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National Geographic
19 hours ago
- Health
- National Geographic
Statin drugs are an Internet villain. Do they deserve it?
Cholesterol-lowering medicines are some of the most commonly prescribed, effective drugs. Influencers on TikTok have other ideas. The cholesterol-lowering drug Simvastatin. Like other statins, this drug reduces the levels of low-density lipoprotein (LDL) cholesterol in the body. Over 40 million Americans currently take statins. Photograph by James King-Holmes, Science Photo Library Inside the average doctor's office, statins aren't controversial; they're a crucial lifesaving tool used to lower dangerously high cholesterol levels, reducing risk of heart attack. But on social media, the drug is often villainized, painted as a poison pill, or a symptom of a diseased medical system. Recently, influencers have claimed that statins cause more harm than good and have endless side effects. Others take even bigger swings, claiming that the fundamental science behind cholesterol is a myth, one that's used simply to sell more statins . 'If you only went online,' Spencer Nadolsky says, 'you would never want to have a statin.' Nadolsky, a physician who specializes in obesity and lipids, is familiar with the social media critiques. 'It's one of the most fear-mongered yet amazing drugs of our time,' he says. How did boring generic pharmaceutical—a drug prescribed to 200 million people worldwide—become controversial? Part of the answer is influencers who proselytize ketogenic and carnivore diets, promising weight loss and other health benefits through the consumption of high fat consumption and limited carbohydrates. When adhering to one of these diets, the body uses fat as its main fuel source instead of carbohydrates, which can lead to loss of body fat while maintaining muscle mass. The success of these diets is often bolstered by fit social media influencers eating red meat off a cutting board, touting the benefits of their preferred version of a low-carbohydrate, high-fat diet. One influencer even claimed that her transition from a vegan diet to a carnivore diet cured her of everything from brain fog to flatulence. But keto and carnivore have been associated with dramatic increases in low density lipoprotein (LDL) cholesterol—the cholesterol most strongly associated with heart disease, often called the 'bad' cholesterol. Rejecting the lipid hypothesis, many influencers cast doubt on the widely accepted concept that cholesterol contributes to atherosclerosis, which is the buildup of fats and cholesterol in and on the artery walls. The head of a 60 year old patient with high blood pressure and high blood cholesterol. The blood vessels are the result of atherosclerosis which is the buildup of fats and cholesterol in and on the artery walls. Image by Zephyr/Science Photo Library Clinical lipidologist Tom Dayspring describes claims like these as 'ketogenic nonsense.' He says that patients might not experience any symptoms of atherosclerosis until it's too late. What some people don't understand, Dayspring explains, is that heart disease only presents symptoms like chest pain and arrhythmia in very late stages of progression. Symptoms, Dayspring notes, can't be used to diagnosis the disease. 'Most people are dropping dead before they get any symptoms of heart disease,' he says. A scent, a touch, or a sip can be just what you need to lock an important moment into your mind forever. Dayspring says that LDL levels in the United States follow a bell curve. In general, doctors want to get their patients to the 20th percentile or lower, or around 100 mg of LDL cholesterol per deciliter of blood. Once you go above the 20th percentile, the exponential risk becomes a 'straight line to heaven,' Dayspring says. The only way to reduce serious medical issues like heart attacks, heart failure, and strokes brought on by plaque accumulation in the arteries is to achieve very low levels of LDL cholesterol. Dayspring describes it as 'an illegal dump job of cholesterol in your artery wall.' A lipid can only travel through plasma when it's wrapped in a protein known as a lipoprotein. 'Some lipoproteins, for whatever reason, leave plasma, crash the artery wall, and dump their cholesterol.' That's where statins can help. Low-density lipoproteins, or LDLs, are molecules that are a combination of fat and protein and are the form in which lipids are transported in the blood. LDLs transport cholesterol from the liver to the tissues of the body, including the arteries, which has lead LDL being known as "bad" cholesterol. Micrograph by Science Photo Library A colored transmission electron micrograph of high density lipoprotein (HDL), or 'good' cholesterol. HDL cholesterol plays a role in fat metabolism and contributes to cardiovascular health Micrograph by Lennart Nilsson, TT/Science Photo Library Approved in the United States in 1987, statins work by blocking an enzyme in the liver—where most of the body's cholesterol is produced—which prevents LDL production. Statins reduce the risk of heart attack, stroke, and