Between 2001 and 2019, 16 of 22 cancer types rose significantly among women aged 20 to 49 in England, while 11 of 21 types rose significantly among men of the same ages, according to a study in BMJ Oncology that drew on national cancer registry data. The authors found that excess body weight explained part of the pattern but could not account for all of it.
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The researchers, based at The Institute of Cancer Research in London and Imperial College London, set out to test whether changes in smoking, alcohol, diet, weight and physical inactivity could explain the rise. For most of those factors the answer was no, because the trends were flat or improving, which leaves the cause of much of the increase unexplained.
The registry data and the 16 of 22 count
The paper appeared in BMJ Oncology in April 2026 and was republished in October through a ScienceDaily summary. The authors presented the work at a Science Media Centre briefing in late April alongside Prof. Amy Berrington of The Institute of Cancer Research. It analysed incidence from England’s national cancer registry across 22 cancer sites in women and 21 in men, in adults aged 20 to 49 and in those 50 and older. Risk-factor trends came from national health surveys, and the authors estimated the share of cases attributable to each factor, assuming a 10-year lag between exposure and diagnosis.
The count of 16 of 22 for women covers all cancer types in the registry that were analysed. A narrower set of 11 cancers with established behavioural risk factors was rising in the under-50s: thyroid, liver, kidney, gallbladder, bowel, pancreas, mouth, breast, ovary, multiple myeloma and endometrial cancer. Three of those are specific to women, according to the paper’s abstract.
Which cancers rose faster in younger women
Most of the 11 also rose in people over 50, with two exceptions. Bowel and ovarian cancer rose significantly only in younger adults. Among younger women, endometrial, kidney, pancreatic, thyroid cancer and multiple myeloma rose faster than in older women, while multiple myeloma was the only one to rise significantly faster in younger men than in older men.
Prof. Montserrat García-Closas of The Institute of Cancer Research, listed first among the authors, said excess weight is an important contributor, although it cannot fully account for the scale of the rise. Prof. Marc Gunter of Imperial College London said the trends do not have a single cause or a simple answer.
Excess weight explains some, not all
Excess weight was linked to 10 of the 11 cancers, with mouth cancer the exception. The share of cases attributable to it ranged from 5% for ovarian cancer to 37% for endometrial cancer, per the ScienceDaily summary. Obesity was also the one major risk factor that moved the wrong way, according to the paper: overweight and obesity have risen steadily since 1995, with the largest relative increase, 2.6% a year, in younger women.
Weight alone leaves a large remainder, and the attributable shares for other factors vary widely by site. In 2019, according to the summary, behaviours such as smoking, alcohol and diet accounted for 68% of mouth cancers in younger men and 52% in younger women, and 42% of liver cancers in younger men and 44% in younger women. The paper’s abstract puts the range across cancers at 7% to 65% for younger adults, which means that for some cancers most cases have no known behavioural driver. The ecancer report on the study gives an example: bowel cancer in younger women that was linked to body mass index rose from 0.9 to 1.6 per 100,000, but cases not linked to it rose from 6.4 to 9.6 per 100,000. Both categories grew, so BMI alone does not explain the increase. The abstract’s own conclusion is that, apart from BMI, the behavioural risk factors are unlikely to explain the rising incidence in younger adults, and it calls for research into emerging risk factors alongside prevention of the known ones.
Risk factors that improved while cancers rose
Apart from weight, most established risk factors were stable or improving over the one to two decades examined. Smoking among younger adults fell by about 2% a year, and alcohol use stabilised or declined. Younger men’s red meat intake fell from 38 grams to 17 grams a day between 2008 and 2018, and younger women’s from 22 to 10 grams, though more than 90% of younger adults still missed fibre recommendations in 2018.
Prof. Kristian Helin, chief executive of The Institute of Cancer Research, said that traditional lifestyle risks alone cannot explain current trends, and that the burden remains overwhelmingly higher in older people. The authors pointed to possible contributors such as gut microbiome disruption as worth further study, while stressing that its role is unproven.
The study has limits: it is observational, covers England only, lacked reliable long-term national data for some risk factors, and did not assess reproductive history, early-life exposures or changes in screening and detection. The authors also stress that the absolute burden remains far higher in older adults, so the findings describe a rising trend in a younger group rather than a shift in where most cancers occur.
This article was produced with the assistance of AI and reviewed by Morning Overview editors prior to publication.
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