Abstract
Background: In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15–39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods: Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15–39 years to define adolescents and young adults. Findings: There were 1·19 million (95% UI 1·11–1·28) incident cancer cases and 396 000 (370 000–425 000) deaths due to cancer among people aged 15–39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59·6 [54·5–65·7] per 100 000 person-years) and high-middle SDI countries (53·2 [48·8–57·9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14·2 [12·9–15·6] per 100 000 person-years) and middle SDI (13·6 [12·6–14·8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23·5 million (21·9–25·2) DALYs to the global burden of disease, of which 2·7% (1·9–3·6) came from YLDs and 97·3% (96·4–98·1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation: Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Funding: Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities, St Baldrick's Foundation, and the National Cancer Institute.
| Original language | English |
|---|---|
| Pages (from-to) | 24-52 |
| Journal | The Lancet Oncology |
| Volume | 23 |
| Issue number | 1 |
| Early online date | 1 Dec 2021 |
| DOIs | |
| Publication status | Published - Jan 2022 |
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In: The Lancet Oncology, Vol. 23, No. 1, 01.2022, p. 24-52.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - The global burden of adolescent and young adult cancer in 2019: a systematic analysis for the Global Burden of Disease Study 2019
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AU - Taheri, Majid
AU - Taherkhani, Amir
AU - Takahashi, Ken
AU - Tampa, Mircea
AU - Tan, Ker-kan
AU - Tat, Vivian Y
AU - Tavakoli, Ahmad
AU - Tbakhi, Abdelghani
AU - Tehrani-banihashemi, Arash
AU - Temsah, Mohamad-hani
AU - Tesfay, Fisaha Haile
AU - Tesfaye, Bekele
AU - Thakur, Jarnail Singh
AU - Thapar, Rekha
AU - Thavamani, Aravind
AU - Thiyagarajan, Arulmani
AU - Thomas, Nihal
AU - Tobe-gai, Ruoyan
AU - Togtmol, Munkhsaikhan
AU - Tohidast, Seyed Abolfazl
AU - Tohidinik, Hamid Reza
AU - Tolani, Musliu Adetola
AU - Tollosa, Daniel Nigusse
AU - Touvier, Mathilde
AU - Tovani-palone, Marcos Roberto
AU - Traini, Eugenio
AU - Tran, Bach Xuan
AU - Tran, Mai Thi Ngoc
AU - Tripathy, Jaya Prasad
AU - Tusa, Biruk Shalmeno
AU - Ukke, Gebresilasea Gendisha
AU - Ullah, Irfan
AU - Ullah, Saif
AU - Umapathi, Krishna Kishore
AU - Unnikrishnan, Bhaskaran
AU - Upadhyay, Era
AU - Ushula, Tolassa Wakayo
AU - Vacante, Marco
AU - Valadan Tahbaz, Sahel
AU - Varthya, Shoban Babu
AU - Veroux, Massimiliano
AU - Villeneuve, Paul J
AU - Violante, Francesco S
AU - Vlassov, Vasily
AU - Vu, Giang Thu
AU - Waheed, Yasir
AU - Wang, Ning
AU - Ward, Paul
AU - Weldesenbet, Adisu Birhanu
AU - Wen, Yi Feng
AU - Westerman, Ronny
AU - Winkler, Andrea Sylvia
AU - Wubishet, Befikadu Legesse
AU - Xu, Suowen
AU - Yahyazadeh Jabbari, Seyed Hossein
AU - Yang, Lin
AU - Yaya, Sanni
AU - Yazdi-feyzabadi, Vahid
AU - Yazie, Taklo Simeneh
AU - Yehualashet, Sisay Shewasinad
AU - Yeshaneh, Alex
AU - Yeshaw, Yigizie
AU - Yirdaw, Birhanu Wubale
AU - Yonemoto, Naohiro
AU - Younis, Mustafa Z
AU - Yousefi, Zabihollah
AU - Yu, Chuanhua
AU - Yunusa, Ismaeel
AU - Zadnik, Vesna
AU - Zahir, Mazyar
AU - Zahirian Moghadam, Telma
AU - Zamani, Mohammad
AU - Zamanian, Maryam
AU - Zandian, Hamed
AU - Zare, Fariba
AU - Zastrozhin, Mikhail Sergeevich
AU - Zastrozhina, Anasthasia
AU - Zhang, Jianrong
AU - Zhang, Zhi-jiang
AU - Ziapour, Arash
AU - Zoladl, Mohammad
AU - Murray, Christopher J L
AU - Fitzmaurice, Christina
AU - Bleyer, Archie
AU - Bhakta, Nickhill
N1 - Funding: J A Loureiro acknowledges support from Base Funding UIDB/00511/2020 of the LEPABE funded by national funds through the FCT/MCTES (PIDDAC) and Scientific Employment Stimulus (FCT) [CEECINST/00049/2018].
PY - 2022/1
Y1 - 2022/1
N2 - Background: In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15–39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods: Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15–39 years to define adolescents and young adults. Findings: There were 1·19 million (95% UI 1·11–1·28) incident cancer cases and 396 000 (370 000–425 000) deaths due to cancer among people aged 15–39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59·6 [54·5–65·7] per 100 000 person-years) and high-middle SDI countries (53·2 [48·8–57·9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14·2 [12·9–15·6] per 100 000 person-years) and middle SDI (13·6 [12·6–14·8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23·5 million (21·9–25·2) DALYs to the global burden of disease, of which 2·7% (1·9–3·6) came from YLDs and 97·3% (96·4–98·1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation: Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Funding: Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities, St Baldrick's Foundation, and the National Cancer Institute.
AB - Background: In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15–39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods: Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15–39 years to define adolescents and young adults. Findings: There were 1·19 million (95% UI 1·11–1·28) incident cancer cases and 396 000 (370 000–425 000) deaths due to cancer among people aged 15–39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59·6 [54·5–65·7] per 100 000 person-years) and high-middle SDI countries (53·2 [48·8–57·9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14·2 [12·9–15·6] per 100 000 person-years) and middle SDI (13·6 [12·6–14·8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23·5 million (21·9–25·2) DALYs to the global burden of disease, of which 2·7% (1·9–3·6) came from YLDs and 97·3% (96·4–98·1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation: Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Funding: Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities, St Baldrick's Foundation, and the National Cancer Institute.
U2 - 10.1016/S1470-2045(21)00581-7
DO - 10.1016/S1470-2045(21)00581-7
M3 - Article
SN - 1470-2045
VL - 23
SP - 24
EP - 52
JO - Lancet Oncology
JF - Lancet Oncology
IS - 1
ER -