heart disease, which is still the leading cause of death in the United States. Over 40 million Americans currently take statins. Until the early 2000s, statins were the only game in town for managing cholesterol, Dayspring says. Now, there are newer drugs that can also help. One class of drugs, PCSK9 inhibitors, lowers LDL cholesterol by blocking the protein that binds to LDL receptors, keeping these receptors available to clear LDL cholesterol from the blood stream. Unlike statins, these drugs haven't been vilified by. While LDL is often referred to as the 'bad' cholesterol because it can contribute to plaques, and HDL is called the 'good' cholesterol for clearing excess cholesterol from the arteries, it's not black and white. The body requires LDL to function since it assists in cellular construction and repair and serves as a building block for many essential hormones. 'I tell patients up front, [LDL] is the delivery cholesterol, because every tissue in your body needs tens of thousands of doses of cholesterol every day,' says Stephen Kopecky, a preventative cardiologist and the director of the Mayo Clinic's Statin Intolerance Clinic in Minnesota. 'If you didn't have it, you'd be dead,' Kopecky explains. 'So it can't be that bad. There's a sweet spot.' But LDL is just one measure of cholesterol. Dayspring thinks the most measurement to pay attention to is apolipoprotein B, or ApoB, the protein component found in several lipids, including LDL, but not HDL. ApoB, involved in cholesterol transport, is considered superior to LDL cholesterol to assess the risk of heart disease. Unlike LDL cholesterol, ApoB captures a more complete picture of all potentially plaque-causing particles in the blood. For example, a person with normal LDL cholesterol but high ApoB would still be at risk for heart disease. Looking at ApoB is relatively new in the United States, which has historically used LDL. But the rest of the world uses this measurement, says Kopecky. Statin side effects and intolerance Like all medication, statins have side effects. On social media, these side effects are often front-and-center, used by influencers to show that the drug is inefficient or steer followers from considering the medication altogether. The most common are muscle aches, headaches, digestive issues. More seriously, for people with insulin resistance, there's an increased risk to develop Type 2 diabetes (though the American Diabetes Association advises that people with diabetes go on a statin if they're older than 40). To Nadolsky, the benefits outweigh the risks. He compares taking statin to taking daily multivitamin. In his practice, he's able to convince skeptical patients who've bought into the influencer-driven narrative around statins with some basic facts. If the patient claims that LDL cholesterol is not the cause of development of plaque in the arteries, he'll point out that the association is 'one of the most grounded scientific things we know.' Nadolsky's claims are backed up by a trove of evidence, including a 2017 a meta-analysis in the European Heart Journal. That paper found that the totality of evidence 'unequivocally establishes' that LDL causes atherosclerotic cardiovascular disease (ACSVD.) In 2020, the panel restated its conclusion, and also identified emerging evidence for ApoB's role in ASCVD. Some patients, however, are statin intolerant. A 2022 meta-analysis drawing on 4.1 million patients found statin intolerance within 9.1 percent of this population. By Kopecky's estimation, there are three types of statin intolerant patients: those who experience body aches on the medication, and who cycle their use on and off to manage their cholesterol. Kopecky is part of this group. He experiences muscle aches after several months on a statin. Doctors will sometimes temporarily discontinue a patient's statins and then add statins back to their regimen with either modified doses or a different statin to curb side effects. A second group experiences 'these weird symptoms that aren't really related to when they take the medicine.' Researchers have observed a nocebo effect, or negative placebo effect associated with statins, and one 2020 study found this effect might be increasing. The third group, which Kopecky finds most concerning, are those worried about potential statin intolerance, who won't ever visit Kopecky's office. Many patients, he says, will come in and say, 'I don't want to take this drug. I've been on the Internet. I know that's bad for me, doctor.' A statin's effects on the brain are another concern around the medication. Statins are the only drug that can cross the blood-brain barrier and inhibit cholesterol synthesis in the brain, which is the body's most cholesterol-rich organ, Dayspring explains. Cholesterol is required for the brain to operate, but excess cholesterol in the brain can cause neurodegenerative diseases, including Alzheimer's. Dayspring points to the evidence which, he says, shows that 'statins do not hurt the brain in any way, but they actually improve dementia a little bit.' For the exceedingly rare group of