Worldwide cancer statistics of adolescents and young adults in 2019: a systematic analysis of the Global Burden of Disease Study 2019

Abstract

Background: The cancer burden in adolescents and young adults (AYAs) deserves more attention. However, global cancer statistics for AYAs are often presented as aggregates, concealing important heterogeneity. This study aimed to describe the worldwide profile of cancer incidence, mortality, and corresponding trends from 1990 to 2019 among 15-39-year olds by focusing on the patterns by age, sex, sociodemographic index (SDI), and regions.

Patients and methods: Global, regional, and country data on the number of cancer cases and cancer-related deaths for 29 cancer types were collected from the 2019 Global Burden of Disease (GBD) Study. We also summarized the results using five levels of the SDI and 21 GBD regions.

Results: In 2019, an estimated 1 335 100 new cancer cases and 397 583 cancer-related deaths occurred among AYAs worldwide. While the incidence rate increased mildly, the death rate decreased significantly between 1990 and 2019, with an estimated annual percentage change of 0.38 (95% confidence interval 0.36-0.39) and -0.93 (95% confidence interval -0.95 to -0.92), respectively. The cancer burden was disproportionally greater among women than among men. The cancer profiles varied substantially across geographical regions, with the highest burden being in South Asia and East Asia. Besides, the cancer incidence in the high SDI regions was four times higher than that in the low SDI regions; however, the mortality burden in the high SDI region was lower than that in the low SDI region, which reflected the differences in cancer profiles across SDI regions and the inferior outcomes in the low SDI regions.

Conclusion: This study updates the previous epidemiological data of the cancer burden of AYAs. The cancer burden in AYAs varied substantially according to age, sex, SDI, and geographical regions. These findings highlight that the specific cancer profile of AYA patients requires targeted cancer control measures to reduce the cancer burden in this age group.

Keywords: adolescents and young adults; cancer burden; death; incidence; trend.

Figure 1

Worldwide trends of incidence and death rate by cancer type and SDI quintile among 15-39-year olds from 1990 to 2019. (A) Top 10 cancer types in terms of incidence; (B) top 10 cancer types in terms of death rates; (C) incidence rates in different SDI quintiles; (D) death rates in different SDI quintiles. CNS, central nervous system; SDI, sociodemographic index.

Figure 2

Global map of the most common cancer type by country in terms of (A) incidence cases and (B) cancer-related death cases among 15-39-year olds in 2019. Numbers in brackets are the number of countries where this type of cancer is the most common. CNS, central nervous system.

Figure 3

Worldwide distribution of cancer type by (A) age group and incidence, and (B) death cases in 2019. CNS, central nervous system.

Figure 4

Worldwide distribution of the top five cancer types by SDI quintile in terms of incidence and death cases among 15-39-year olds in 2019. (A) Low SDI; (B) low–middle SDI; (C) middle SDI; (D) high–middle SDI; (E) high SDI. CNS, central nervous system; SDI, sociodemographic index.

Figure 5

Global map of (A) incidence and (B) death rate for total cancers by country among 15-39-year olds in 2019.

Figure 6

Incidence and death rates for the 29 cancer types by geographical region among 15-39-year olds in 2019. (A) Incidence rates; (B) death rates. CNS, central nervous system.