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. 2020 Dec 1;3(12):e2027738.
doi: 10.1001/jamanetworkopen.2020.27738.

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

Alyssa R Scott  1   2 , Kelsey C Stoltzfus  1   2 , Leila T Tchelebi  1 , Daniel M Trifiletti  3 , Eric J Lehrer  4 , Pooja Rao  5 , Archie Bleyer  6   7 , Nicholas G Zaorsky  1   2
Affiliations

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

Alyssa R Scott et al. JAMA Netw Open. .

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 < .001). Kidney carcinoma increased at the greatest rate for both male (APC, 3.572; 95% CI, 3.049-4.097; P < .001) and female (APC, 3.632; 95% CI, 3.105-4.162; P < .001) AYAs.

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.

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Conflict of interest statement

Conflict of Interest Disclosures: Ms Scott reported receiving grants from the National Institutes of Health (NIH) during the conduct of the study. Dr Zaorsky reported receiving startup funding from Penn State Cancer Institute and Penn State College of Medicine; support from grant LRP 1 L30 CA231572-01 from the NIH; support from grant CSDG-20-013-01-CCE from the American Cancer Society–Tri State CEOs Against Cancer Clinician Scientist Development; and remuneration from Springer Nature for his textbook, Absolute Clinical Radiation Oncology Review. No other disclosures were reported.

Figures

Figure.
Figure.. Cancer Incidence Trends for Top 12 Disease Sites With the Highest Absolute Incidence for Male and Female Adolescents and Young Adults (AYAs) From 1973 to 2015
Disease sites with the highest absolute incidences from 1973 to 2015 for both male and female AYAs were included in this figure.
See this image and copyright information in PMC

References

    1. Adolescent and Young Adult Oncology Review Group Closing the Gap: Research and Care Imperatives for Adolescents and Young Adults With Cancer. US Dept of Health and Human Services; 2006.
    1. Bleyer A, Barr R, Ries L, Whelan J, Ferrari A, eds. Cancer in Adolescents and Young Adults. 2nd ed Springer International Publishing; 2017.
    1. Bleyer A, O’Leary M, Barr R, Ries LAG, eds. Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age, Including SEER Incidence and Survival: 1975-2000 National Cancer Institute; 2006.
    1. Centers for Disease Control and Prevention. United States and Puerto Rico cancer statistics, 1999-2015 incidence request. WONDER online database. Published 2018. Accessed March 16, 2019. https://wonder.cdc.gov/cancer-v2015.html
    1. Bleyer WA. Cancer in older adolescents and young adults: epidemiology, diagnosis, treatment, survival, and importance of clinical trials. Med Pediatr Oncol. 2002;38(1):1-10. doi:10.1002/mpo.1257 - DOI - PubMed

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