Baby Boomers have lower cancer rates compared to Gen X

Generation X is surpassing baby boomers in an unfortunate manner.

Gen X, individuals born between 1965 and 1980, see higher incidents of cancer compared to their parent and grandparent generations, as indicated in a study presented June 10 in the JAMA Network Open.

The outlook appears grim for Gen X as they now approach typical ages for cancer diagnosis. Biostatistician Philip Rosenberg from the U.S. National Cancer Institute, along with NCI's Adalberto Miranda-Filho, warn that if this pattern persists, millennials (born 1981 to 1996) and subsequent generations could also face a higher prevalence of cancer.

Rosenberg, who identifies as a baby boomer (1946–1964), wanted to determine if his generation was healthier than his parents' generations, the Greatest (1908–1927) and Silent (1928–1945), and if the millennial (1981–1996) and Gen Z (1997–2012) generations might yet be even better off.

“You expect to witness improvements in health metrics, lifespan, and cancer rates," he states.

The duo collected data from 3.8 million people diagnosed with colorectal cancer to compare generational differences in cancer diagnoses at various body locations. They then predicted Gen X's rate at age 60. Considering Gen X is of an age where cancers usually develop, they could identify trends. However, since millennials are still too young for most cancers, they couldn't make accurate projections for that generation.

Unfortunately, the results were disappointing. Compared to baby boomers, the study projected rises in various cancers, including thyroid, kidney, rectal, uterine, colon, pancreatic, and ovarian cancers, and non-Hodgkin’s lymphoma for Gen X women, while Gen X men saw increases in thyroid, kidney, rectal, colon, and prostate cancer. The team's findings focused on new cancer diagnoses rather than cancer mortality.

On the positive side, Gen X women saw a decrease in lung and cervical cancers compared to their baby boomer counterparts. Gen X men showed fewer lung, liver and gallbladder cancers, and non-Hodgkin’s lymphoma.

However, when considering all cancer types collectively, the overall outlook was bleak as the “growing cancers numerically exceeded declining cancers,” according to the study findings.

The evidence shows Generation X is receiving more cancer diagnoses than prior generations. The study included 20 leading cancers for women (yellow lines) and 18 for men (blue lines) to project overall cancer rates at age 60. The data displays cancer diagnoses per person-year, that is, the expected number of diagnoses from observing 100,000 people over a year.

Cancer diagnoses showed a declining trend among men of the Greatest and Silent Generations, but they rose again with the Boomers and continues its rise through Gen X. Asian and Pacific Islander men are an exception with their cancer rates still on the decline. Women in earlier generations generally had fewer cancers than men, but this difference has largely diminished, except in non-Hispanic Black populations where men still have higher cancer rates.

Hispanic women experienced a significant rise of 35 percent. Their rate increased from 598 cancer diagnoses per 100,000 person-years in the Silent and boomer generations to 806 diagnoses per 100,000 person-years in Gen X. This equates to the number of new cancer diagnoses you could expect from observing 100,000 people over a one-year period.

All races and ethnic groups examined in the study saw increases in cancer diagnoses except for Asian and Pacific Islander men. The rates for these men fell from 562 cancer diagnoses per 100,000 person-years at age 60 in the Silent and boomer generations to 519 diagnoses per 100,000 person-years for Gen X, marking a decrease of 8.2 percent. Non-Hispanic Black men in Gen X showed the highest combined cancer rate, with an increase of about 12 percent.

Increases in certain cancers, including colorectal cancers affecting individuals under 50, and rising kidney and thyroid cancers have been previously identified, states Ahmedin Jemal, a cancer epidemiologist with the American Cancer Society. It’s also noted that the upsurge isn’t isolated to America, with similar increases being reported in other financially stable countries.

The uptick of cancer in Gen X “is like a yellow flag,” Rosenberg says. “These numbers suggest there are some unfavorable trajectories.” He hopes other researchers will use the data to uncover what is driving those increases and find ways to turn the trends around.

Researchers are only beginning to gather data on Gen X and cancer as people in that generation reach middle age, says Corinne Joshu, a cancer epidemiologist at the Johns Hopkins Bloomberg School of Public Health.

Some of the increase may be due to better screening and early detection, Joshu says. “Sometimes that’s hard to say how much of this is related to changes in detection and changes in just clinical awareness to look for something, versus a true increase.” Some prostate cancers can be nasty, but many will be so slow growing that they don’t cause health problems, so there are concerns about overdiagnosing such cancers, she says.

Many of the cancers on the rise among Gen Xers are linked to obesity, lack of exercise, eating too much red meat and other lifestyle factors. But changing that is not easy, Joshu says. “The healthy choices are not the easy choices to make in our society.”

She and Jemal say that drops in lung cancer came about because of multilayered policy changes that banned smoking indoors and taxes that made cigarettes too expensive for people most likely to start smoking as teenagers. Vaccines against human papillomavirus (HPV) and other public health measures have been instrumental in reducing cervical cancer (SN: 4/28/17).

But taking something away that isn’t good for health may be easier than making positive lifestyle changes accessible and affordable for everyone, Joshu says. “We do not see it easier and more affordable to eat healthier,” she says. “I think we could move the needle on that, but it takes societal effort and for people to come together and say, ‘This is important and it’s worth changing.’ … And that presumably would lead to not only a decrease in cancer, but a decrease in [other] major causes of death.”