Younger, not invisible:
rewriting cancer care –
starting with the pancreas

By Sommer Bazuro

World Pancreatic Cancer Day is a moment to look beyond biology and face a generational shift. The global cancer burden continues to climb and a growing share now falls on younger adults aged 18-50.

It’s reshaping what awareness, diagnosis and care must look like in the UK and across Europe. New efforts, such as ‘Jess’s Rule’, which urges clinicians to consider cancer earlier in adults with unresolved symptoms, and EU-level reform signal a new age of cancer care focused on earlier action and younger patients.

Traditionally, cancer was seen as a disease occurring in older age groups. However, the landscape is changing. Between 2009 and 2019, there was a 79% increase in the global incidence of early onset cancer cases. The causes are complex and likely a mix of environment, lifestyle and microbiome influences, so the responsible reaction is not guesswork, but better awareness, earlier evaluation and smarter pathways for patients under 50.

The WHO cancer agency – the International Agency for Research on Cancer (IARC) – is supplying the common ‘scoreboard’ through the Global Cancer Observatory/GLOBOCAN 2022, which provides age-stratified incidence and mortality for 36 cancers in 185 countries and publishes focused analyses on early-onset trends – critical for tracking under-50s risk.  Europe has started to organise for this challenge. The EU Cancer Mission (Horizon Europe) and Europe’s Beating Cancer Plan work in tandem via National Cancer Mission Hubs to translate research and policy into earlier detection, better treatment and improved quality of life.

Despite these efforts, pancreatic cancer remains one of the deadliest malignancies, too often diagnosed late because early signals like abdominal pain, weight loss and new-onset diabetes are non-specific. For younger adults, the diagnosis collides with work, parenting and future-building. Daniel King, a pancreatic cancer specialist at Northwell Health based in the US, says: “Out of the 150 new pancreas cancer patients I see each year, about one in five are early onset. They leave a strong impression because younger patients have different needs – they are at a different time in their lives.”

Breakdowns typically occur because of irregular primary care, cost and time barriers, and the cultural reflex to downplay symptoms in younger adults. Clinicians, trained around older-age prevalence and guideline thresholds, may ‘watch-and-wait’. As Dr King explains: “The pancreas sits deep inside the body. Symptoms are vague… but these often go unnoticed in younger adults who are busy with work or family.”

The goals for all patients should be to shorten time to evaluation and stop abnormal results from stalling in the system.

Cancer in your 20s, 30s or 40s is not only a medical crisis, but also a life crisis. “Cancer is not only physical; it’s an emotional disease. For younger patients, we’re not just fighting the tumour; we’re fighting for their families, their futures, their sense of normalcy,” says Dr King. That means building mental health support, fertility preservation and work/study-friendly navigation into the care plan from day one.

Europe has now defined what Adolescent Young Adult (AYA)-fit care looks like. New minimum standards for specialist AYA units call for AYA-aware multidisciplinary teams (MDTs), flexible trial eligibility, fertility services, psychosocial care, survivorship clinics and smooth transitions between paediatric, AYA and traditional services. Centres can begin implementing changes immediately, even with limited resources. Embedding these standards into accreditation will help make age-appropriate care the default across Europe.

Similar momentum is building elsewhere, as the NCCN has AYA-specific guidelines in the US, NCI-designated centres are scaling dedicated AYA programmes, and Australia and Canada have national AYA frameworks – together signalling that age-appropriate, multidisciplinary cancer care is becoming a global norm.

The next frontier pairs smarter pathways with smarter tools, AI-assisted imaging, better follow-up on incidental findings and maturing blood-based detection that may help flag high-risk people earlier (with rigorous evidence and safeguards). As Dr King notes: “Technology is evolving, and blood-based screening tests may soon help us find cancers like pancreatic earlier. We welcome that future.”

On World Pancreatic Cancer Day, remembrance must fuel renewal. In this New Age of Cancer, we need to design our oncology ecosystem for younger patients. Everyone across the world: listen to your body; advocate for yourself, and talk to your doctor, so that ‘too young’ doesn’t turn into ‘too late’.

References are available on request.