people who experience brain fog while on statins, he theorizes that they've over-suppressed the brain's synthesis of cholesterol. But since the brain makes its own cholesterol, drugs that lower cholesterol levels in the liver do not affect the brain's cholesterol levels. Self-guided research on cholesterol and statins can lead to conflicting advice. A quick scan of the best-selling heart health books on Amazon shows titles like The Great Cholesterol Myth and The Cholesterol Hoax, and other offerings that advise readers to load up on red meat, Kopecky says. These books capitalize on a well-established formula. Diet books, Malcolm Gladwell wrote in the New Yorker more than two decades ago, are 'selling something that people want to buy: the idea that they can eat whatever they want.' Beyond misinformation, part of the mistrust around statins is that drug companies didn't initially provide all the information about the drug's side effects, leading doctors, including Kopecky, to pass on incomplete information to patients. It took 20 years before doctors realized that statins can cause a minor increase in blood glucose, which can lead to type 2 diabetes. The lagging response, Kopecky says, has led to some patients to distrust their doctors on this specific treatment. Cholesterol deposits causing the narrowing of a blood vessel which raises blood pressure and puts strain on the heart. Atherosclerosis is the main cause of heart attacks. Photograph by Lennart Nilsson, Boehringer Ingelheim/TT/Science Photo Library Colored coronary angiogram of a 53 year old patient with severe narrowing of the circumflex coronary artery. Photograph by Zephy/Science Photo Library Regardless of claims on the internet, the only lifestyle change that can help control LDL cholesterol is significantly reducing the consumption of saturated fats, Dayspring says. For people with cardiovascular risk that can't be controlled by lifestyle factors, pharmacological intervention is the only option. And the first drug doctors reach for is statins. Lifestyle, Kopecky says, is incredibly important. While a large portion a person's cholesterol is genetic, any positive change is welcome, according to the data. 'Nothing you do to improve your health is ever too little, and nothing you do to improve your health is ever too late in your life,' he says. But he's bearish on keto. 'You just can't eat a keto diet forever,' Kopecky says. There is a healthy version of the diet, he notes—one that relies on extra virgin olive oil, nuts, and avocado oils as the primary fat sources, with just one ounce of red meat per day—but that's a far cry from the steak-loaded cutting boards influencers tout on social media. The carnivore diet often conjures mental images of predators in the wild, consuming double-digit pounds of meat per day. There is even one strict regimen of red meat, salt, and water, is known as the 'Lion Diet.' But despite the image of a diet bridging the gap to our animalistic nature, only humans have high cholesterol, Dayspring notes. 'Things that eat meat all day long, have LDL cholesterols of 15 to 20.' One criticism of statins is that they're overprescribed. And a recent study published in JAMA Internal Medicine found that's likely the case, but it didn't question the benefits of statins or their necessity. According to the study, '50 million US adults aged 40 years and older meet criteria for elevated ASCVD risk,' for a statin prescription, even by the study's revised numbers. To convince wary patients, Nadolsky shares a personal datapoint: he's on a statin. 'I practice what I preach,' he says. Statins are one of the best medicines in use, according to Nadolsky. 'It's just a shame that people aren't utilizing them, due to the fear mongering that is done online.' A 2019 study published in JAMA Cardiology showed less adherence to taking statin medication was associated with more incidences of death for patients with ASCVD. Kopecky, too, is concerned with patients who explicitly say they don't want to take statins after reading about them on the internet. In response, his clinic polled 1,200 of these patients to see what would tip the scales to change their minds about statins. The patients wanted to know three things: cholesterol is involved in heart disease, doctors have a way to lower risk of heart disease, and the treatment is safe. As a result, Kopecky and the Mayo Clinic released a series of videos to address each of these three points. Still, medical misinformation still runs rampant on social media and even crops up next to reputable professionals on social media. When viewing a YouTube video of Kopecky discussing statin misinformation on Mayo Clinic Radio, two of the recommended videos in the sidebar were a video purporting to reveal the 'big pharma' conspiracy behind statins and a second one claiming that LDL cholesterol is a myth. 'LDL is not a myth, and you have to look at the totality of evidence,' Kopecky says. He thinks anyone with high cholesterol should seek treatment for it but understands they might not want to: 'You can't make everybody drink the Kool-Aid.'
