Reports of cancer incidence in young adults, generally defined as those under 50 years of age, have increased in recent years. Many factors impact cancer incidence statistics, including the effectiveness of diagnostics and the availability of screening. Incidence, particularly that of early-stage malignancies, can be seen as a positive in some ways. For example, detecting early-stage, curable cancers, such as stage 1 prostate cancer, which has a nearly 100% five-year survival rate. Increased incidences of such cases likely correlate with less prostate cancer-related mortality if incident cases are cured before advancing to a highly lethal late-stage disease.
Cancer mortality, therefore, often produces a better picture of how the cancer burden changes over time. To this end, a group of authors known for their work in cancer statistics published a research letter in the Journal of the American Medical Association detailing changes in cancer mortality in the United States over the past thirty years. Their examination focuses on the top five leading cancer-related deaths among people younger than 50. The authors included cancer death data from SEER*Stat, a statistical software maintained by the National Cancer Institute that calculates cancer trends from raw data. The National Center for Health Statistics (NCHS) reports mortality data into this database. The cause of death listed on a death certificate determines the underlying cause of death for purposes of the analysis.
The analysis showed that 1,267,520 people under age 50 died of cancer in the United States between 1990 and 2023. Just over half (53%) of those deaths occurred in females. During this time period, the age-standardized death rate decreased by 44%, reaching 14.2 per 100,000 people by 2023.
The authors paid close attention to the five leading causes of cancer mortality (brain, breast, lung, and colorectal cancers and leukemia). With the exception of colorectal cancer, each of these malignancies experienced a mean annual decline between 2014 and 2023, with the largest decrease (5.7%) observed in lung cancer.
Colorectal cancer mortality, however, increased by 1.1% annually between 2005 and 2023. This results in advancement from the fifth most common cancer mortality in the early 1990s to the most common in 2023. Lung cancer (previously first) and leukemia (previously third) each dropped in the rankings to third and fifth, respectively.
The study presents a novel reporting of the current mortality rates of young adults in the United States from different types of cancer. The concerning finding describing the rise of colorectal cancer mortality in young people underscores the need for further research into the causes of early-onset colorectal cancer as well as effective treatments to control the disease.
Sources: Lancet, J Am Med Assoc