Cancer statistics for adolescents and young adults, 2020

Abstract

Cancer statistics for adolescents and young adults (AYAs) (aged 15-39 years) are often presented in aggregate, masking important heterogeneity. The authors analyzed population-based cancer incidence and mortality for AYAs in the United States by age group (ages 15-19, 20-29, and 30-39 years), sex, and race/ ethnicity. In 2020, there will be approximately 89,500 new cancer cases and 9270 cancer deaths in AYAs. Overall cancer incidence increased in all AYA age groups during the most recent decade (2007-2016), largely driven by thyroid cancer, which rose by approximately 3% annually among those aged 20 to 39 years and 4% among those aged 15 to 19 years. Incidence also increased in most age groups for several cancers linked to obesity, including kidney (3% annually across all age groups), uterine corpus (3% in the group aged 20-39 years), and colorectum (0.9%-1.5% in the group aged 20-39 years). Rates declined dramatically for melanoma in the group aged 15 to 29 years (4%-6% annually) but remained stable among those aged 30 to 39 years. Overall cancer mortality declined during 2008 through 2017 by 1% annually across age and sex groups, except for women aged 30 to 39 years, among whom rates were stable because of a flattening of declines in female breast cancer. Rates increased for cancers of the colorectum and uterine corpus in the group aged 30 to 39 years, mirroring incidence trends. Five-year relative survival in AYAs is similar across age groups for all cancers combined (range, 83%-86%) but varies widely for some cancers, such as acute lymphocytic leukemia (74% in the group aged 15-19 years vs 51% in the group aged 30-39 years) and brain tumors (77% vs 66%), reflecting differences in histologic subtype distribution and treatment. Progress in reducing cancer morbidity and mortality among AYAs could be addressed through more equitable access to health care, increasing clinical trial enrollment, expanding research, and greater alertness among clinicians and patients for early symptoms and signs of cancer. Further progress could be accelerated with increased disaggregation by age in research on surveillance, etiology, basic biology, and survivorship. CA Cancer

Incidence, Survival, and Mortality Trends of Cancers Diagnosed in Adolescents and Young Adults (15–39 Years): A Population-Based Study in The Netherlands 1990–2016

“…In line with previous global finding, rising trends in incidence were among the highest for AYAs diagnosed with thyroid and kidney carcinomas and a markedly higher burden of thyroid carcinomas was observed within the female AYA population [8,9,15,24,25]. These rising trends have been primarily attributed to overdiagnosis [9,32,33].…”

“…Similar to earlier findings in most countries worldwide, the incidence of AYA cancers in the Netherlands has increased significantly since 1990 [7][8][9]24,25]. Rising trends in overall cancer incidence among AYAs have been attributed to thyroid cancer overdiagnosis (detection of cancers that would not have affected the lives of individuals during their lifetimes when left undetected) and trends stabilised after these malignancies were excluded from the analyses, in particular for females [25,26]. In our study, stabilisation of trends only occurred for female AYAs aged 20-24 years (AAPC: +0.53, p = 0.20) after excluding thyroid carcinomas from the analyses.…”

“…It is well-known that the spectrum of cancers in AYAs is distinct and differs considerably from that in paediatric and older adult cancer patients [10,15,24,25]. Our data reconfirm and add to this by also presenting the distribution of AYA cancers over time, which highlights the minimal impact that time has had on the distribution of AYA cancers from 1990-1999 to 2010-2016.…”

“…Support for this was provided in a more recent study, were mutations associated with ultraviolet radiation damage were found at similar rates among AYAs compared with older patients [31]. Primary prevention efforts aimed at reducing ultraviolet ray exposure have already proven effective in lowering melanoma incidence among Australian (1998-2012) and American AYAs (2007-2016) and might also do so in other countries, especially among those with high sunbed use [25,30].…”

“…The relative higher cancer incidence rates among female AYAs have been observed worldwide and could be explained by the extension of the upper-age-limit of AYAs from 25 to 39 years and is mainly based on the increased incidence of so-called female cancers (i.e., breast, cervix, and uterus) [7,15,24,25]. The approximately three times higher rates of thyroid carcinoma incidence among females likely also contributed.…”