The pain was so sharp that Chris Williams took himself to the hospital. It was a Tuesday evening in September 2021 when Williams began experiencing throbbing abdominal pain accompanied by nausea. By the next morning, the symptoms had escalated, prompting him to seek emergency care. “I had to go to the ER,” said Williams, a Brooklyn resident. At the hospital, he was diagnosed with appendicitis and subsequently underwent surgery to remove his appendix.
About a week post-surgery, Williams returned to meet with his medical team to have the staples removed and to discuss his recovery. This is when he received the shocking news: “They found a tumor sitting on my appendix, and they biopsied that tumor and determined it was cancer,” he recalled. At 48 years old, Williams faced a daunting diagnosis. “It was actually a blessing,” he reflected. “This was really just a godsend, in my eyes. The tumor triggered my appendix to almost rupture, allowing it to be discovered. Later, they confirmed it was stage III cancer. Had it stayed in me longer, it could have advanced to stage IV,” which is considered the most severe stage of cancer and is notoriously more difficult to treat.
Williams is now cancer-free after completing treatment in November 2022, and he is part of an alarming trend: a growing number of appendix cancer patients in the United States diagnosed at a younger age. The appendix, a small pouch-like organ attached to the large intestine, plays a role in the immune system. While cancer of the appendix is rare—affecting approximately 1 or 2 individuals per million in the United States each year—recent studies indicate a sharp rise in diagnoses among Generation X and millennials.
According to a new study published in the Annals of Internal Medicine, incidence rates of appendix cancer have more than tripled among individuals born between 1976 and 1984, and quadrupled among those born between 1981 and 1989 when compared to those born from 1941 through 1949. This data, analyzed from the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program database, covered 4,858 individuals diagnosed with appendix cancer between 1975 and 2019.
Dr. Andreana Holowatyj, the lead author of the study and an assistant professor at Vanderbilt University Medical Center, expressed her concerns: “It’s alarming overall. We’re seeing generational effects for various cancers, including those of the colon and rectum.” The researchers noted that the rise in appendix cancer incidence is unlikely to be due to advancements in screening techniques, as many cases are incidentally discovered during appendicitis treatment. Instead, they speculate that environmental factors may contribute to this troubling trend.
Obesity has been identified as a risk factor for appendix cancer and is also linked to colon cancer. Dr. Holowatyj emphasized the importance of identifying the risk factors driving these trends, stating, “Understanding what these shared factors are can help us develop effective prevention strategies.” The study suggests that lifestyle changes, dietary habits, and environmental factors may all play a role in the rise of gastrointestinal cancers among younger generations.
While there are no specific screening recommendations for appendix cancer, common symptoms include abdominal or pelvic pain, bloating, nausea, and vomiting—symptoms that often mimic appendicitis. Treatment typically involves surgery to remove the appendix, and if the cancer has metastasized, chemotherapy may be administered. Dr. Holowatyj noted, “If not caught before the appendix ruptures, tumor cells can disperse throughout the abdominal cavity, leading to metastatic disease in up to 50% of patients.”
The increase in appendix cancer cases among younger adults aligns with a broader trend of early-onset gastrointestinal cancers. Dr. Andrea Cercek, co-director of the Center for Early Onset Colorectal and GI Cancers at Memorial Sloan Kettering Cancer Center, highlighted that while appendix cancers remain rare, their rising incidence is a significant concern. “We’ve known that early-onset appendix cancer is part of the bigger story of early-onset GI cancers,” she said. However, the specific factors driving this increase remain unclear.
Williams’ journey post-diagnosis was challenging, but he remains grateful for the care he received. After being diagnosed, he sought treatment at Memorial Sloan Kettering, where he underwent further surgery and chemotherapy. “I could choose to complain or be grateful that this was found in time for treatment,” he said. “It could have been life-threatening, and because it wasn’t, I feel I have everything to be grateful for.”
Despite leading a mostly healthy lifestyle, Williams experienced multiple heart attacks linked to stress, which he attributes to his work and personal life. Inspired by his health challenges, he founded the Brooklyn-based nonprofit Heart, Body & Soul to connect communities of color, particularly Black men in underserved areas, with essential health resources and advocacy tools. “It’s crucial to prioritize our health and establish a care team, especially as we see younger individuals diagnosed with serious diseases,” he emphasized. “A holistic approach to health is essential.”
