Screening, therapeutics, and fertility are converging into a new paradigm in oncology care.
In 2024, cancer was not on 32-year-old Ally Hartenstine’s mind. It wasn’t on her doctors’ either.
Hartenstine, living and working in Brooklyn, noticed a few masses above her collarbone that fall. Despite bloodwork coming back out of range, her doctor reassured her it wasn’t cancer. But after receiving an ultrasound, she got a note of “suspicion of metastatic masses” on her chart.
A chest CT scan showed lymphoma and a large medial spinal tumor. The scan detected 25 swollen lymph nodes that were blocking the airway in her throat.
“I was technically in an oncology emergency because of the blockage,” she shares. “I remember that day very specifically. How did it get so bad that I didn’t even realize it?”
Hartenstine later reflected on symptoms that may have been culprits: some weight loss, fatigue, night sweats, a puffy face, and bruising. Still, the collarbone masses were the only physical sign that seemed wrong to her.
“None of them in isolation made me think,” she says.
Cancer mortality in the U.S. has declined by 34% between 1991 and 2023, preventing an estimated 4.8 million deaths. And yet, adults under 50 are facing cancer diagnoses at an increasingly alarming rate.
Women, in particular, are bearing the brunt of that rise.
A 2025 report from the American Cancer Society found that the cancer incidence for women under 50 is 82% higher than for men the same age compared to 51% higher in 2002.
“In that under 50 population, it’s not equal,” Karen Knudsen, the CEO of the Parker Institute for Cancer Immunotherapy, tells HLTH in an interview for The Pulse. “If you take out the pediatric population and you define a young adult age 15 to 39, that’s 88,000 new diagnoses this year alone. That’s a lot of people.”
Breast cancer rates are rising nearly 1.5% each year for women under 50. Meanwhile, colorectal cancer rates are rising nearly 3% each year for all those under 50. Despite being commonly referred to as a cancer of older adults, colorectal cancer is now the No. 1 cancer killer of adults under 50.
“That was really not expected, and something, frankly, that we still don’t really understand,” says Knudsen of the overall rising rates in young adults. “The leading hypotheses are all associated with early exposures. So, is it microplastics? Is it ultra-processed food? Is it pesticides? Is it a helicopter of all of those things plus something else? We know that there must be a ‘something else’ because this change in incidence is particular to that under 50 population.”
The decades of hard-won progress in decreasing cancer mortality is colliding with an uncomfortable trend that is exposing the limits of the current healthcare system. The response isn’t just clinical. It’s financial and it’s about supporting a workforce through sudden life-altering diagnoses. At HLTH, our oncology programming is addressing prevention, early detection, the promise of AI, and the future of survivorship care.
While experts may debate the underlying causes for these trends, many have also been challenging screening protocols for early detection, educating on prevention, grappling with treatments that balance survivorship and quality of life, and ultimately, solving for the affordability question.
“There’s strong data that younger patients with cancer are less able than their older counterparts to pay for their cancer care, resulting in higher rates of medical debt and greater likelihood to experience financial toxicity from their care,” Dr. Yousuf Zafar, a gastrointestinal medical oncologist and the Chief Medical Officer of Access Hope, tells HLTH.
So where do we go from here?
Read the full article by Alexa Mikhail, Content Lead and Senior Health Writer at HLTH, to learn how advances in screening, therapeutics, fertility preservation, and survivorship could reshape cancer care for younger generations.