The recent rise in the incidence of cancer in younger adults has been described in high-income countries. This study aimed to identify cancer incidence trends in France among adolescent and young adult (AYA) population.
Methods:
All cases of cancer diagnosed in 15–39 years, recorded by all French population-based registries (24% of the population), over the 2000–2020 period, were included. World age-standardized incidence rates (ASR) and annual percentage change (APC) of incidence over time were calculated.
Results:
We analyzed 54,735 cancer diagnoses in AYAs. The ASR over the 2000–2020 period in 15–39 years was 58.1 per 100,000 (95% confidence interval [CI] 57.0–59.2). ASR was lower in males (47.2 [45.7–48.6]) than in females (68.9 [67.2–70.6]). Incidence per 100,000 differed with age group from the lowest, 20.5 (19.8–21.2) in 15–19 years, to the highest, 130.3 (128.6–132.0) in 35–39 years. Increases in incidence were observed for essential thrombocythemia (APC: 3.33% [1.52–5.16]), Hodgkin lymphoma (HL) (APC: 1.86% [1.21–2.52]), liposarcoma (APC: 3.68% [0.83–6.61]), carcinomas of urinary tract (APC: 3.95% [2.85–5.06]), gastrointestinal tract (APC: 2.62% [1.96–3.28]), and breast (APC: 1.61% [1.22–2.01]) from 2000 to 2020, glioblastoma (APC: 6.11% [3.06–9.26]), and other astrocytomas (APC: 7.41% [5.13–9.75]) from 2005 to 2020. Decreases in incidence were observed for oligodendroglioma (APC: −8.78% during 2005–2020), and other invasive carcinomas (APC: −3.34% during 2000–2020).
Conclusion:
Increases in the incidence of some AYA cancer types are observed HL, liposarcoma, carcinomas of colorectum, breast, and kidney. Results for central nervous system tumors are still to be confirmed in the years to come. Extensive efforts are needed to identify underlying risk factors responsible for these trends to inform prevention strategies.
RazeT, LacourB, Cowppli-BonyA, et al.Cancer among adolescents and young adults between 2000 and 2016 in France: Incidence and improved survival. J Adolesc Young Adult Oncol, 2021; 10(1):29–45; doi: 10.1089/jayao.2020.0017
2.
BarrRD, RiesLAG, TramaA, et al.A system for classifying cancers diagnosed in adolescents and young adults. Cancer, 2020; 126(21):4634–4659; doi: 10.1002/cncr.33041
3.
TramaA, StarkD, Bozovic-SpasojevicI, et al.Cancer burden in adolescents and young adults in Europe. ESMO Open, 2023; 8(1):100744; doi: 10.1016/j.esmoop.2022.100744
4.
SmithAW, SeibelNL, LewisDR, et al.Next steps for adolescent and young adult oncology workshop: An update on progress and recommendations for the future. Cancer, 2016; 122(7):988–999; doi: 10.1002/cncr.29870
5.
TycsynskiJ, DemaretE, ParkinD, et al.Standards and guidelines for cancer registration network in Europe. The ENCR recommendations. IARC technical publication n° 40: Lyon; 2003.
6.
FriztA, PercyC, JackA, et al.International classification of diseases for oncology. Third edition. First revision. World Health Organization: Geneva; 2013.
7.
BrayF. Chapter 8. Age-standardization. In: Cancer incidence in five continents. (ParkinD, WhelanSL, FerlayJ, et al. eds) IARC scientific publications n°155: Lyon; 2002; pp. 87–9.
8.
DobsonAJ, KuulasmaaK, EberleE, et al.Confidence intervals for weighted sums of Poisson parameters. Stat Med, 1991; 10(3):457–462.
9.
GoujonS, KyrimiE, FaureL, et al.Spatial and temporal variations of childhood cancers: Literature review and contribution of the French national registry. Cancer Med, 2018; 7(10):5299–5314; doi: 10.1002/cam4.1774
10.
HowladerN, NooneAM, KrapchoM, et al.SEER cancer statistics review, 1975–2018, National Cancer Institute, Bethesda, MD. Available from: https://seer.cancer.gov/data-software/documentation/seerstat/nov2020/, based on November 2020 SEER data submission [Last accessed: July 24, 2024].
11.
KimH-J, FayMP, FeuerEJ, et al.Permutation tests for joinpoint regression with applications to cancer rates. Statist Med, 2000; 19(3):335–351; doi: 10.1002/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z
12.
Joinpoint Regression Program. Version 5.2.0.0. April, 2024. Statistical research and applications branch, National Cancer Institute.
13.
LouisDN, OhgakiH, WiestlerOD, et al.The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol, 2007; 114(2):97–109; doi: 10.1007/s00401-007-0243-4
14.
