sometimes just little icebreakers will help,” she said.

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