Appendix cancer has traditionally been thought of as a very rare diagnosis, usually occurring in patients in their 40s or 50s. But doctors are increasingly seeing a disturbing trend: cases, most notably of mucinous adenocarcinoma and other unusual variants, such as Disseminated Carcinomatosis of the Peritoneum (DCL) adenocarcinoma, are not only showing up with increasing frequency among younger people, such as millennials, Gen-Xers, and even adolescents.
A recent paper highlighted this rise, and oncologists say it’s not just better detection, it’s a real increase, likely tied to both genetic and environmental factors.
We spoke to Dr Mandeep Singh Malhotra, Director - Oncologist, CK Birla Hospital, Delhi NCR and Co-Founder, Art of Healing Cancer, who explained the cause of the increasingly rare appendix cancer in the younger generation.
Why Are Younger People Being Affected?
Traditionally, cancers of the appendix occurred predominantly in individuals who were middle-aged or older. However, nowadays, oncologists find that they are treating patients in their 20s, and in some cases, even below 18, with these rare cancers.
1. Genetic Predisposition Plays a Role
"There are some inherited conditions that are strongly associated with appendix and colorectal cancers, including Familial Adenomatous Polyposis (FAP) and Lynch Syndrome (Hereditary Nonpolyposis Colorectal Cancer). These syndromes can run in families, significantly increasing lifetime cancer risk," said Dr Malhotra. People with such inherited tendencies need early and regular check-ups, sometimes from as young as their late teenage years.
Also Read: Younger Generations See Spike in Rare Appendix Cancers, Here's What The Study Suggests
2. Lifestyle and Diet Are Key Factors
While genetics explains part of the story, oncologists hold lifestyle modifications as prime suspects in the increased number of cases among otherwise healthy young adults. "Diets rich in red and processed meat, refined carbs, and added sugars, but poor in fibre, set up conditions in the gut that can trigger inflammation, change the microbiome, and potentially lead to cancer formation," added Dr Malhotra.
A 2025 meta-analysis has demonstrated that the Western diet is associated with increased risk of gastrointestinal cancer, mainly because of these dietary imbalances.
3. The Role of Environmental Pollutants
Beyond diet and genes, doctors are now drawing attention to the less visible but increasingly significant role of environmental contaminants.
- Microplastics: Found in food, water, and even air, these tiny plastic particles can disrupt endocrine systems and trigger chronic inflammation, both of which are associated with cancer risk.
- Insecticides and Pesticides: Common in non-organic produce, long-term exposure to certain chemicals has been linked to gastrointestinal cancers.
- Industrial Pollutants and Air Quality: Polluted environments may contribute to systemic inflammation and DNA damage over time, increasing susceptibility to malignancies.
While direct causation between these pollutants and appendix cancer is still being studied, new evidence indicates they are probable contributing causes, especially as exposure starts early in life.
Also Read: Appendix Cancer: Symptoms, Risk Factor, Prevention Tips, And Treatment Options
Why Awareness Matters Now
Due to the infrequency of appendix cancer, symptoms like abdominal pain, bloating, or altered bowel habits are confused with common gastrointestinal complaints. This translates to delayed diagnosis, and many are found incidentally upon undergoing surgery for appendicitis.
For younger people, particularly those with a history of gastrointestinal cancer or genetic syndromes within the family, screening and evaluation early on are vital. Doctors recommend:
- Genetic counselling in families with a history of FAP or Lynch Syndrome
- More frequent colonoscopies at an earlier age than is common
- Paying attention to persistent or unusual digestive symptoms, no matter how young the patient
What Can Be Done?
- Boost your fibre intake by eating whole grains, fruits, and vegetables.
- Reduce processed meats and refined carbohydrates.
- Minimise exposure to toxins by selecting cleaner food and water sources where feasible.
- Promote environmental activism, since reducing mass contamination might have public health dividends far greater than cancer prevention.
- Encourage environmental advocacy, as reducing widespread contamination could have public health benefits far beyond cancer prevention.
Bottomline
While appendix cancers remain rare, their rise in Gen-Xers, millennials, and even children is a stark reminder that cancer is no longer just a disease of ageing. A mix of genetics, diet, and environmental exposure seems to be shifting the age curve downward.
Oncologists stress that the key is awareness and early detection. For those at higher risk, proactive health choices and timely screenings could mean the difference between catching these cancers early or not at all.