EU Urged to Tackle Rising Digestive Cancers in Young Adults
In response to the alarming rise in digestive cancers among young adults, doctors, researchers, patients, and European policymakers are urging Europe to rethink its strategies for screening, treatment, and support of digestive cancers.
The ENTERO2024 conference, held recently at the European Parliament in Brussels, Belgium, addressed this issue and provided a platform for affected individuals to share their experiences. The event was organised by Digestive Cancers Europe (DiCE), Brussels, Belgium, an umbrella organisation representing over 30 national member groups across the World Health Organization European region.
Through the ENTERO programme, DiCE brought together patients, caregivers, clinicians, and politicians to develop a collective response. Testimonies and proposed solutions were presented as part of a formal 'call to action.'
For 5 years, the organisation has been working to better understand and address the needs of young people with colorectal, oesophageal, gastric, pancreatic, and biliary cancers. The goals are to accelerate early diagnosis, improve access to testing, and strengthen support for these patients.
Many of those affected by digestive cancers are as young as 40 years old, with no significant family history and active lifestyles. Yet they suddenly find themselves facing intensive treatment, chronic pain, and long-term uncertainty. Since the 1990s, the incidence of digestive cancers, including colorectal, gastric, and pancreatic cancers, has been steadily increasing among young adults, raising concerns in the medical community.
'Can we really afford to wait until these young patients turn 50 years of age to start screening them?' asked Vytenis Povilas Andriukaitis, heart surgeon and member of the European Parliament, during the morning session.
Over the past three decades, the incidence of early age-onset digestive cancers has increased by 80%. This increase is linked to environmental and behavioural factors, and poorly understood causes remain.
Andriukaitis criticised the slow pace of political adaptation and urged policymakers to implement risk-based screening instead of relying solely on age. He also called for more research funding and emphasised the need to protect cancer survivors from discrimination because of their medical history or illness.
Cancer Has no Age
At 31, Mila Ollaga Toledo, a patient advocate, discovered that she had digestive cancer after months of wandering around the healthcare system. Her experience reflects a troubling trend: Early age-onset digestive cancers increasingly affect young adults, often with poor treatment.
Currently, 900,000 people get a diagnosis of digestive cancer annually in Europe, and the incidence of colorectal cancer among adults between 20 and 29 years is increasing by 7.9% annually.
Young patients often find their symptoms trivialised, which delays their treatment. According to recent surveys, 60% of patients are diagnosed at an advanced stage. 'We need to change our way of thinking and recognise that cancer has no age limit,' Mila concluded. 'Changing mindsets and practices is essential to prevent an entire generation from being sacrificed due to a late diagnosis.'
Emily Harrold, MD, a Dublin-based oncologist, also highlighted that colorectal cancer is now the leading cause of cancer death among men aged 20-49 years in the United States and the second leading cause in women.
Due to the severity of the issue, Harrold suggested lowering the screening age to 45 years, developing genetic tests, and training doctors to better recognise early signs of cancer.
New Avenues
Karl Smith-Byrne, PhD, senior molecular epidemiologist at the Cancer Epidemiology Unit, University of Oxford, Oxford, England, shared his own battle against an aggressive digestive cancer. After undergoing several surgeries, prolonged hospitalisations, and drastic weight loss, he managed to survive and continue his research.
Referring to the hope offered by a vaccine currently under development to prevent the recurrence of digestive cancers, 'we now have promising avenues,' he noted. 'Traditional risk factors explain only a part of the disease,' he added, calling for more research on environmental-genetic interactions.
Gianluca Mauri, MD, an oncologist in Milan, Italy, confirmed that understanding the typical biology of early cancers is now a priority. He advocated a collaborative approach that combines epidemiological, biological, and technological data to develop non-invasive screening strategies tailored to young adults.
Access to Care
Among the various patient testimonies, Natalia Ramirez Montigny's particularly resonated with the audience. It highlighted the complexities surrounding access to innovative treatments. Diagnosed in 2021 at the age of 34 with metastatic gastric cancer, she survived thanks to her participation in a phase 1 clinical trial in Paris, France, an opportunity she would never have discovered without her personal network. 'The chances of me being here today were almost nil,' she testified. 'There was less than a 2% chance I would survive. It all started with a cough, but within weeks, I was suffering unbearable pain and was bedridden.'
'According to the World Health Organization, more than 70% of young adults with cancer have never been informed about the possibility of participating in a clinical trial,' she emphasised.
'Due to a lack of information, financial resources, or logistical support, many patients can only accept standard treatments that are often ineffective or discontinued. It is essential to make access to clinical trials more inclusive, fair, and evident across Europe,' she concluded.
European Strategy
Eric Van Cutsem, MD, PhD, gastroenterologist and digestive oncologist at KU Leuven, Leuven, Belgium, reminded attendees that recent advances in treatment are largely due to clinical trials. However, he also pointed out the bureaucratic hurdles and lack of harmonisation among member states, which are hampering European innovation and complicating access to protocols for many patients.
'We need a Europe that invests better and simplifies access to clinical research,' he argued, stressing the need to maintain and strengthen budgets dedicated to fighting cancer.
'Without strong measures to harmonise access to innovative treatments and financially support research, Europe risks widening inequalities among its citizens.'
Psychological Support
Beyond medical treatment, the emotional support of patients also plays a significant role in discussions. Luzia Travado, MD, PhD, clinical psychologist and researcher of psycho-oncology at the Champalimaud Clinical and Research Centre in Lisbon, Portugal, reminded everyone how the shock of diagnosis and the treatment journey disturb the emotional balance of young patients and their loved ones.
'Psychological distress affects up to 60% of cancer patients,' she said. 'Structured psychological support not only improves the quality of life but also the chances of survival. However, access to psycho-oncological care remains inconsistent, despite its proven effectiveness. The systematic integration of psychological support into care pathways, advocating for a truly person-centred care model, is essential.'
Act Now
Three priority areas must be addressed, concluded Zorana Maravic, molecular biologist and CEO of DiCE. There is a need to increase awareness and screening, accelerate interdisciplinary research, and ensure fair access to treatment and psychological support. The European Union (EU) must integrate early age-onset digestive cancers into its future cancer-fighting strategies, she argued. It must also secure funding within the next Multiannual Financial Framework, the EU's long-term budget.
'Today was not just a conversation, but a call to action. Behind these numbers and behind every epidemiological curve, there are faces, stories, and entire lives relying on a diagnosis, a treatment, a chance,' concluded Aurelijus Veryga, Lithuania's former health minister and now a member of the European Parliament.
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