WIRED
a day ago
- Automotive
- WIRED
How to Convert an Analog Bike to an Electric Bike
Michael Venutolo-Mantovani You can save yourself thousands of dollars on an electric bike by upgrading your current ride. Let us walk (or cycle!) you through it. Courtesy of Science Photo Library via Getty Images All products featured on WIRED are independently selected by our editors. However, we may receive compensation from retailers and/or from purchases of products through these links. Say you want to get a bicycle up and down hills with a minimal amount of pedal power. What do you do? The first option is simple: buy an electric bike. However, ebikes aren't cheap. These days, the least expensive but still reliable ebike you can buy is Aventon Soltera 2.5, which costs around $1,200. You can rent an ebike, or find a city bike program that uses them, or, if you're really lucky, find an ebike in a lending library. Or you can just make your regular bike into an electric bike. That is, you can slap an aftermarket unit on your traditional bike, creating a motor-assisted ebike with little more than your bicycle and any of a variety of aftermarket power sources. What used to be a very niche field with only a small handful of offerings has become a cottage industry full of contenders and pretenders, and any number of startups offering a readymade conversion for your bike. So how do you turn your traditional bike into an ebike? And what are some of the best offerings out there? We'll walk you through it. If you don't see anything you like, make sure you check out our guides to the Best Electric Bikes or the Best Electric Scooters. Hot to Throt Well, first, you need to decide what kind of conversion you want. There are two basic kinds of ebikes, pedal-assist and throttle, with many newer models boasting some combination of both. Pedal assist is a mechanism that provides an added boost of electric power when you're pedaling. Via the use of cadence and/or torque sensors (how fast your pedals are rotating and the power that's being applied to them, respectively), pedal-assist units kick on at a certain point, making pedaling easier. Sometimes pedal assist can be so minimal, it's difficult to tell just how much work you're doing versus how much of the load your bike is handling. Throttle units act more like a motorcycle or moped, allowing the rider to either twist a tube mounted near the handgrip or use a thumb-based knob to deliver immediate power to the wheels. Throttle-based ebikes can be ridden without pedaling. When it comes to ebike conversions, where your power comes from and how it's delivered can look several different ways. Some mechanisms deliver power to either your bicycle's rear or front hub. Others are situated in the bottom bracket (that is, where the cranks meet the bike frame). And some newer conversion kits act something like a treadmill mounted to your bike, using rollers to help propel your wheel forward. Roll the Clip Photograph: Stephanie Pearson Having said all that, it's important to consider your level of bicycle know-how when it comes to what kind of ebike conversion you want to undertake. If you're a wrencher, the conversion process is generally straightforward, regardless of the type of unit. If you can change a tire or swap out your cassette, you'll probably be fine with a bit of trial and error and the help of YouTube tutorials. If you're asking yourself, 'What's a cassette?' it's probably best to visit your local bike shop and have a pro handle the work. Those 'treadmill' style conversion kits—such as the Rubbee X, Livall PikaBoost 2 rear-wheel units, or the Clip front-wheel unit—are typically the easiest to install, as you simply need to fix the machine to either your bike's seatpost frame or its fork, make sure its rollers are contacting your tire, and off you go. However, that 'contacting your tire' bit is a bit of a rub (pun intended), as the added contact with your rubber might lead to some extra wear. As disc brakes are becoming ever more the norm (as opposed to a traditional rim brake), Skarper offers a conversion unit that is equally as simple to install to your bike's disc-brake mounts and can be done by almost anyone who knows how