Duarte, Calif.-based City of Hope has called for “bold” changes to address the rising cancer rates among women younger than 50.
Cancer incidence rates among women younger than 50 is 82% higher than incidence rates among men of the same age, according to a May 20 news release from the cancer center. Younger women have unique concerns that typical cancer care strategies may not address.
“We need to stop treating 30-year-old women like 70-year-olds. Radiation, chemotherapy, surgery — every decision has a lasting impact when you’re treating someone with half a lifetime still to go,” Lily Lai, MD, a City of Hope colon and breast cancer specialist, said in the release.
Hope Rugo, MD, recently joined City of Hope as division chief of breast medical oncology and as director of the Women’s Cancer Program.
Dr. Rugo shared with Becker’s what healthcare industry leaders need to know about the increase in women’s cancers, as well as the mindset shifts that need to occur and the national standards that need to be met to address the issue.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What changes do you believe health systems must prioritize to better detect and treat cancer in women?
Dr. Hope Rugo: City of Hope is calling for three bold changes in our approach to caring for younger women with cancer. This includes more age-specific research and a national standard for supportive care.
The other change where I am particularly focused is integrating more genetic screening and risk assessment into routine care, especially for younger women and those with family histories of cancer. This does not mean lowering the age for mammography. We are advocating for simple tests to screen for common risk factors, such as genetic mutations, family history and lifestyle. A younger woman who is at a higher risk can be monitored and, most importantly, she can be empowered to take proactive steps to reduce her risk.
Q: What national standards would you like to see adopted to help younger women navigate a cancer diagnosis?
HR: We need a national framework that recognizes the unique psychosocial and economic challenges younger women face. This includes standardized access to fertility counseling, mental health support and financial navigation services from the moment of diagnosis. Working with an organization such as our partner, Together for Supportive Cancer Care, we are looking for practices that embed survivorship planning into care from day one, not as an afterthought. These models should also include peer support networks, because the emotional toll of cancer at a young age is often compounded by isolation.
Q: What mindset shifts do you feel cancer care leaders need to have in regard to taking time for fertility preservation before cancer treatment?
HR: Too often, fertility preservation is treated as optional or secondary, something to consider only if there’s time. But for many of the 20,000 women of childbearing age diagnosed with breast cancer each year, losing the ability to have children in the future compounds the devastation of a cancer diagnosis.
We need to shift from a mindset of “only if there’s time” to one of “a critical choice to make” at the outset of care. That means fertility discussions before treatment begins. This is not about delaying care; it’s about integrating fertility planning into the treatment timeline with the same urgency we give all aspects of treatment.
For example, ovarian stimulation is the most proven method of fertility preservation for young women with breast cancer. With current techniques, this now takes only about two weeks, which is a very modest delay for most women starting chemotherapy. This is not a delay but a way to begin considering developing the right treatment plan for some women.
Q: If you could give hospital and health system leaders one piece of advice regarding the increasing cancer incidence rates among young adult women, what would it be?
HR: The data is there. The rise in cancer among young adult women is not just an interesting statistical trend; it’s a call to reimagine how we deliver care.
Leaders must invest in early detection strategies tailored to younger populations, including risk-based screening protocols. Beyond detection, we need to build systems that are agile and responsive to the life-stage needs of these patients — whether that’s new therapies, better ways of managing issues such as hair loss, and integrated fertility and mental health services. We need to act and adapt to this demographic shift.
Q: What is missing from broader industry-wide conversations when it comes to women and cancer?
HR: Personalization and a patient-centered approach are at the heart of effective advanced cancer care. The rising incidence of cancer among younger women underscores the urgent need for individualized treatment strategies. The most effective approach involves integrating tumor biology and genomic testing into every treatment decision to tailor therapy to each patient’s unique profile.
Equally important is the emphasis on supportive care — proactively managing side effects to enhance quality of life throughout treatment.
We must also work to ensure equitable access to these advanced therapies for all patients, regardless of background. Empowering individuals with knowledge about their risk can significantly improve early detection and prevention outcomes.
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