LouisDN, PerryA, ReifenbergerG, et al.The 2016 world health organization classification of tumors of the central nervous system: A summary. Acta Neuropathol, 2016; 131(6):803–820; doi: 10.1007/s00401-016-1545-1
15.
LouisDN, PerryA, WesselingP, et al.The 2021 WHO classification of tumors of the central nervous system: A summary. Neuro Oncol, 2021; 23(8):1231–1251; doi: 10.1093/neuonc/noab106
16.
BleyerA. Increasing cancer in adolescents and young adults: Cancer types and causation implications. J Adolesc Young Adult Oncol, 2023; 12(3):285–296; doi: 10.1089/jayao.2022.0134
17.
ArberDA, OraziA, HasserjianR, et al.The 2016 revision to the world health organization classification of myeloid neoplasms and acute leukemia. Blood, 2016; 127(20):2391–2405; doi: 10.1182/blood-2016-03-643544
18.
HjalgrimH. On the aetiology of Hodgkin lymphoma. Dan Med J, 2012; 59(7):B4485.
19.
KellyKM, FriedbergJW. Classic Hodgkin lymphoma in adolescents and young adults. J Clin Oncol, 2024; 42(6):653–664; doi: 10.1200/JCO.23.01799
20.
MathewsJD, ForsytheAV, BradyZ, et al.Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: Data linkage study of 11 million Australians. Bmj, 2013; 346(1):f2360; doi: 10.1136/bmj.f2360
21.
LiQ, ChangET, BassigBA, et al.Body size and risk of Hodgkin’s lymphoma by age and gender: A population-based case–control study in Connecticut and Massachusetts. Cancer Causes Control, 2013; 24(2):287–295; doi: 10.1007/s10552-012-0100-1
22.
PouchieuC, LacourB, DelafosseP, et al.Chapitre : Système nerveux central. Estimations nationales de l’incidence et de la mortalité par cancer en France métropolitaine entre 1990 et 2018. Etude à partir des registres des cancers du réseau Francim. Volume 1–Tumeurs solides. P308–P22.
23.
BrownM, SchrotR, BauerK, et al.Incidence of first primary central nervous system tumors in California, 2001–2005. J Neurooncol, 2009; 94(2):249–261; doi: 10.1007/s11060-009-9864-x
MillerAB, MorganLL, UdasinI, et al.Cancer epidemiology update, following the 2011 IARC evaluation of radiofrequency electromagnetic fields (monograph 102). Environ Res, 2018; 167:673–683; doi: 10.1016/j.envres.2018.06.043
26.
PoonMTC, BrennanPM, JinK, et al.Might changes in diagnostic practice explain increasing incidence of brain and central nervous system tumors? A population-based study in Wales (United Kingdom) and the United States. Neuro Oncol, 2021; 23(6):979–989; doi: 10.1093/neuonc/noaa282
27.
AcheyRL, KhannaV, OstromQT, et al.Incidence and survival trends in oligodendrogliomas and anaplastic oligodendrogliomas in the United States from 2000 to 2013: A CBTRUS report. J Neurooncol, 2017; 133(1):17–25; doi: 10.1007/s11060-017-2414-z
28.
BockS, HoffmannDG, JiangY, et al.Increasing Incidence of liposarcoma: A population-based study of national surveillance databases, 2001–2016. Int J Environ Res Public Health, 2020; 17(8):2710; doi: 10.3390/ijerph17082710
GerryD, FoxNF, SpruillLS, et al.Liposarcoma of the head and neck: Analysis of 318 cases with comparison to non–head and neck sites. Head Neck, 2014; 36(3):393–400; doi: 10.1002/hed.23311
31.
WibmerC, LeithnerA, ZielonkeN, et al.Increasing incidence rates of soft tissue sarcomas? A population-based epidemiologic study and literature review. Ann Oncol, 2010; 21(5):1106–1111; doi: 10.1093/annonc/mdp415
32.
MillerKD, Fidler-BenaoudiaM, KeeganTH, et al.Cancer statistics for adolescents and young adults, 2020. CA Cancer J Clin, 2020; 70(6):443–459; doi: 10.3322/caac.21637
33.
GreeneMH, MaiPL, LoudJT, et al.Familial testicular germ cell tumors (FTGCT) – overview of a multidisciplinary etiologic study. Andrology, 2015; 3(1):47–58; doi: 10.1111/andr.294
34.
NordsborgRB, MelikerJR, WohlfahrtJ, et al.Cancer in first‐degree relatives and risk of testicular cancer in Denmark. Int J Cancer, 2011; 129(10):2485–2491; doi: 10.1002/ijc.25897
35.
