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. 2021 Jun 9;14(1):89.
doi: 10.1186/s13045-021-01093-3.

The global, regional, and national burden of cancer among adolescents and young adults in 204 countries and territories, 1990-2019: a population-based study

Yi Feng Wen  1 , Meng Xuan Chen  1 , Guosheng Yin  2 , Ruitao Lin  3 , Yu Jie Zhong  4 , Qian Qian Dong #  1 , Hai Ming Wong #  5
Affiliations

The global, regional, and national burden of cancer among adolescents and young adults in 204 countries and territories, 1990-2019: a population-based study

Yi Feng Wen et al. J Hematol Oncol. .

Abstract

Background: Accurate appraisal of burden of adolescents and young adults (AYAs) cancers is crucial to informing resource allocation and policy making. We report on the latest estimates of burden of AYA cancers in 204 countries and territories between 1990 and 2019 in association with socio-demographic index (SDI).

Patients and methods: Estimates from the Global Burden of Disease study 2019 were used to analyse incidence, mortality, and disability-adjusted life years (DALYs) due to AYA cancers at global, regional, and national levels by sex. Association between AYA cancer burden and SDI were investigated. Burdens of AYA cancers were contextualized in comparison with childhood and older adult cancers. All estimates are reported as counts and age-standardized rates per 100,000 person-years.

Results: In 2019, there were 1.2 million incident cases, 0.4 million deaths, and 23.5 million DALYs due to AYA cancers globally. The highest age-standardized incidence rate occurred in Western Europe (75.3 [Females] and 67.4 [Males] per 100,000 person-years). Age-standardized death (23.2 [Females] and 13.9 [Males] per 100,000 person-years) and DALY (1328.3 [Females] and 1059.2 [Males] per 100,000 person-years) rates were highest in Oceania. Increasing SDI was associated with a higher age-standardized incidence rate. An inverted U-shaped association was identified between SDI and death and DALY rates. AYA cancers collectively is the second leading cause of non-communicable diseases-related deaths globally in 2019. DALYs of AYA cancers ranked the second globally and the first in low and low-middle SDI locations when compared with that of childhood and older adult cancers.

Conclusion: The global burden of AYA cancers is substantial and disproportionally affect populations in limited-resource settings. Capacity building for AYA cancers is essential in promoting equity and population health worldwide.

Keywords: Adolescents and young adults; Cancer; Global burden of disease study; Mortality; Prevalence.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Levels and trends in burden of AYA cancers across 21 GBD regions by sex. The age-standardized incidence (a), death (b), and DALY (c) rates of AYA cancers in 2019. The percentage change in age-standardized incidence (d), death (e), and DALY (f) rates of AYA cancers from 1990 to 2019. GBD = Global Burden of Diseases, Injuries, and Risk Factors Study
Fig. 2
Fig. 2
Burden of AYA cancers across 204 countries and territories in both sexes, 2019. Age-standardized rates of incidence (a), deaths (b), and DALYs (c) of AYA cancers
Fig. 3
Fig. 3
Burden of AYA cancers by age and sex, 2019. Global age-specific counts and rates of incident cases (a), deaths (b), and DALYs (c) of AYA cancers per 100,000 population by sex, 2019
Fig. 4
Fig. 4
Global trends in absolute and proportional burden of incident cases, deaths, and DALYs by AYA cancer type and sex among 20- to 29-year-olds, 1990–2019. (a) Trends in the number of incident cases of AYA cancers by type. (b) Trends in composition of total incident cases of AYA cancers. (c) Trends in the number of deaths of AYA cancers by types. (d) Trends in composition of total deaths of AYA cancers. (e) Trends in the number of DALYs of AYA cancers by types. (f) Trends in composition of total DALYs of AYA cancers. AYA cancer types were sorted in decreasing magnitude in terms of the total number of incident cases, deaths, or DALYs among 15- to 39-year-olds for both sexes combined from 1990 to 2019
Fig. 5
Fig. 5
Association between SDI and AYA cancer burden at national level, both sexes combined, 2019. The association between SDI and the age-standardized incidence rate (a), death rate (b), and DALY rate (C) are depicted. Each colour represents one of the seven GBD super-regions. The small, lighter-coloured points represent countries. The larger, darker-coloured points represent GBD regions. The black lines indicate locally weighted smoothing estimates of age-standardized rates of relevant measures based on SDI in all countries. The grey shading around the black lines represents the 95% confidence interval of the estimated rates
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