Generation X is outdoing baby boomers, but not in a good way.
Per capita, Gen X (born from 1965 through 1980) is getting cancer more often than their parents’ and grandparents’ generations, researchers report June 10 in JAMA Network Open.
The forecast doesn’t look good for Gen Xers, who are starting to reach ages when cancers most often appear, say Philip Rosenberg, a biostatistician at U.S. National Cancer Institute in Rockville, Md. If the trend continues, millennials (born from 1981 to 1996) and younger generations might also experience more cancer, Rosenberg and his NCI colleague Adalberto Miranda-Filho warn.
Rosenberg, who describes himself as a boomer, wanted to see whether his generation (born from 1946 through 1964) was better off than his parents’ Greatest (1908–1927) and Silent (1928–1945) generations. And whether his millennial (1981–1996) and Gen Z (1997–2012) children might be better off still.
“You hope to see things get better when it comes to health metrics, life expectancy [and] cancer rates,” he says. “You hope to see all that improve.”
Rosenberg and Miranda-Filho gathered data from 3.8 million people diagnosed with invasive cancer. The researchers compared generational differences in diagnoses of cancer at multiple sites in the body, and projected Gen X’s rate at age 60. Gen X is of an age to develop cancers, so the researchers could detect trends for them. Since millennials are not yet old enough to get many cancers, the team couldn’t make estimates for that generation.
The forecast was not what Rosenberg had hoped. Compared with baby boomers, Gen X women had projected increases in thyroid, kidney, rectal, uterine, colon, pancreatic and ovarian cancers, as well as non-Hodgkin’s lymphoma and leukemia. Gen X men have forecasted rises in thyroid, kidney, rectal, colon and prostate cancers. The study looks at how often people are newly diagnosed with cancer, not at whether they die of it.
There were some bright spots too. Gen X women had decreases in lung and cervical cancers compared with baby boomers, while Gen X men had less lung, liver and gallbladder cancers and non-Hodgkin’s lymphoma.
But when combining all the cancers, the picture was bleak because the “gaining cancers numerically overtook falling cancers,” the researchers found.
Reversal of fortune
Generation X is being diagnosed with more cancer than earlier generations in the United States. Researchers lumped 20 leading cancers for women (yellow lines) and 18 for men (blue lines) to forecast trends in overall cancer rates at age 60. (Since the oldest Gen Xers are just approaching 60, shaded areas indicate possible ranges where the incidence rate could land, although the solid line is the most likely projection.) The graphs chart cancer diagnoses per person-year (p-y), that is, how often you would expect a cancer diagnosis if you watched 100,000 people for a year.
Among men, cancer diagnoses declined in the Greatest and Silent Generations but then ticked up again in Boomers and continue to rise in Gen X. Asian and Pacific Islander men are the exception. Their cancer rates continued to decline into Gen X. Women tended to get fewer cancers than men in early generations, but the differences have largely been erased, except in the non-Hispanic Black population where men still get cancer more often. Scroll through to see how cancer incidence has changed through the generations for four racial or ethnic groups.
U.S. cancer diagnoses across generations, 1908–1983
Hispanic women had one of the biggest increases, a rise of 35 percent. They went from 598 cancers diagnosed per 100,000 person-years in the Silent and boomer generations (born from 1936 through 1960) to 806 diagnoses per 100,000 person-years in Gen X. That rate is the number of new cancer diagnoses you would expect if you watched 100,000 people for a year.
All racial and ethnic groups included in the study experienced increases in cancer diagnoses except for Asian and Pacific Islander men, for whom cancer rates fell from 562 cancers diagnosed per 100,000 person-years at age 60 in the Silent and boomer generation to 519 cancers per 100,000 person-years for Gen Xers, a decrease of 8.2 percent. Non-Hispanic Black men in Gen X had the highest combined rate of cancer at 1,561 cases per 100,000 person-years. That’s up about 12 percent from the 1,399 cancer diagnoses per 100,000 person-years in the boomer and Silent generations.
Increases in many cancers, including colorectal cancers in people under 50, and upticks in kidney and thyroid cancers have previously been noted, says cancer epidemiologist Ahmedin Jemal of the American Cancer Society in Atlanta (SN: 8/14/23). And the jump is not limited to the United States. Other high-income countries have reported similar increases.
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.”
