Abstract 1198: Global analysis of incidence and mortality trends in early-onset and later-onset cancers
Authors: Miyu Terashima, Kota Nakayama, Sora Shirai, Hwa-Young Lee, Satoko Ugai, Hiroki Mizuno, Minkyo Song, Naoko Sasamoto, Ichiro Kawachi, Edward Giovanucci, Tomotaka Ugai
Journal: Cancer Research (2025)

Abstract Background: The global increase in the incidence of early-onset cancers (defined as cancers diagnosed at 20-49 years) is a serious public health problem. It remains inadequately explored whether trends in the incidence of early-onset cancers differ from those of later-onset cancers (defined as cancers diagnosed at age 50 and above). Also, considering the potential over-detection of clinically non-significant cancers by screening, it is crucial to examine whether early-onset cancer incidence has increased concurrently with mortality. Method: We retrieved age-standardized incidence and mortality rates of early-onset and later-onset cancers diagnosed between 2000 and 2017 in 31 countries from data available in the GLOBOCAN database. Using joinpoint regression models, we assessed average annual percentage changes (AAPCs) in cancer incidence and mortality for each cancer type in each country, with statistical significance corresponding to a positive 95% CI that does not include zero (indicating an increasing trend). We examined 1) whether trends in the incidence of early-onset cancers differ from those of later-onset cancers, and 2) whether both incidence and mortality of early-onset cancers have increased concurrently. Differences in AAPCs were assessed by comparing 95% CIs, where nonoverlapping 95% CIs were considered statistically significantly different. Results: We observed that 9 female and 6 male early-onset cancers had statistically significant positive AAPCs in at least 10 countries. Among these, the following early-onset cancer types had significantly higher AAPCs than later-onset cancer types: colorectal cancer (7 countries; AAPC range: 1.8%-3.8%), kidney cancer (5 countries; AAPC range: 2.1%-7.5%), multiple myeloma (5 countries; AAPC range: 3.1%-9.8%), and uterine cancer (4 countries; AAPC range: 1.5%-10.3%) in females; prostate cancer (13 countries; AAPC range: 2.7%-13.2%), colorectal cancer (8 countries; AAPC range: 1.0%-4.1%), and kidney cancer (8 countries; AAPC range: 2.8%-9.7%) in males. Additionally, we observed statistically significant positive AAPCs in both the incidence and mortality of the following early-onset cancer types: colorectal cancer (4 countries), kidney cancer (4 countries), and uterine cancer (3 countries) in females; colorectal cancer (8 countries) in males. Conclusion: Our study highlights global differences in cancer incidence trends between early-onset and later-onset cancer types. Notably, the incidence of certain early-onset types, such as obesity-related cancers, including colorectal, kidney, uterine cancer, and myeloma showed more dramatic increases compared to later-onset cancer types in North America, Oceania, and parts of Europe. Additionally, we noted concurrent rises in incidence and mortality for several early-onset cancer types, including colorectal, kidney, and uterine cancer. Citation Format: Miyu Terashima, Kota Nakayama, Sora Shirai, Hwa-Young Lee, Satoko Ugai, Hiroki Mizuno, Minkyo Song, Naoko Sasamoto, Ichiro Kawachi, Edward Giovanucci, Tomotaka Ugai. Global analysis of incidence and mortality trends in early-onset and later-onset cancers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 1198.