to use an Allen wrench. The cool thing about each of these aforementioned units is the ease with which they can be attached and removed, meaning your ebike conversion isn't permanent. With them, you can use your road bike as a commuter during the week, yet keep on with your weekend group rides on the weekend. Hub It Out If you're looking for something more permanent (and way more powerful), units such as the Bafang M-Series replace your traditional bottom bracket with a motor that can deliver up to 1,000 watts of added power to the crank arms of your bike. However, as replacing a bottom bracket is one of the more involved things you can do on a bike, this isn't something you'll want to swap in and out. Somewhere in between the clip-on ease of units like the PikaBoost and the more permanent solution the M-Series offers, are the aforementioned hub-based power units, which tuck motors into the hubs of your wheels. Many of these units also offer battery packs that are meant to be attached to your bike's existing bottle cage mounts. Among the many options for hub-based power units, it's hard to beat the Zehus, which requires nothing more than replacing your existing rear wheel with a Zehus-outfitted wheel. Similarly, Cytronex, one of the earliest and longest-standing ebike brands around, offers a hub-based conversion kit that, while a bit more involved, should take no more than a few minutes of setup. With the explosion in popularity in ebikes, this list is barely scratching the surface. For each of the units mentioned here, there are a dozen or more aftermarket competitors offering similar products. Do your research, talk to the experts at your local bike shop, and decide which unit is right for you and your needs. Once you do that, keep the rubber side down! Power up with unlimited access to WIRED . Get best-in-class reporting that's too important to ignore for just $2.50 $1 per month for 1 year. Includes unlimited digital access and exclusive subscriber-only content. Subscribe Today .
National Geographic
12-06-2025
- Health
- National Geographic
Your breathing pattern is unique like your fingerprint—and may help predict health issues
In a new study, scientists identified people based only on their breathing pattern with almost 97 percent accuracy—and soon might be able to analyze yours to diagnose what ails you. Colored 3D computed tomography (CT) scan of the spaces within the facial bones surrounding the nasal cavity. Illustration by Vsevolod Zviryk, Science Photo Library Everyone's breathing pattern is unique, and soon scientists might be able to analyze yours to diagnose what ails you. Scientists were able to identify individual people based just on their breathing pattern with 96.8 percent accuracy, and different patterns corresponded to differences in physical and mental traits, according to a new study in Current Biology. Because it happens subconsciously, breathing may seem simple, but it's controlled by a complex brain network. 'Respiration has to be coordinated with almost everything,' says Noam Sobel, neurobiologist at the Weizmann Institute of Science in Israel and co-author of the new study. From timing our breathing when we speak, to when we swim, the respiratory system is often negotiating with various parts of the brain. 'Although breathing starts with this breathing center in the brain stem, it actually ends up being coordinated with a humongous chunk of your brain,' says Sobel. Those different parts of the brain include regions responsible for language, emotion, and motor skills. Inhaling drives specific waves in the brain's memory center that help consolidate memories. When we inhale, pressure in the nasal cavity changes, which excites neurons that send signals to the brain, according to Detlef Heck, a University of Minnesota neuroscientist who was not involved with the new research. The moment of transition from breathing out to breathing in might have a sort of reset effect in the brain, so changing the breath can help stress regulation and cognitive performance. Slow breathing techniques are used to reduce stress and anxiety, alter mood, and changing breathing patterns can affect cognitive ability and focus. Scientists are still