Original Investigation | Global Health
Patterns in Cancer Incidence Among People Younger Than 50 Years in the US , 2010 to 2019
Benjamin Koh ; Darren Jun Hao Tan ; Cheng Han Ng , MBBS ; Clarissa Elysia Fu ; Wen Hui Lim ; Rebecca Wenling Zeng ; Jie Ning Yong ; Jia Hong Koh , MBBS ; Nicholas Syn , MBBS ; Wang Meng , MBBS ; Karn Wijarnpreecha , MD ; Ken Liu , PhD ; Choon Seng Chong , MBBS ; Mark Muthiah , MBBS ; Hung N . Luu , PhD ; Arndt Vogel , MD ; Siddharth Singh , MD ; Khay Guan Yeoh , MBBS ; Rohit Loomba , MD ; Daniel Q . Huang , MBBS , MMED
Abstract
IMPORTANCE Emerging 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 .
OBJECTIVE To 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 PARTICIPANTS This 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 MEASURES Primary 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 .
RESULTS Among 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 ).
Key Points Question What are the patterns in the incidence of cancers in people younger than 50 years ( ie , early-onset cancers )?
Findings In this cohort study of 562 145 people with early-onset cancer in the US from 2010 to 2019 , the incidence rates of early-onset cancers increased substantially over the study period . Gastrointestinal cancers had the fastestgrowing incidence rates among all earlyonset cancers .
Meaning These data may be useful for the development of surveillance strategies and funding priorities .
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CONCLUSIONS AND RELEVANCE In 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 . JAMA Network Open . 2023 ; 6 ( 8 ): e2328171 . doi : 10.1001 / jamanetworkopen . 2023.28171
Open Access . This is an open access article distributed under the terms of the CC-BY License .
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JAMA Network Open . 2023 ; 6 ( 8 ): e2328171 . doi : 10.1001 / jamanetworkopen . 2023.28171 ( Reprinted ) August 16 , 2023 1 / 14