The global, regional, and national burden of cancer among adolescents and young adults in 204 countries and territories, 1990\u20132019: a population-based study

Yi Feng Wen,Guosheng Yin,Qian Qian Dong,Hai Ming Wong,Ruitao Lin,Yu Jie Zhong,Meng Xuan Chen

doi:10.1186/s13045-021-01093-3

Abstract

BackgroundAccurate appraisal of burden of adolescents and young adults (AYAs) cancers is crucial to informing resource allocation and policy making. We report on the latest estimates of burden of AYA cancers in 204 countries and territories between 1990 and 2019 in association with socio-demographic index (SDI).Patients and methodsEstimates from the Global Burden of Disease study 2019 were used to analyse incidence, mortality, and disability-adjusted life years (DALYs) due to AYA cancers at global, regional, and national levels by sex. Association between AYA cancer burden and SDI were investigated. Burdens of AYA cancers were contextualized in comparison with childhood and older adult cancers. All estimates are reported as counts and age-standardized rates per 100,000 person-years.ResultsIn 2019, there were 1.2 million incident cases, 0.4 million deaths, and 23.5 million DALYs due to AYA cancers globally. The highest age-standardized incidence rate occurred in Western Europe (75.3 [Females] and 67.4 [Males] per 100,000 person-years). Age-standardized death (23.2 [Females] and 13.9 [Males] per 100,000 person-years) and DALY (1328.3 [Females] and 1059.2 [Males] per 100,000 person-years) rates were highest in Oceania. Increasing SDI was associated with a higher age-standardized incidence rate. An inverted U-shaped association was identified between SDI and death and DALY rates. AYA cancers collectively is the second leading cause of non-communicable diseases-related deaths globally in 2019. DALYs of AYA cancers ranked the second globally and the first in low and low-middle SDI locations when compared with that of childhood and older adult cancers.ConclusionThe global burden of AYA cancers is substantial and disproportionally affect populations in limited-resource settings. Capacity building for AYA cancers is essential in promoting equity and population health worldwide.

Highlights

Cancer, as a major disease cluster of noncommunicable diseases, is a global health problem affecting populations of all ages [1]
Age-standardized death (23.2 [Females] and 13.9 [Males] per 100,000 person-years) and Disability-adjusted life years (DALY) (1328.3 [Females] and 1059.2 [Males] per 100,000 person-years) rates were highest in Oceania
An inverted U-shaped association was identified between socio-demographic index (SDI) and death and DALY rates

Summary

Introduction

As a major disease cluster of noncommunicable diseases, is a global health problem affecting populations of all ages [1]. The present cohort of over 2.9 billion adolescents and young adults (AYAs) aged 15–39 years is the largest in history, among which nearly 90% live in lowincome and middle-income countries (LMICs) [4, 5]. With 1.2 million cases and 0.4 million deaths attributable to cancers among AYAs in 2018 [6], addressing AYA cancers provides an unequivocal opportunity to accelerate the achievement of development goals and promote equity. Accurate appraisal of the global burden of AYA cancers is an important first step towards improving outcomes of AYA cancers. Accurate appraisal of burden of adolescents and young adults (AYAs) cancers is crucial to informing resource allocation and policy making. We report on the latest estimates of burden of AYA cancers in 204 countries and territories between 1990 and 2019 in association with socio-demographic index (SDI)

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Results

Discussion

Conclusion