learning about how the brain shapes breath, how breath shapes the brain, and what information this could one day tell doctors about a patient's health. Unique breath 'fingerprints' The team conducting the new research mostly studies the brain-breath connection in olfaction, or how taking in scents through the nose brings information directly to the brain to process. Since every brain is unique, the study authors hypothesized that the respiratory patterns shaped by those brains would also be unique. To test their hypothesis, the team developed a lightweight, wearable tube that fit inside the participant's nose and continuously tracked nasal airflow over 24 hours. A hundred healthy young adults wore the nasal tube device while going about their daily lives, and logged their activities in a cell phone app. Study participants all had remarkably distinct breathing patterns, according to the results. The research team was able to identify individuals from only their breathing patterns with 96.8 percent accuracy using a machine learning analysis. This level of accuracy was consistent across multiple retests over two years, meaning the test's precision rivals that of some voice recognition technologies. 'It's very rare that you can predict a biological process so accurately,' says Sobel. Each respiratory 'fingerprint' also provided insights into each person's mental and physical condition, since certain breathing patterns correlated with body mass index, sleep-wake cycle, and depression and anxiety. Participants who had higher anxiety levels based on questionnaire responses, for example, tended to have shorter inhales and more varied pauses between breaths while sleeping. Pauses between breaths turned out to be an especially meaningful parameter: one person might consistently pause for one second after each breath, while another person might sometimes pause for one second and other times pause for five seconds. This variability statistic was a powerful tool in the predictive models, says Sobel. Nasal airflow is so closely connected to the brain because of the evolution of the sense of smell, scientists theorize. Nasal breathing has also been linked to how we form mental images, for example, and smell is associated with how we store memories. That may be because smell is the oldest sensory system to exist in mammals, says Sobel, and it's considered a sort of evolutionary scaffolding organizing the evolution of the structure of the mammalian brain. Although modern humans are more visually-oriented, connections between nasal breathing and so many parts of the brain could be a mechanism left over from evolution, explains Daniel Kluger, neuroscientist at the University of Münster in Germany, who was not involved with the new research. In studies on performance in visual and spatial tasks—having nothing to do with smell—people tend to perform better while inhaling than while exhaling. This could be because inhalation makes us more sensitive toward any sensory inputs, not only smell, says Kluger, so we're more likely to perceive visual, auditory, and tactile information when it's presented while we're breathing in. 'You're in a particular bodily state [while inhaling] that makes you more sensitive to incoming sensory stimuli,' explains Kluger. Change your breath to change your brain? Measuring the link between breathing patterns and health conditions on more people could help develop breath analysis as a diagnostic tool, say scientists. 'This is a super exciting finding, but someone needs to show it also works for other [groups],' says Heck, 'but in general I think this is a very promising direction.' The study authors are now testing their device and analysis method to screen for diseases. The findings also raise questions about whether changing breath patterns could change what's going on in the brain. 'There's a chicken and egg question here, of what drove what: are you breathing this way because you're depressed, or are you depressed because you breathe this way?' asks Sobel. 'If it's the latter, then that's potentially exciting because that opens paths to intervention—so, can I teach you to breathe in a way that will make you less depressed or less anxious?'
