Abstract
Many cancer referral guidelines use patient’s age as a key criterium to decide who should be referred urgently. A recent rise in the incidence of colorectal cancer in younger adults has been described in high-income countries worldwide. Information on other cancers is more limited. The aim of this rapid review was to determine whether other cancers are also increasing in younger age groups, as this may have important implications for prioritising patients for investigation and referral. We searched MEDLINE, Embase and Web of Science for studies describing age-related incidence trends for colorectal, bladder, lung, oesophagus, pancreas, stomach, breast, ovarian, uterine, kidney and laryngeal cancer and myeloma. ‘Younger’ patients were defined based on NICE guidelines for cancer referral. Ninety-eight studies met the inclusion criteria. Findings show that the incidence of colorectal, breast, kidney, pancreas, uterine cancer is increasing in younger age groups, whilst the incidence of lung, laryngeal and bladder cancer is decreasing. Data for oesophageal, stomach, ovarian cancer and myeloma were inconclusive. Overall, this review provides evidence that some cancers are increasingly being diagnosed in younger age groups, although the mechanisms remain unclear. Cancer investigation and referral guidelines may need updating in light of these trends.
Highlights
Growing evidence suggests that younger patients with cancer are more likely to experience a diagnostic delay
Previous reviews have generally focused on single cancers, and mostly on cancers with extensive data of an increase in young adults, such as colorectal [103]
That the incidence of colorectal, breast, pancreatic, kidney, and uterine cancer in younger people is rising, whilst the incidence of bladder, laryngeal and lung cancer is decreasing
Summary
In August 2020, we searched Ovid MEDLINE(R) and Epub Ahead of presented visually in the form of tables and figures for each. 5 years of data after 1995; (6) editorials, case-report, expert Cancers with evidence of an increase in younger age groups opinion, studies only published as abstract. Forty-three studies reported trends in the incidence of colorectal cancer in patients aged under 50 years. Studies for which there was disagreement group in a wide range of wealthy countries worldwide, often between reviewers were included for full-text screening This was accompanied by a decreasing incidence in those aged 50 and conducted by one of five of the study authors. Decrease in those aged >50 years; conflicting evidence for those aged
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