Global Incidence of Early-Onset Cancer Has Surged Since 1990
— Early-onset breast cancer has highest incidence and mortality rates
The global incidence of early-onset cancer has increased by 79% over the last three decades, researchers reported.
In 2019, new cancer diagnoses in people under 50 totaled 3.26 million compared with 1.82 million in 1990, according to Xue Li, PhD, of Zhejiang University School of Medicine in China, and colleagues.
Meanwhile, 1.06 million people under the age of 50 died of cancer in 2019, representing a smaller increase of about 28% compared with deaths in 1990 (0.83 million), they noted in BMJ Oncology.
“Dietary risk factors, alcohol use and tobacco consumption were the main risk factors for top early-onset cancers in 2019,” Li and colleagues wrote. Encouraging a healthy lifestyle could reduce early-onset cancer disease burden.”
Using data from the Global Burden of Disease (GBD) 2019 study for 29 cancers in 204 countries and regions, the authors showed that early-onset breast cancer had the highest incidence rate (13.7 per 100,000) and mortality (3.5 per 100,000).
In addition, early-onset nasopharyngeal and prostate cancers showed the fastest increase in incidence, with an estimated annual percentage change (EAPC) of 2.28% (95% CI 2.1-2.47) and 2.23% (95% CI 1.97-2.49), respectively, while early-onset liver cancer showed the sharpest decline, with an EAPC of -2.88% (95% CI -3.46 to -2.3).
The early-onset cancers with the highest mortality and disability-adjusted life years were early-onset breast, tracheal, bronchus and lung, stomach, and colorectal cancers. Mortality from early-onset kidney cancer (EAPC 0.81%, 95% CI 0.70-0.92) and ovarian cancer (EAPC 0.59%, 95% CI 0.49-0.69) showed the fastest increasing trends, while mortality from early-onset liver cancer (EAPC -3.39%, 95% CI -4.00 to -2.77) showed the sharpest decline.
The results “contrast with a more traditionally held view of ‘typical’ cancers in adults aged under 50 years,” wrote Ashleigh C. Hamilton, PhD, and Helen G. Coleman, PhD, both of Queen’s University Belfast, in an editorial accompanying the study. “Full understanding of the reasons driving the observed trends remains elusive, although lifestyle factors are likely contributing, and novel areas of research such as antibiotic usage, the gut microbiome, outdoor air pollution and early-life exposures are being explored.”