Scottish Sun
11-06-2025
- Health
- Scottish Sun
Taking common contraceptive pill long-term could increase your risk of life-threatening brain tumour, scientists warn
Find out all the pros and cons of the contraceptive pill below BITTER PILL Taking common contraceptive pill long-term could increase your risk of life-threatening brain tumour, scientists warn TAKING a progesterone-only contraceptive pill for more than five years is linked to an increased risk of a life-threatening brain tumour, say scientists. Desogestrel is a synthetic progestogen hormone used in oral contraceptives, specifically the progestogen-only pill (POP) or mini-pill. 1 Long-term use of desogestrel has been linked to intracranial meningiomas Credit: Science Photo Library - Getty While it offers several benefits beyond preventing pregnancy, such as regulating the menstrual cycle, reducing heavy or painful periods, new research suggests taking it continuously for more than five years is linked to a small increased risk of developing an intracranial meningioma. An intracranial meningioma is a tumour that develops from the meninges, the layers of tissue that cover the brain and spinal cord. These tumours are typically benign (non-cancerous) and slow-growing. But they can be life-threatening depending on size, location, and growth rate. The tumours are more common in older women, but previous studies lack information on the specific type of progestogen used - and risk has not been measured for continuous, current, and long term use. In the study from France published by The BMJ, researchers set out to assess the real-life risk of the brain tumour and short-term (less than a year) and prolonged (one to seven or more years) use of oral contraceptives containing desogestrel 75µg, levonorgestrel 30µg, or levonorgestrel 50-150 µg combined with oestrogen. Their findings were based on data from the French national health data system (SNDS) for 8,391 women who had undergone surgery for intracranial meningioma in 2020-2023. Each case was matched to 10 control women without meningioma of the same age and area of residence. The results showed a small increased risk associated with use of desogestrel for more than five continuous years. An increased risk wasn't found for shorter durations or when desogestrel had been discontinued for more than one year. Women taking fat jabs need 'effective contraception' - as health chiefs warn of serious harm to unborn babies The risk was greater in women older than 45 and after prolonged use of one of the known high risk progestogens before desogestrel. Although the researchers added the risk disappeared one year after stopping taking the pill. It was estimated that 67,000 women would need to use desogestrel for one woman to need surgery for intracranial meningioma, and 17,000 women if current use was for more than five years. No increased risk was found for levonorgestrel, alone or combined with oestrogen, regardless of duration of use. The researchers suggested desogestrel be discontinued if an intracranial meningioma is identified and patients monitored rather than undergoing immediate surgery.
Yahoo
09-06-2025
- Health
- Yahoo
Appendix Cancer Has Quadrupled in Millennials
Credit - Science Photo Library—Getty Images Cancer is generally a disease of old age. But researchers are increasingly finding that certain types—including colon, breast, stomach, and pancreatic cancers—are hitting people younger than 50 far more commonly than they used to. In a new report, published in the Annals of Internal Medicine, researchers at Vanderbilt University focus on a relatively rare cancer—appendiceal cancer, which occurs in the appendix—and found that its rates are also rising, especially among millennials. Andreana Holowatyji, assistant professor of hematology and oncology at Vanderbilt University Medical Center, and her colleagues analyzed data from the National Cancer Institute's Surveillance, Epidemiology and End Results program, a cancer registry that includes patients from 1975 to 2019. The scope of the dataset allowed them to look for generational differences in cancer rates. They specifically tracked appendix cancer, which for many years was misclassified as colorectal cancer since the appendix sits at the start of the large intestine. Recent studies have shown an increase in colorectal cancers among those under 50, and Holowatyji wanted to learn if the same trend was occurring for appendix cancer. 'We don't know what the risk factors are for appendix cancer, and seeing whether there are generational effects could help us to continue to put the pieces together of this complex puzzle,' she says. Read More: The Race to Explain Why More Young Adults Are Getting Cancer In their analysis, which involved more than 4,800 people diagnosed with appendix cancer, rates of the cancer tripled among those born in 1980—and quadrupled among those born in 1985—compared to people born in 1945. Rates increased in every birth cohort after 1945. In that time, rates of appendectomies remained about the same, which the researchers say largely rules out the possibility that more cases were detected from appendectomies performed. It's likely not a single factor but the interaction of several that contributes to an increased cancer risk in this age group, such as rising rates of obesity and metabolic syndrome as well as environmental exposures, Holowatyji says. 'The challenging thing now is to disentangle not only what these exposures are, but what molecular changes these exposures cause, and what the consequences of those changes are on our cells that may end up increasing the risk of carcinogenesis,' she says. Much more data is needed to better understand appendiceal cancer, and that starts with greater awareness and better diagnosis. Because it's rarer than colorectal cancer, Holowatyji says health care professionals and the public should be more attuned to potential symptoms and not ignore or dismiss them. These can include general complaints like bloating, changes in bowel movements, and loss of appetite. If they persist, people should see their doctor. Half of appendix cancers are diagnosed after it has already spread, so being more vigilant and intervening early could lead to better outcomes. 'While rare, appendix cancer is rising,' she says. 'Individuals know their bodies best, and if they experience any changes or symptoms, those aren't things they should overlook." Contact us at letters@
