The incidence and deaths from early-onset cancers, in adolescents and young adultshave increased substantially globally Since 1990, According to the main conclusions of a study published today in the journal ‘BMJ Oncology’.
“This study assesses whether cancer in young people is more frequent and has higher mortality today than 30 years ago. To do this, they evaluate the changes occurred in 30 years [entre los años 1990 y 2019] in the diagnosis of cancer in adolescents and young adults, which in this study was defined as those diagnosed between the ages of 14 and 49,” notes Alejandro Perez Fidalgo, assistant physician of the Oncology Service of the Hospital Clínico de València.
To do this, they compared the incidence rates, disability-adjusted life years or DALYs (that is, the sum of the potential years of life lost, added to the years of life with disease) and the mortality from 29 diagnostic cancers in adolescents and young adults in 204 different countries. The data was extracted from a global database (Global Burden of Disease).
The incidence of tumors collected in 2019 is 1.82 million including all countries, which reflects the volume of data in this database and provides reliability to the results.
The conclusions of the study are that the incidence of cancer in young people is clearly increasing since 1990, as well as the DALYs. The mortality On the other hand, for cancer tends to decrease. This allows us to hypothesize that changes in lifestyle or exposure to new agents, more frequent today than in 1990, may be behind this increase in incidence. On the contrary, the other hypothesis is that the best methods of diagnosis and treatment allow to reduce mortality.
Types of tumors
The distribution by type of tumor is uneven. So, for example, the common tumors in women As the breast cancer and gynecological tumors, show a significant increase in their incidence, which reflects that this increase in cancer in young people (which occurs in both sexes) is somewhat more pronounced in women. Other tumors that also show a marked increase in incidence are nonmelanoma skin cancer and gastrointestinal tumors.
A possible confounding factor in this type of study is the overdiagnosis either underdiagnosis and classification bias. In other words, given that the reliability of diagnostic techniques and of diagnostic professionals also improves over time, and that access to these techniques is usually also greater, the false feeling that there is a higher incidence.
However, the fact that the increase in incidence is precisely higher in developed countries (where this difference in access to techniques should not be so great) and that this study coincides with other similar ones with other databases suggest that this confounding factor is not that relevant and that the data on the increase in the diagnosis of cancer in adolescents and young adults is a reality.
Therefore, more and more data suggest that the young cancer patient is becoming more frequent and therefore it would be reasonable implement measures aimed at assisting to a young patient, with specific needs and who requires a certain professionalization in their management.
“In addition, it is increasingly necessary to carry out studies that allow us to identify potential causes that may be behind this increase in cancer in these population groups,” says Pérez.
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