Patterns in Cancer Incidence Among People Younger Than 50 Years in the US, 2010 to 2019

Abstract

ImportanceEmerging data suggest that the incidence of early-onset cancers, defined as cancers diagnosed in people younger than 50 years, is increasing, but updated data are limited.ObjectiveTo characterize the patterns in the incidence of early-onset cancers in the US from 2010 to 2019 and provide granular data on the cancers with the fastest-growing incidence rates.Design, Setting, and ParticipantsThis population-based cohort study analyzed data from 17 National Cancer Institute Surveillance, Epidemiology, and End Results registries from January 1, 2010, to December 31, 2019. Age-standardized incidence rates per 100 000 people were extracted for early-onset cancers, with rates age adjusted to the US standard population. A total of 562 145 patients with early-onset cancer between 2010 and 2019 were identified and included. Data were analyzed from October 16, 2022, to May 23, 2023.Main Outcomes and MeasuresPrimary outcomes were incidence rates and descriptive epidemiological data for people younger than 50 years with cancer. The annual percentage change (APC) of the age-standardized incidence rate was estimated using the Joinpoint regression program.ResultsAmong 562 145 patients (324 138 [57.7%] aged 40-49 years; 351 120 [62.5%] female) with early-onset cancer, 4565 (0.8%) were American Indian or Alaska Native, 54 876 (9.8%) were Asian or Pacific Islander, 61 048 (10.9%) were Black, 118 099 (21.0%) were Hispanic, 314 610 (56.0%) were White, and 8947 (1.6%) were of unknown race and/or ethnicity. From 2010 to 2019, the age-standardized incidence rate of early-onset cancers increased overall (APC, 0.28%; 95% CI, 0.09%-0.47%; P = .01) and in female individuals (APC, 0.67%; 95% CI, 0.39%-0.94%; P = .001) but decreased in male individuals (APC, −0.37%; 95% CI, −0.51% to −0.22%; P < .001). In contrast, the age-standardized incidence rate of cancers in individuals aged 50 years and older decreased over the study period (APC, −0.87%; 95% CI, −1.06% to −0.67%; P < .001). In 2019, the highest number of incident cases of early-onset cancer were in the breast (n = 12 649). From 2010 to 2019, gastrointestinal cancers had the fastest-growing incidence rates among all early-onset cancer groups (APC, 2.16%; 95% CI, 1.66%-2.67%; P < .001). Among gastrointestinal cancers, those with the fastest-growing incidence rates were in the appendix (APC, 15.61%; 95% CI, 9.21%-22.38%; P < .001), intrahepatic bile duct (APC, 8.12%; 95% CI, 4.94%-11.39%; P < .001), and pancreas (APC, 2.53%; 95% CI, 1.69%-3.38%; P < .001).Conclusions and RelevanceIn this cohort study, the incidence rates of early-onset cancer increased from 2010 to 2019. Although breast cancer had the highest number of incident cases, gastrointestinal cancers had the fastest-growing incidence rates among all early-onset cancers. These data may be useful for the development of surveillance strategies and funding priorities.

Breast Cancer Incidence Among US Women Aged 20 to 49 Years by Race, Stage, and Hormone Receptor Status

“…Our findings of increased incidence rates among young US women are consistent with previous studies . Non-Hispanic Black women aged 20 to 29 and 30 to 39 years had the highest ASIR with a rising trend of ASIR and cohort and period effects.…”

Increasing Annual Cancer Incidence in Patients Age 20-49 Years: A Real-Data Study

“…More critically, this increase in incidence was greater than that observed in individuals born in the 1950s. 2 , 19 This increase in incidence has been observed in several types of neoplasms, especially in those related to obesity: colorectal, 2 , 4 - 7 , 12 , 13 , 19 , 20 uterine corpus, 2 , 13 gallbladder, 2 kidney, 2 , 12 , 13 pancreas, 2 , 9 , 13 breast, 13 , 21 esophageal adenocarcinoma, 2 , 10 gastric, 2 , 13 , 22 and multiple myeloma. 2 The number of cases diagnosed in successive generations has also been observed to increase in neoplasms unrelated to obesity, such as gastric noncardia, cutaneous melanoma, and oropharyngeal-related or testicular tumors.…”

Surgical outcomes for non‐small cell lung cancer in younger adults: A population‐based study

“…Most cases of lung cancer occur among individuals aged 50–80 years 2 . Although only about 5%–10% of lung cancer are diagnosed in individuals aged 50 years and younger, 2,3 the impact on younger adults is substantial. This is particularly noteworthy during the formative years of life when individuals may be raising children, initiating or progressing in their careers, or serving as the primary breadwinner, making the economic and social consequences more pronounced 4…”