The global burden of adolescent and young adult cancer in 2019: a systematic analysis for the Global Burden of Disease Study 2019

Abstract

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults.Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. FindingsThere were 1•19 million (95% UI 1•11-1•28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59•6 [54•5-65•7] per 100 000 person-years) and high-middle SDI countries (53•2 [48•8-57•9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14•2 [12•9-15•6] per 100 000 person-years) and middle SDI (13•6 [12•6-14•8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23•5 million (21•9-25•2) DALYs to the global burden of disease, of which 2•7% (1•9-3•6) came from YLDs and 97•3% (96•4-98•1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally.Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts.

Socioeconomic Inequalities in Cancer Incidence: A Comparative Investigation Based on Population of Iranian Provinces

“…Evidence from studies in other countries has also con rmed the existence of socio-economic inequalities (SDI) in the distribution of cancer burden. For example, in con rmation of our ndings, the highest age-standardized incidence rates occurred in high SDI and high-middle SDI countries [27]. O'Connor et al…”

The Global, Regional, and National Burden and Trends of Infective Endocarditis From 1990 to 2019: Results From the Global Burden of Disease Study 2019

“…To better exhibit the age distribution of IE burden, IE patients were classified into 5 groups, namely those aged under 5 years, from 5 to 14 years, from 15 to 49 years and from 50 to 69 years, as well as above 70 years. Social developmental index (SDI) was a composite indicator of total fertility, per capita income, and the years of schooling, which was formulated to reflect the social developmental degree (17). The value ranged from 0 to 1, where 0 represented the fewest years of schooling, lowest per capita income, and highest fertility, whereas 1 represented the opposite.…”

Adolescents and young adults with cancer: Considerations from the Southeast Asian perspective

“…A recent study by the GBD 2019 Adolescent Young Adult (AYA) Cancer Collaborators 1 reported that countries outside the highest sociodemographic quintile, including those in South America, southern sub-Saharan Africa, and Asia, carried the heaviest burden of cancer among AYA (defined as age 15-39 years). We would like to draw attention to Southeast Asia (SEA), a region comprising 11 countries and over 650,000,000 people, of whom over 260,000,000 are AYA.…”

“…Furthermore, several SEA countries, including the populous countries of the Philippines, Indonesia, and Thailand, have a relatively high AYA cancer burden, and fall within the second highest quintile in terms of age-standardized disabilityadjusted life-years attributable to AYA cancers. 1 The socioeconomic sequelae of cancer are relevant to AYA in the region, as despite socioeconomic diversity in SEA, the majority of the population resides in lower middle income countries (LMICs). The ACTION study, a longitudinal survey of the socioeconomic burden and survivorship following cancer surgery conducted in eight LMICs within SEA, found that almost one in three patients experienced financial catastrophe within 3 months, with women and individuals of lower socioeconomic status disproportionately affected.…”