Dr Rathmell: Crossing the BRIDGE to More Integrated Early-Onset Cancer Care

The rising incidence of cancer among younger adults is challenging long-held assumptions about when and how malignancies develop—and, critically, when they should be detected. New population-level evidence presented at the 2026 American Association for Cancer Research (AACR) Annual Meeting underscores the urgency of this shift. Drawing on national data, investigators found that nearly 60% of cancers diagnosed in adults younger than 50 fall into categories that are already potentially screen-detectable, highlighting a significant gap between existing screening practices and emerging epidemiologic realities.¹

At The Ohio State University Comprehensive Cancer Center, efforts to close that gap are taking shape through the BRIDGE (Building Research, Innovation and Care Delivery for Groups with Early Onset Cancers) Program, a multidisciplinary initiative designed to rethink how oncology care and research address patients diagnosed in early adulthood. Rather than focusing on tumor type alone, the program centers on age as a defining factor, integrating clinical care with research, patient support, and policy exploration to better serve this distinct and growing population.

In an interview with Targeted Oncology, W. Kimryn Rathmell, MD, PhD, chief executive officer of The Ohio State University Comprehensive Cancer Center Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, reflected on how the growing recognition of early-onset cancer is reshaping care delivery—and how initiatives like the BRIDGE Program aim to better coordinate research, clinical care, and patient support for this population.

Targeted Oncology: What is the key finding of the AACR abstract that you believe oncologists should take away?

W. Kimryn Rathmell, MD, PhD: The important finding that comes from the study is taking a look at the breadth of cancers that are represented in this newly described group—people in the ages 20 to 50, with cancers that are traditionally cancers of aging—so that's early-onset cancer. [The study] asks a really straightforward question: how many of those cancers could we have screened for? We have screening available today for breast, prostate, colon, lung, cervical, and skin cancers, but most of the guidelines are for older patients. When [investigators] looked at how many patients fit into those discrete buckets, it was [about] 60%, so most cancers have the opportunity to be detected early. That's a really important finding and can help to guide some of the ways we think about how we approach this problem.

How did insights like these inform the clinical priorities and structure of the BRIDGE Program?

The BRIDGE Program is a unique program because it encompasses all patients in that age group. I will also say that it's called BRIDGE and not the early-onset program, because it encompasses patients who have adolescent and young adult [AYA] tumors—so the AYA cancer population as well. Whether a cancer is one that is common in this age group or a surprise in this age group, either way, [it] affects a young person differently than it would an older person. The impact is significant for the family unit, for fertility issues, for financial counseling, and just for how we manage these patients.

The BRIDGE Program doesn't take cancer by cancer. It takes by age cohort and allows us to look broadly across this group. All of these patients will have disease experts, right? If you're 30 years old and you have colon cancer, you want a colon cancer doctor taking care of you, but you want one who understands the ramifications of being a young person with cancer. And then there are things that are common across the space, and there we can provide some navigation and some tools and support to be able to meet patients with the needs that they're bringing forward. So that's the impetus for the program; it was really just to have a cohesive way of approaching this group of patients, and then it gives us a platform to do research, to ask questions about policy or screening [or] prevention, and to talk about best practices for treatment.

The BRIDGE Program has 5 core pillars that center around research, comprehensive care, patient and family support, community engagement, and program sustainability. How do the 5 pillars of BRIDGE play out in everyday practice?

The 5 pillars help us to remember and create open doors for people to come in, whether they're coming at it from the research perspective or the survivorship perspective, and because different investigators, different people have different ways that they are able to contribute to making a big difference for this population. So, the structure of the program allows for all of those components to be there and to overlap in a very nice way.

I envision many people plugging into the program—for example, there will be some contribution to patients who carry a genetic risk, and so someone who's a genome scientist may want to have access to a younger patient group to be able to study from a biological perspective or from a screening and detection perspective. Someone else may have ways that they want to understand how we best manage behavioral health issues and how the psychosocial response to a cancer diagnosis is best managed in a younger population. Some of this will also involve technology and being able to apply technological ways of interacting with our patients, so that we can have a cancer diagnosis more rapidly move back into normal health. I'm really excited about every one of the pillars; they're all essential.

From your experience building BRIDGE, what has been the greatest challenge in implementation, and what lessons from that experience might apply to other oncology care settings?

I'll [explain] first where I encountered this initially. A faculty member at my prior institution brought to my attention how many patients with colon cancer were coming to their clinic—young patients—and they wanted to be able to provide unique services, and they partnered very effectively with a sarcoma doctor and a lymphoma doctor. And so, it was actually both the expertise and the breadth that made that program really start to shine. That was very early days.

And then when I was at the NIH [National Institutes of Health], we were looking at how could utilize all of the strengths of the NIH to make a big difference in [some area]. And early-onset cancer—first of all, it's rising. We didn't really even know how much; we didn't know which cancers were affected. We didn't know how people were approaching this problem, because if it was breast cancer, it was being lumped in all breast cancer, not recognizing that there might be differences in the biology or the treatment or the outcomes for patients who are quite a lot younger. So, we decided to work across the NCI [National Cancer Institute] to make a difference. There's now a center there. And so, when I came to Ohio State, I was really delighted to find that there was already interest, and there was already a collaborative group thinking about how they could make a very multidisciplinary team come together. That's sort of the impetus.

[In terms of] barriers—treatment of colon cancer and multiple myeloma [for instance] are quite different, managed by completely different sets of people and completely different teams. Even if they're in the same department, being able to bridge that gap is part of why it's called the BRIDGE Program; it bridges in so many different ways. I've actually found that that's not a major barrier. That's more of a technical, logistical barrier; how do you actually communicate things across spaces that work in prescribed units? But [through] that kind of very distant cross-collaboration, you can learn things from groups that have been approaching it from a completely different angle. It's really fascinating.

With BRIDGE in its early stages, what impact have you seen thus far on patients enrolled in the program or clinicians treating these patients?

It still really is early. We only announced the program in November and are just rolling out a lot of the [program activities], so we're excited to see what the outcomes are. I think the early outcomes are that people appreciate the attention, people like having the coordination of care and value that there's recognition that this is different, so that's number one. I think the other big impact is how many people have been working on early-onset or younger adult cancers for a while but not really recognizing it, or having big datasets where they can look at early-onset cancer and previously had not…I think this is going to touch a lot of people who work in all different kinds of areas.

Do you have anything else to add regarding treating early-onset cancer broadly?

The only other thing I'd add, I think, for people who are thinking about how to approach this, or why it's important: I think that outliers are always interesting and valuable. And so, [patients] having cancer at a much younger age than they should give us insights. I think that there's huge value in focusing our attention there. And I think the other is recognizing that curing a patient at 20 or 30 years old gives us a lot of productive life-years saved, and so that value is incredibly important. And then, thinking about how we do it well, so that we don't disrupt family units, economic stability, transitions to independence—all of these are why this kind of a program can be truly valuable.

REFERENCE

1. Ewing, A. Prevalence of screen-detectable cancers among adults aged 18-49 years: Findings from HINTS-SEER. Presented at: AACR Annual Meeting 2026; April 17–22; San Diego, California. Abstract 916.