In a study using SEER (Surveillance, Epidemiology, and End Results) registry data reported in JAMA Network Open, Daniel Q. Huang, MBBS, MMED, of the National University of Singapore, and colleagues found that the incidence of cancer among U.S. persons up to age 50 (early-onset cancer) increased significantly between 2010 and 2019.1 Incidence was highest for breast cancer, and the greatest increase in incidence was observed for gastrointestinal cancers.
Daniel Q. Huang, MBBS, MMED
Study Details and Key Findings
The study involved data from 17 SEER registries on persons diagnosed with cancer at age < 50 years between January 1, 2010, and December 31, 2019. Age-standardized incidence rates per 100,000 people were extracted for early-onset cancers; the rates were age-adjusted to the U.S. standard population.
Among 562,145 patients included in the analysis (57.7% aged 40–49 years, 62.5% female), 4,565 (0.8%) were American Indian/Alaska Natives, 54,876 (9.8%) were Asian/Pacific Islanders, 61,048 (10.9%) were Black, 118,099 (21.0%) were Hispanic, 314,610 (56.0%) were White, and 8,947 (1.6%) were of unknown race and/or ethnicity.
Between 2010 to 2019, the age-standardized incidence rate of early-onset cancer increased significantly among all individuals (annual percentage change [APC] = 0.28%, 95% confidence interval [CI] = 0.09%–0.47%, P = .01) and among females (APC = 0.67%, 95% CI = 0.39%–0.94%, P = .001), but it decreased significantly among males (APC = −0.37%, 95% CI = −0.51% to −0.22%, P < .001). By comparison, the age-standardized incidence rate of cancers in individuals aged 50 and older in SEER data decreased significantly over the study period (APC = −0.87%, 95% CI = −1.06% to −0.67%, P < .001).
Mean annual percentage changes increased in American Indian/Alaska Natives (1.97%, 95% CI = 0.69%–3.27%, P < .001), Asian/Pacific Islanders (0.97%, 95% CI = 0.58%–1.35%, P = .007), and Hispanics (1.43%, 95% CI = 1.05%–1.81%, P < .001); they were stable in Whites (0.04%, 95% CI −0.24% to 0.31%, P = .77) and decreased in Blacks (−0.47%, 95% CI = −0.77% to −0.17%, P = .007).
In 2019, the highest numbers of incident cases of early-onset cancer were in the breast (n = 12,649), thyroid (n = 5,869), and colon/rectum (n = 4,097).
Although breast cancer had the highest number of incident cases, gastrointestinal cancers had the fastest-growing incidence rates among all early-onset cancers.— Daniel Q. Huang, MBBS, MMED, and colleagues
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From 2010 to 2019, gastrointestinal cancers had the greatest increase in incidence rates among all early-onset cancer groups (APC = 2.16%, 95% CI = 1.66%–2.67%, P < .001). Those with the greatest increases were cancers of 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). Incidence rates decreased for cancers of the liver (APC = −4.67%, 95% CI = −5.70% to −3.63%, P < .001) and remained stable for those of the esophagus (APC = −0.94%, 95% CI = −2.56% to 0.71%, P = .22).
The greatest decreases in incidence rates were observed for cancer in the floor of the mouth (APC = −7.58%, 95% CI = −9.59% to −5.52%, P < .001), acute monocytic leukemia (APC = −6.51%, 95% CI = −8.86% to −4.11%, P < .001), and prostate cancer (APC = −6.12%, 95% CI = −8.16% to −4.04%, P < .001).
The investigators concluded: “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.”
DISCLOSURE: The study was supported by the National Center for Advancing Translational Sciences, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Medical Research Council of the Singapore Ministry of Health, and others. Dr. Huang has served on an advisory board for Gilead Sciences. For full disclosures of all study authors, visit jamanetwork.com.
REFERENCE
1. Koh B, Tan DJH, Ng CH, et al: Patterns in cancer incidence among people younger than 50 years in the US, 2010 to 2019. JAMA Network Open 6:e2328171, 2023.
