Substantial variations in global young adult cancer burden revealed
medwireNews: Among young adults, the global incidence of cancer and associated mortality varies considerably by demographic factors and socioeconomic development levels, indicates research published in The Lancet Oncology.
Using the International Agency for Research on Cancer’s GLOBOCAN database, the study authors estimated that 975,396 new cancer cases and 358,392 cancer-related deaths occurred among young adults globally in 2012, where young adults were defined as individuals aged between 20 and 39 years according to the recommendations of the Adolescent and Young Adult Oncology Progress Review Group.
This gave an annual age-standardized rate (ASR) of 43.3 cases per 100,000 persons for cancer incidence and 15.9 deaths per 100,000 persons for cancer-related mortality, they report.
Breast cancer, cervical cancer, thyroid cancer, and leukemia were the most common neoplasms in terms of new cases worldwide, with annual ASRs of 8.4, 4.9, 3.5, and 2.2 cases per 100,000 people, respectively, while the tumor types that contributed most often to mortality were breast cancer, leukemia, liver cancer, and cervical cancer, with corresponding yearly ASRs of 2.1, 1.6, 1.6, and 1.2 deaths per 100,000 persons.
Rather unsurprisingly, given these results, the overall burden of cancer incidence and mortality was greater in women than men, with annual ASRs for incidence of 57.0 versus 30.1 cases per 100,000 women versus men, and for mortality of 17.5 versus 14.4 deaths per 100,000 women versus men. Of note, thyroid cancer occurred around four times more frequently in women than men, at respective yearly ASRs of 5.7 and 1.4 cases per 100,000.
Variations were also evident when the data were stratified by the Human Development Index (HDI), which uses life expectancy, education, and gross national income to give an indication of socioeconomic development.
Although breast and cervical cancer remained the two most common malignancies in terms of incidence in countries with low, medium, and high HDI, and breast cancer was the most common neoplasm in countries with very high HDI, thyroid cancer, melanoma of the skin, and testicular cancer overtook cervical cancer in the very high HDI countries.
Furthermore, infection-associated malignancies, such as Kaposi’s sarcoma, occurred more frequently in low HDI countries.
On the whole, cancer incidence among young adults was higher in very high HDI countries than in low HDI countries, at annual ASRs of 64.5 versus 46.2 cases per 100,000 people, but the cancer-related mortality was lower, with yearly ASRs of 9.2 versus 25.4 deaths per 100,000 people, “reflecting differences in cancer profiles and inferior outcomes,” say the researchers.
They also report differences by geographical location, such that the cancer incidence was highest among young adults in Australia, New Zealand, USA, Canada, and western Europe, and lowest in parts of Africa and western and southern Asia, with the trends generally reversed with regard to cancer-related mortality.
The team led by Miranda Fidler, from the International Agency for Research on Cancer in Lyon, France, writes: “The considerable societal and economic effects of cancer in young adults as a major cause of premature morbidity and mortality requires targeted, resource-dependent interventions.
“Through continuous surveillance, vaccination, early detection programmes, and curative treatment the cancer burden can be reduced in this underserved age group.”
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