ReeceA, HulseG. State trends of cannabis liberalization as a causal driver of increasing testicular cancer rates across the USA. Int J Environ Res Public Health, 2022; 19(19):12759; doi: 10.3390/ijerph191912759
36.
HolmanDM, Open-AccessmanMB, ShoemakerML. Trends in melanoma incidence among non-Hispanic whites in the United States, 2005 to 2014. JAMA Dermatol, 2018; 154(3):361–362; doi: 10.1001/jamadermatol.2017.5541
37.
WémeauJ-L, SadoulJ-L, d’HerbomezM, et al.Guidelines of the French society of endocrinology for the management of thyroid nodules. Ann Endocrinol (Paris), 2011; 72(4):251–281; doi: 10.1016/j.ando.2011.05.003
38.
PatelN, BavikarR, LadYP, et al.A comparison of the WHO 2004 and WHO 2017 thyroid tumor classifications. J Cancer Res Ther, 2024; 20(1):311–314; doi: 10.4103/jcrt.jcrt_1797_22
39.
Van Der MeerDJ, Karim-KosHE, Van Der MarkM, et al.Incidence, survival, and mortality trends of cancers diagnosed in adolescents and young adults (15–39 years): A population-based study in the Netherlands 1990–2016. Cancers (Basel), 2020; 12(11):3421; doi: 10.3390/cancers12113421
40.
di MartinoE, SmithL, BradleySH, et al.Incidence trends for twelve cancers in younger adults-a rapid review. Br J Cancer, 2022; 126(10):1374–1386; doi: 10.1038/s41416-022-01704-x
41.
LouwmanWJ, VoogdAC, van DijckJAAM, et al.On the rising trends of incidence and prognosis for breast cancer patients diagnosed 1975-2004: A long-term population-based study in southeastern Netherlands. Cancer Causes Control, 2008; 19(1):97–106; doi: 10.1007/s10552-007-9075-8
42.
JohnsonRH, AndersCK, LittonJK, et al.Breast cancer in adolescents and young adults. Pediatr Blood Cancer, 2018; 65(12):e27397; doi: 10.1002/pbc.27397
43.
WhiteJL, GrabowskiMK, RositchAF, et al.Trends in adolescent human papillomavirus vaccination and parental hesitancy in the United States. J Infect Dis, 2023; 228(5):615–626; doi: 10.1093/infdis/jiad055
44.
de PouvourvilleG, GuyotE, FargeG, et al.Human papillomavirus (HPV) vaccination coverage among French adolescents: A claims data study. Vaccine, 2024; 42(22):126039; doi: 10.1016/j.vaccine.2024.06.007S0264-410X(24)00667–4;
45.
ThierryP, LasserreA, RossignolL, et al.Human papillomavirus vaccination in general practice in France, three years after the implementation of a targeted vaccine recommendation based on age and sexual history. Hum Vaccin Immunother, 2016; 12(2):528–533; doi: 10.1080/21645515.2015.1078042
46.
JernmanJ, VälimäkiMJ, LouhimoJ, et al.The novel WHO 2010 classification for gastrointestinal neuroendocrine tumours correlates well with the metastatic potential of rectal neuroendocrine tumours. Neuroendocrinology, 2012; 95(4):317–324; doi: 10.1159/000333035
47.
World Health Organization. International statistical classification of diseases and related health problems. 10th revision, fifth edition. World Health Organization: Geneva, Switzerland; 2016.
48.
UllahMF, FlemingCA, MealyK. Changing trends in age and stage of colorectal cancer presentation in Ireland–From the nineties to noughties and beyond. Surgeon, 2018; 16(6):350–354; doi: 10.1016/j.surge.2018.03.006
49.
FontbonneA, CurrieA, TounianP, et al.Prevalence of overweight and obesity in France: The 2020 obepi-roche study by the “ligue contre l’obésité. J Clin Med, 2023; 12(3):925; doi: 10.3390/jcm12030925
50.
LarssonSC, BurgessS. Causal role of high body mass index in multiple chronic diseases: A systematic review and meta-analysis of mendelian randomization studies. BMC Med, 2021; 19(1):320; doi: 10.1186/s12916-021-02188-x
51.
LarssonSC, SpyrouN, MantzorosCS. Body fatness associations with cancer: Evidence from recent epidemiological studies and future directions. Metabolism, 2022; 137:155326; doi: 10.1016/j.metabol.2022.155326
52.
PatiS, IrfanW, JameelA, et al.Obesity and cancer: A current overview of epidemiology, pathogenesis, outcomes, and management. Cancers (Basel), 2023; 15(2):485; doi: 10.3390/cancers15020485
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
