Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China; Zhejiang Province Key Laboratory of Hematology Oncology Diagnosis and Treatment, Hangzhou, Zhejiang, People's Republic of China.
Xinyuan Institute of Medicine and Biotechnology, School of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou, People's Republic of China.
ESMO Open. 2021 Oct;6(5):100255. doi: 10.1016/j.esmoop.2021.100255. Epub 2021 Sep 1.
The cancer burden in adolescents and young adults (AYAs) deserves more attention. However, global cancer statistics for AYAs are often presented as aggregates, concealing important heterogeneity. This study aimed to describe the worldwide profile of cancer incidence, mortality, and corresponding trends from 1990 to 2019 among 15-39-year olds by focusing on the patterns by age, sex, sociodemographic index (SDI), and regions.
Global, regional, and country data on the number of cancer cases and cancer-related deaths for 29 cancer types were collected from the 2019 Global Burden of Disease (GBD) Study. We also summarized the results using five levels of the SDI and 21 GBD regions.
In 2019, an estimated 1 335 100 new cancer cases and 397 583 cancer-related deaths occurred among AYAs worldwide. While the incidence rate increased mildly, the death rate decreased significantly between 1990 and 2019, with an estimated annual percentage change of 0.38 (95% confidence interval 0.36-0.39) and -0.93 (95% confidence interval -0.95 to -0.92), respectively. The cancer burden was disproportionally greater among women than among men. The cancer profiles varied substantially across geographical regions, with the highest burden being in South Asia and East Asia. Besides, the cancer incidence in the high SDI regions was four times higher than that in the low SDI regions; however, the mortality burden in the high SDI region was lower than that in the low SDI region, which reflected the differences in cancer profiles across SDI regions and the inferior outcomes in the low SDI regions.
This study updates the previous epidemiological data of the cancer burden of AYAs. The cancer burden in AYAs varied substantially according to age, sex, SDI, and geographical regions. These findings highlight that the specific cancer profile of AYA patients requires targeted cancer control measures to reduce the cancer burden in this age group.
青少年和年轻人（AYA）的癌症负担值得更多关注。然而，全球 AYA 癌症统计数据通常以聚合形式呈现，掩盖了重要的异质性。本研究旨在描述 1990 年至 2019 年期间，15 至 39 岁人群的癌症发病率、死亡率和相应趋势的全球概况，重点关注年龄、性别、社会人口指数（SDI）和地区的模式。
从 2019 年全球疾病负担（GBD）研究中收集了 29 种癌症类型的全球、区域和国家癌症病例和癌症相关死亡数据。我们还使用 SDI 的五个级别和 21 个 GBD 区域对结果进行了总结。
2019 年，全球约有 133.51 万例新的癌症病例和 39.7583 例癌症相关死亡发生在 AYA 中。虽然发病率略有上升，但死亡率在 1990 年至 2019 年间显著下降，估计年变化率分别为 0.38（95%置信区间为 0.36-0.39）和-0.93（95%置信区间为-0.95 至-0.92）。癌症负担在女性中不成比例地大于男性。地理区域之间的癌症情况差异很大，南亚和东亚的负担最重。此外，高 SDI 地区的癌症发病率是低 SDI 地区的四倍，而高 SDI 地区的死亡率负担却低于低 SDI 地区，这反映了 SDI 地区之间癌症情况的差异以及低 SDI 地区的结果较差。
本研究更新了以前关于 AYA 癌症负担的流行病学数据。AYA 的癌症负担根据年龄、性别、SDI 和地理区域而有很大差异。这些发现强调，AYA 患者的特定癌症情况需要有针对性的癌症控制措施，以降低该年龄组的癌症负担。
