Global cancer statistics for adolescents and young adults: population based study

Abstract

Background: Accurate and up-to-date estimates of the global cancer burden in adolescents and young adults (AYA) are scarce. This study aims to assess the global burden and trends of AYA cancer, with a focus on socioeconomic disparities, to inform global cancer control strategies.

Methods: AYA cancer, defined as cancer occurring in individuals aged 15-39, was analyzed using data from the Global Burden of Disease (GBD) 2021 study and the Global Cancer Observatory (GLOBOCAN) 2022 project. We examined the global burden by age, sex, geographic location, and Human Development Index (HDI), as well as its temporal trends. Primary outcomes included age-standardized incidence and mortality rates (ASIR, ASMR) and the average annual percent change (AAPC).

Results: In 2022, an estimated 1,300,196 incidental cases and 377,621 cancer-related deaths occurred among AYAs worldwide, with an ASIR of 40.3 per 100,000 and an ASMR of 11.8 per 100,000. The most common cancers were breast, thyroid, and cervical, while the leading causes of death were breast, cervical, and leukemia. The incidence and mortality were disproportionately higher among females (ASIR: 52.9 for females vs. 28.3 for males; ASMR: 13.1 for females vs. 10.6 for males). Countries with higher HDI experienced a higher incidence of AYA cancers (ASIR: 32.0 [low HDI] vs. 54.8 [very high HDI]), while countries with lower HDI faced a disproportionately higher mortality burden (ASMR: 17.2 [low HDI] vs. 8.4 [very high HDI]) despite their relatively low incidence. Disproportionality and regression measures highlighted significant HDI-related inequalities. AYA cancer incidence was stable from 2000 to 2011 (AAPC: - 0.04) but increased from 2012 to 2021 (AAPC: 0.53), driven by growing gonadal and colorectal cancers. Mortality decreased substantially from 2000 to 2011 (AAPC: - 1.64), but the decline slowed from 2012 (AAPC: - 0.32) probably due to increased deaths from gonadal cancers. These trends varied by sex, cancer type, geography, and HDI.

Conclusion: AYA cancers present a significant and growing global burden, with marked disparities across sex, geographic locations, and HDI levels. Policymakers should prioritize equitable resource allocation and implement targeted interventions to reduce these inequalities, particularly in low-HDI regions and with regard to gonadal cancers.

Keywords: Adolescents and young adults; Cancer; Disparities; Global analysis; Incidence; Mortality; Trend.

Fig. 1

Global burden of adolescent and young adult cancers, 2022. A Global age-specific counts and rates of incident cases and deaths by sex. B Global age-specific counts and proportion of incident cases and deaths by cancer type. C Global age-specific counts of incident cases and deaths for the 10 most common cancers

Fig. 2

Regional burden of adolescent and young adult cancers, 2022. A Age-standardized incidence and mortality rates by region, with national data included; countries with the highest rates within each region are highlighted. B Region-specific proportion of incident cases and deaths. C Rankings of the top 10 AYA cancer incidences across and within regions. Abbreviation: ASIR age-standardized incidence rate, ASMR age-standardized mortality rate, AYA adolescents and young adults

Fig. 3

National burden of adolescent and young adult cancers, 2022. A Global maps present the age-standardized rates of incidence and mortality in each country. B Global maps present the most common type of cancer incidence and mortality in each country

Fig. 4

Burden of adolescent and young adult cancers by HDI level. A HDI-specific age-standardized rates of incidence and mortality. B HDI-specific proportion and age-standardized rates of incidence and mortality for the 5 most frequent cancers. C Rankings of the top 10 AYA cancer incidences across and within different HDI levels. Abbreviation: HDI human development index

Fig. 5

HDI-related inequalities in burden of adolescent and young adult cancers, 2022. A Associations between the age-standardized incidence rate, age-standardized mortality rate, and incidence-mortality ratio with HDI. Each dot represents a country, with the size of the dot indicating the number of incidental cases in that country. B Concentration curve illustrating HDI-related inequalities in age-standardized rates and incidence-mortality ratio. Abbreviation: HDI human development index

Fig. 6

Temporal trend in burden of adolescent and young adult cancers from 2000 to 2021. A By sex. B By the 10 most frequent cancer type. C By region. D By HDI. Abbreviation: AAPC average annual percent change, HDI human development index. Source: The Global Burden of Disease Study 2021