Dataset Information

Trends in Cancer Incidence in US Adolescents and Young Adults, 1973-2015.

ABSTRACT: Importance:Previous studies have demonstrated that adolescents and young adults (AYAs) with cancer are a distinct cancer population; however, research on long-term epidemiological trends and characteristics of cancers in AYAs is lacking.

Objective:To characterize the epidemiology of cancer in AYAs aged 15 to 39 years with respect to (1) patient demographic characteristics, (2) frequencies of cancer types, and (3) cancer incidence trends over time.

Design, setting, and participants:This retrospective, serial cross-sectional, population-based study used registry data from the Surveillance, Epidemiology, and End Results (SEER) database from January 1, 1973, to December 31, 2015 (SEER 9 and SEER 18). The study population was from geographically distinct US regions, chosen to represent the racial and ethnic heterogeneity of the country. Initial analyses were performed from January 1 to August 31, 2019.

Main outcomes and measures:Incidence rates and descriptive epidemiological statistics for patients aged 15 to 39 years with invasive cancer.

Results:A total of 497?452 AYAs diagnosed from 1973 to 2015 were included in this study, with 293?848 (59.1%) female and 397?295 (79.9%) White participants. As AYAs aged, an increase in the relative incidence of carcinomas and decrease in the relative incidence of leukemias, lymphomas, germ cell and trophoblastic neoplasms, and neoplasms of the central nervous system occurred. Among the female AYAs, 72?564 (24.7%) were diagnosed with breast carcinoma; 48?865 (16.6%), thyroid carcinoma; and 33?828 (11.5%), cervix and uterus carcinoma. Among the male AYAs, 37?597 (18.5%) were diagnosed with testicular cancer; 20?850 (10.2%), melanoma; and 19?532 (9.6%), non-Hodgkin lymphoma. The rate of cancer in AYAs increased by 29.6% from 1973 to 2015, with a mean annual percentage change (APC) per 100?000 persons of 0.537 (95% CI, 0.426-0.648; P?
Conclusions and relevance:In this cross-sectional, US population-based study, cancer in AYAs was shown to have a unique epidemiological pattern and is a growing health concern, with many cancer subtypes having increased in incidence from 1973 to 2015. Continued research on AYA cancers is important to understanding and addressing the distinct health concerns of this population.

SUBMITTER: Scott AR

PROVIDER: S-EPMC7709088 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Trends in Cancer Incidence in US Adolescents and Young Adults, 1973-2015.

Scott Alyssa R AR Stoltzfus Kelsey C KC Tchelebi Leila T LT Trifiletti Daniel M DM Lehrer Eric J EJ Rao Pooja P Bleyer Archie A Zaorsky Nicholas G NG

JAMA network open 20201201 12

<h4>Importance</h4>Previous studies have demonstrated that adolescents and young adults (AYAs) with cancer are a distinct cancer population; however, research on long-term epidemiological trends and characteristics of cancers in AYAs is lacking.<h4>Objective</h4>To characterize the epidemiology of cancer in AYAs aged 15 to 39 years with respect to (1) patient demographic characteristics, (2) frequencies of cancer types, and (3) cancer incidence trends over time.<h4>Design, setting, and participa ...[more]

PMID: 33258907

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Project description:BackgroundFor adolescents and young adults (AYAs, aged 15-39 years) with cancer, metastatic disease at diagnosis is the strongest predictor of mortality, but its associations with age and sociodemographic factors are largely unexplored.MethodsUsing Surveillance, Epidemiology, and End Results Program data from 2000 to 2016, we collected incident cases of poor-prognosis metastatic cancer (5-year survival < 50%) and compared the proportion, incidence, time trends, and incidence rate ratios for race and ethnicity, sex, and socioeconomic status among AYAs, middle-aged adults (aged 40-64 years) and older adults (aged 65-79 years).ResultsFrom 2000 to 2016, a total of 17 210 incident cases of poor-prognosis metastatic cancer were diagnosed in AYAs, 121 274 in middle-aged adults, and 364 228 in older adults. Compared with older patients, the proportion of AYAs having metastatic disease was equivalent or substantially lower in nearly every site except stomach and breast cancers, which were statistically significantly higher for AYAs compared with middle-aged and older adults (stomach: 57.3% vs 46.4% and 39.5%; breast: 6.6% vs 4.4% and 5.6%, respectively; 2-sided P < .001 for all comparisons). Incidence rates rose significantly faster among AYAs for breast, stomach, and kidney cancers and among AYAs and middle-aged adults for colorectal cancer. Markedly higher incidence rate ratios were noted for AYA racial and ethnic minorities with breast, stomach, and especially kidney cancer, where only non-Hispanic Black AYAs were at considerably higher risk. For most sites, incidence rate ratios were higher among male patients and individuals of low socioeconomic status across age groups.ConclusionsFor most cancers, AYAs are not more likely to present with metastases than middle-aged and older adults. Further investigation is warranted for the disproportionate rise in incidence of metastatic breast, stomach, and kidney cancer among AYAs and their excess burden among AYA racial and ethnic minorities. The rising incidence of colorectal cancer among AYAs and middle-aged adults remains an additional concern.

Dataset Information

Trends in Cancer Incidence in US Adolescents and Young Adults, 1973-2015.

Publications

Trends in Cancer Incidence in US Adolescents and Young Adults, 1973-2015.

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