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Charmella Roark remembers the shock that stopped her in her tracks when she learned of her younger sister’s cancer diagnosis.
In 2018, Kiki Roark wrote in their family’s group text that she had been diagnosed with stage I breast cancer — the same disease that took their aunt’s life a few years earlier.
“I was in disbelief,” Charmella said of her sister’s diagnosis. “He’s my first best friend.”
The New Jersey sisters never imagined that four years later, Charmella would receive the same diagnosis.
The Roark sisters represent an ongoing trend in the United States: more and more young women are being diagnosed with cancer.
Cancer rates generally declined among men in the United States early this century before leveling off, but they appear to be increasing among women, particularly young women. Cancer diagnoses are shifting from older to younger adults and from men to women, according to a report released Thursday by the American Cancer Society.
Middle-aged women now have a slightly higher risk of cancer than their male counterparts, and Young women are nearly twice as likely to be diagnosed with the disease as young men, according to the report published in CA: A Cancer Journal for Clinicians. It appears that breast and thyroid cancers in women are behind this growing trend.
“Breast and thyroid cancers account for nearly half of all cancer diagnoses in women under 50,” said Rebecca Siegel, lead author of the report and senior scientific director of surveillance research at the American Cancer Society.
Kiki was 37 when she was diagnosed with breast cancer in August 2018.
A sharp pain in her armpit had spread to her chest and she had three of her doctors order a mammogram to check for cancer. But everyone told her a mammogram wasn’t necessary at her age, she said.
“Just because I was younger, I feel like they didn’t take me seriously,” Kiki said. “But I kept pressing the problem and saying, ‘No, something’s wrong.'”
It took months, Kiki said, but she finally had a mammogram. He showed signs of cancer and a biopsy confirmed the diagnosis.
“I was just starting out,” said Kiki, a mother of three who works from home.
For treatment, she had both breasts removed in a double mastectomy and was given the hormone therapy drug tamoxifen.
Charmella stayed by her sister’s side throughout her illness. And in the years since, Charmella said, she’s been inspired to stay on top of her routine breast cancer screenings by getting mammograms.
In the summer of 2022, one of those mammograms revealed that Charmella, a high school teacher and mother of two, had stage I breast cancer. She was 44 at the time.
After getting her own diagnosis, Charmella immediately called Kiki.
“I was devastated,” Kiki said. “The first thing I thought: not again.”
Charmella quickly began treatment: six cycles of chemotherapy and a month of radiotherapy.
Charmella and Kiki found themselves among the one in three American women who will be diagnosed with cancer at some point in their lives.
Historically, men have had a higher overall cancer incidence than women, but in 2021, women under the age of 50 in the United States had an 82% higher cancer incidence rate than their male peers, according to the new report from the American Cancer Society, which draws on data from the National Cancer Institute, the U.S. Centers for Disease Control and Prevention and the North American Association of Central Cancer Registries.
“We see for the first time that if you are a woman under 65, you are now more likely to develop cancer than men in the same age group,” said Dr. William Dahut, scientific director of the American Research Institute. Cancer Society.
“The other thing is that we are seeing a change – at the time of cancer diagnosis – in the age at which patients develop cancer,” Dahut said.
“Age remains the main risk factor for cancer overall, and this has not changed. But we are seeing changes,” he said. For men and women combined, “the only age group where we really see an increase in cancer risk and incidence is those under 50.”
Charmella, now 47, and Kiki, 44, are cancer-free and doing well, but they know that as black women in the United States, they are part of a community facing significant disparities in cancer outcomes.
Even though black women in the United States have about a 4 percent lower incidence rate of breast cancer than white women, they are 41 percent more likely to die from the disease, according to previous data from the American Cancer Society.
The new report shows that these large disparities persist.
“As a white woman, you are more likely to develop breast cancer. As a black woman, you are more likely to die from it, especially when looking at younger populations, where the disparities are greatest,” Dahut said.
Black people have a mortality rate twice as high as white people for cancers of the prostate, stomach and uterine corpus, according to the report. Similarly, mortality rates from kidney, liver, stomach, and cervical cancer among Native Americans are two to three times higher than those observed among whites.
There are also geographic differences in cancer onset and outcome.
Nationwide, cancer death rates range from less than 150 deaths per 100,000 people in Utah, Hawaii, and New York to more than 210 deaths per 100,000 people in West Virginia, Kentucky and Mississippi.
But the new report also offers hopeful news.
Overall cancer survival rates are increasing, and the U.S. cancer death rate has continued to decline, preventing nearly 4.5 million deaths between 1991 and 2022, an overall decline of 34%, according to the new report. .
“Year after year, we see a continued decline in cancer-related mortality, and that’s very significant,” said Dr. Mariana Chavez-MacGregor, a professor at the University of Texas MD Anderson Cancer Center at Houston, who did not participate in the study. the new report.
This decline in cancer deaths is largely due to fewer people smoking cigarettes, earlier detection of some cancer cases, and advances in treatment options, including the development of new immunotherapy drugs and therapies. targeted.
The Roark sisters want other women to know the importance of advocating for access to these medical advances in screening and treatment. Screening mammograms are recommended for women every two years starting at age 40, unless the patient meets certain other criteria.
“I always say, stand up for yourself,” Kiki said.
“A breast specialist, a (gynecologist) and a family doctor told me it was nothing,” she said. “If I had listened to them, we don’t know where I would be right now.”
The American Cancer Society report projects that this year there will be more than 2 million cancer diagnoses — or about 5,600 new cases each day — and more than 618,000 cancer deaths in the United States, matching at approximately 1,700 lives lost per day.
As the incidence of cancer among young adults continues to rise, doctors are considering what might be driving this trend. Is it simply because we have gotten better at screening and detecting cancers, or are there real factors that put people at risk?
“In my professional opinion, this phenomenon is multifactorial. We can’t pinpoint a specific factor, but it’s possible that changes in fertility patterns play a role,” Chavez-MacGregor said, referring to how pregnancy and breastfeeding have been associated with risk. reduced breast cancer later in life.
“Obesity and alcohol consumption are likely contributing factors, as is potential lack of physical activity,” she said. “Other unknown variables may also come into play,” such as environmental risk factors.
A better understanding of the factors driving this increase can help determine ways to reduce risk in young adults, said Dr. Neil Iyengar, a medical oncologist at Memorial Sloan Kettering Cancer Center in New York, who not participated in the new report.
“There is, and there must be, a greater shift in the scientific research and resources available to the scientific community to better understand how we can be more effective in preventing cancer, or at least reducing the risk of cancer,” Iyengar said. said.
“We certainly need to understand individual biology and how to prevent cancer based on that individual biology. But we need to broaden that to understand a person’s lifestyle and their environmental risks,” he said. “The exposures and risks of a younger person are likely very different from those of a traditional older person at risk for cancer.”
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The increase in cancer incidence among young people could also have major implications for the future of cancer care, as certain types of cancer in young people may require more aggressive therapies, Iyengar said.
“We must be prepared to support our young men and women who are undergoing perhaps more aggressive cancer treatments while continuing to care for young families and build careers,” he said. “It ranges from practical considerations – like how we plan chemotherapy treatments, for example, so that they are less disruptive to people’s lives, careers and families – to the types of treatments we use.”