Global trends in incidence, death, burden and risk factors of early-onset cancer from 1990 to 2019
What is already known
- Previous studies have suggested that the incidence of cancers of various organs diagnosed in adults younger than 50 years of age has been rising in many parts of the world since the 1990s.
- The global disease burden and secular trend of early onset cancers, and the variations in different socioeconomic categories, have not been described.
- The pattern of attributable risk factors for burdensome early onset cancers has not been investigated.
What this study adds
- Since 1990, the incidence and deaths of early onset cancers have substantially increased globally.
- Early-onset breast, tracheal, bronchus and lung, stomach and colorectal cancers showed the highest mortality and burden in 2019.
- Countries with a high-middle and middle Sociodemographic Index and individuals aged 40–49 years were particularly affected.
- Dietary risk factors (diet high in red meat, low in fruits, high in sodium and low in milk, etc), alcohol consumption and tobacco use are the main risk factors underlying early-onset cancers.
Potential effects on research, policy, and practice
- This study suggests that it is necessary to conduct prospective life-course cohort studies to explore the aetiologies of early-onset cancers.
- Each country should adjust their prevention strategies based on the characteristics of early-onset cancer.
- Meanwhile, encouraging a healthy lifestyle could reduce early-onset cancer disease burden.
The researchers from Edinburgh and China looked at 29 different cancers across 204 counties and regions examining new diagnoses, deaths, health consequences and risk factors in people aged 14 to 49.
In 2019 the number of cancer cases for under 50s hit 3.26 million, an increase of 79.1% since 1990. Deaths were also up by 27.7%.
According The Independent reporting, researchers said that while genetics were likely to play a part, smoking, consuming alcohol and diets high in meat and salt but low in fruit and milk were the “main risk factors”, along with excess weight, a lack of exercise and high blood sugar.
Breast cancer made up the largest proportion of cases – 13.7 per every 100,000 people – while windpipe and prostate cancer cases grew the fastest at 2.28% and 2.23% per year respectively. However, early-onset liver cancer cases were down by 2.88% each year.
The regions with the highest rates of early-onset cancers were North America, Australasia and Western Europe.
Alcohol and cancer – concrete findings
Dietary risk factors, alcohol use and tobacco consumption were the main risk factors for top early onset cancers in 2019.
Globally, the leading risk factors for early-onset breast cancer DALYs were
- alcohol use (4.5%),
- tobacco smoking (4.4%),
- diet high in red meat (2.9%),
- physical inactivity (0.6%), and
- high fasting plasma glucose (2.6%)
Globally, the researchers found that alcohol use and tobacco were always the leading risk factors for early-onset breast cancer DALYs during 1990–2019.
Several previous studies also found that both tobacco use and alcohol consumption increase the risk of developing breast cancer, with tobacco use specifically linked to premenopausal breast cancer and alcohol consumption linked to increased risk regardless of menopausal status.
The above evidences highlights that limiting and quitting alcohol and tobacco may serve as a promising strategy to reduce the growing burden of early-onset breast cancer.
This study aimed to explore the global burden of early-onset cancer based on the Global Burden of Disease (GBD) 2019 study for 29 cancers worldwid.
Methods and analysis
Incidence, deaths, disability-adjusted life years (DALYs) and risk factors for 29 early-onset cancer groups were obtained from GBD.
Global incidence of early-onset cancer increased by 79.1% and the number of early-onset cancer deaths increased by 27.7% between 1990 and 2019.
Early-onset breast, tracheal, bronchus and lung, stomach and colorectal cancers showed the highest mortality and DALYs in 2019.
Globally, the incidence rates of early-onset nasopharyngeal and prostate cancer showed the fastest increasing trend, whereas early-onset liver cancer showed the sharpest decrease. Early-onset colorectal cancers had high DALYs within the top five ranking for both men and women.
High-middle and middle Sociodemographic Index (SDI) regions had the highest burden of early-onset cancer.
The morbidity of early-onset cancer increased with the SDI, and the mortality rate decreased considerably when SDI increased from 0.7 to 1.
The projections indicated that the global number of incidence and deaths of early-onset cancer would increase by 31% and 21% in 2030, respectively.
Dietary risk factors (diet high in red meat, low in fruits, high in sodium and low in milk, etc), alcohol consumption and tobacco use are the main risk factors underlying early-onset cancers.
Early-onset cancer morbidity continues to increase worldwide with notable variances in mortality and DALYs between areas, countries, sex and cancer types. Encouraging a healthy lifestyle could reduce early-onset cancer disease burden.