The Global Trends in Incidence, Death, Burden and Risk Factors of Early-onset Cancer From 1990 to 2019

Jianhui Zhao, Liying Xu, Jing Sun, Mingyang Song, Lijuan Wang, Shuai Yuan, Yingshuang Zhu, Zhengwei Wan, Susanna C. Larsson, Konstantinos K Tsilidis, Malcolm G Dunlop, Harry Campbell, Igor Rudan, Peige Song, Evropi Theodoratou, Kefeng Ding*, Xue Li*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

OBJECTIVE This study aimed to explore the global burden of early-onset cancer (<50 years) based on the Global Burden of Disease (GBD) 2019 study for 29 cancers worldwide.

DESIGN A survey for global burden of early-onset cancer from 1990 to 2019.

DATA SOURCE The GBD database in 2019 based on a total of 1250 censuses and 747 location-years of population registry data worldwide. Individuals with early-onset cancer between 1990 and 2019 from GBD database 2019.

MAIN OUTCOMES AND MEASURES Incidence, deaths, disability-adjusted life-years (DALYs) and risk factors for 29 early-onset cancer groups.

RESULTS Global incidence of early-onset cancer increased by 79.1% and the number of early-onset cancer deaths increased by 27.7% betwen 1990-2019. 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 regions had the highest burden of early-onset cancer. The age-standardized incidence rate of early-onset cancer increased with the sociodemographic index, and the age-standardized death rate decreased considerably when sociodemographic index increased from 0.7 to 1. The projections indicated that the global age-standardized incidence and death rates of early-onset cancer would increase by 31% and 21% in 2030, respectively. Dietary risk factors (diet high in red meat, low in friuts, high in sodium and low in milk, etc.), alcohol consumption, and tobacco use are the main risk factors underlying early-onset cancers.

CONCLUSIONS Early-onset cancer morbidity continues to increase worldwide with notable variances in mortality and DALYs between areas, countries, sex, and cancer types, which could burden countries' health systems. Encouraging a healthy lifestyle could reduce early-onset cancer disease burden.
Original languageEnglish
Article numbere000049
Number of pages12
JournalBMJ Oncology
Publication statusPublished - 5 Sept 2023


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