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. 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). 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. 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.

中文翻译：

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全球青少年和年轻人癌症统计数据：基于人群的研究


对青少年和年轻人 （AYA） 全球癌症负担的准确和最新估计很少。本研究旨在评估 AYA 癌症的全球负担和趋势，重点关注社会经济差异，为全球癌症控制策略提供信息。AYA 癌症，定义为发生在 15-39 岁个体中的癌症，使用来自 2021 年全球疾病负担 （GBD） 研究和全球癌症观察站 （GLOBOCAN） 2022 年项目的数据进行了分析。我们按年龄、性别、地理位置和人类发展指数 （HDI） 研究了全球负担，以及其时间趋势。主要结局包括年龄标准化发病率和死亡率 （ASIR、ASMR） 和平均年百分比变化 （AAPC）。2022 年，全球 AYA 估计发生了 1,300,196 例偶然病例和 377,621 例癌症相关死亡，ASIR 为每 100,000 人 40.3 例，ASMR 为每 100,000 人 11.8 例。最常见的癌症是乳腺癌、甲状腺癌和宫颈癌，而主要死亡原因是乳腺癌、宫颈癌和白血病。女性的发病率和死亡率不成比例地高（ASIR：女性 52.9 比男性 28.3;ASMR：女性为 13.1，男性为 10.6）。HDI 较高的国家 AYA 癌症发病率较高（ASIR：32.0 [低 HDI] vs. 54.8 [非常高的 HDI]），而 HDI 较低的国家面临不成比例的高死亡率负担（ASMR：17.2 [低 HDI] vs. 8.4 [非常高的 HDI]）尽管它们的发病率相对较低。不成比例和回归测量突出了与 HDI 相关的显着不平等。AYA 癌发病率从 2000 年到 2011 年保持稳定 （AAPC： - 0.04），但在 2012 年至 2021 年增加 （AAPC： 0.53） 的推动下，性腺癌和结直肠癌的发病率有所增加。 从 2000 年到 2011 年，死亡率大幅下降 （AAPC： − 1.64），但从 2012 年开始下降放缓 （AAPC： − 0.32），这可能是由于性腺癌死亡人数增加。这些趋势因性别、癌症类型、地理和 HDI 而异。AYA 癌症构成了重大且不断增长的全球负担，性别、地理位置和 HDI 水平之间存在显着差异。政策制定者应优先考虑公平的资源分配并实施有针对性的干预措施以减少这些不平等，尤其是在低 HDI 地区和性腺癌方面。