Background

Compared with children and older adults, the burden of cancer in adolescents and young adults (ages 15–39) is understudied. We aimed to quantify the global burden of adolescent and young adult cancer in 2022 and 2050, and explore patterns in incidence, mortality, and case fatality.

Methods

In this population-based study, we used the GLOBOCAN database to quantify the number of new cases and cancer-related deaths, and corresponding age-standardised incidence and mortality rates (ASRs; per 100 000 people aged 15–39 years), in adolescents and young adults. Estimates were quantified for all cancers combined, excluding non-melanoma skin cancer, and 33 specific cancer types. Case fatality was estimated using mortality-to-incidence ratios. Overall and sex-specific estimates were calculated at the world, regional, human development index (HDI), and income level. We estimated the future cancer burden by applying the GLOBOCAN 2022 rates to sex-specific demographic projections for the year 2050 using the UN World Population Prospects 2019 revision.

Findings

An estimated 1 300 196 cases and 377 621 cancer-related deaths occurred in adolescents and young adults in 2022. Incidence ASRs were 1·9-times higher and mortality ASRs were 1·2-times higher in females than in males (incidence ASR 52·9 vs 28·3; mortality ASR 13·1 vs 10·6). Although the incidence ASR was highest in the high-income countries, the mortality ASR was highest in the low-income countries; as a result, case fatality ranged from 12% in high-income settings to 57% in low-income settings. Of the 33 cancer types included in our analyses, breast or cervical cancer was the most frequently diagnosed cancer and cause of cancer-related death in 163 and 93 countries, respectively; incidence and mortality also varied the most by region for these cancers. Finally, the adolescent and young adult cancer burden globally is projected to increase by about 12% from 2022 to 2050, albeit with declines of 10·7% projected in very high HDI countries. The increase is expected to overwhelmingly impact low HDI settings, where the burden of both cancer cases and deaths is projected to double (a 102·3% increase).

Interpretation

Although the adolescent and young adult cancer burden incidence is highest in the most developed settings, transitioning countries have the poorest outcomes and will face the greatest increases in burden by 2050. These findings act as a reference to the global adolescent and young adult cancer community to inform cancer control priorities and decrease global inequities.

Funding

None.

中文翻译：

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青少年和年轻人当前和未来的全球癌症负担：一项基于人群的研究

 背景

与儿童和老年人相比，青少年和年轻人（15-39 岁）的癌症负担研究不足。我们旨在量化 2022 年和 2050 年全球青少年和年轻成人癌症的负担，并探索发病率、死亡率和病死率的模式。

 方法

在这项基于人群的研究中，我们使用 GLOBOCAN 数据库量化了青少年和年轻人的新病例和癌症相关死亡人数，以及相应的年龄标准化发病率和死亡率 （ASR;每 100 000 名 15-39 岁的人）。对所有癌症组合的估计值进行量化，不包括非黑色素瘤皮肤癌和 33 种特定癌症类型。使用死亡率与发病率比估计病死率。在世界、区域、人类发展指数 （HDI） 和收入水平上计算总体和性别特异性估计。我们使用联合国 2019 年世界人口展望修订版，将 GLOBOCAN 2022 比率应用于 2050 年的性别特定人口预测，从而估计了未来的癌症负担。

 发现

2022 年，青少年和年轻人估计有 1 300 196 例病例和 377 621 例癌症相关死亡。女性的发病率 ASR 比男性高 1·9 倍，死亡率 ASR 高 1·2 倍（发病率 ASR 52·9 对 28·3;死亡率 ASR 13·1 对 10·6）。尽管高收入国家的 ASR 发病率最高，但低收入国家的死亡率 ASR 最高;因此，病死率从高收入国家的 12% 到低收入国家的 57% 不等。在我们分析的 33 种癌症类型中，乳腺癌或宫颈癌分别是 163 个国家和 93 个国家最常被诊断出的癌症和癌症相关死亡的原因;这些癌症的发病率和死亡率也因地区而异。最后，从 12 年到 2022 年，全球青少年和年轻成人癌症负担预计将增加约 2050%，尽管预计 HDI 非常高的国家将下降 10·7%。预计这一增长将压倒性地影响低 HDI 环境，预计癌症病例和死亡的负担将翻倍（增加 102·3%）。

 解释

尽管在最发达的环境中，青少年和年轻成人癌症负担的发病率最高，但转型国家的结果最差，到 2050 年将面临最大的负担增加。这些发现可参考全球青少年和年轻成人癌症社区，为癌症控制优先事项提供信息并减少全球不平等。

 资金

 没有。