The Annual Report to the Nation’s Special Topic highlights cancer trends among adults ages 20 to 49. Scroll down for information on rates and selected cancers in this population.
Cancer Death Rates Among Adults Ages 20-49
During 2012 to 2016, death rates for cancers of all sites combined decreased 2.3% per year among men and 1.7% per year among women age 20–49.
During 2012 to 2016, the three most common causes of cancer death among men age 20-49 were colorectal, lung and bronchus, and brain and other nervous system and among women were breast, lung and bronchus, and colorectal.
Among the top causes of cancer death in people age 20–49, death rates increased during 2012 to 2016 for colorectal (1.6% in men and 1.0% in women), decreased for lung and bronchus (–6.6% in men and –9.2% in women), decreased for breast in women (–1.3%), and were stable for brain and other nervous system in men and women.
For people age 20–49 during 2012 to 2016, black men and women had the highest death rate of any racial and ethnic group for all cancer sites combined.
- Among men, blacks had the highest death rates for colorectal, lung, pancreas, and NHL.
- Among women, blacks had the highest death rates for breast, colorectal, cervix, leukemia (along with Hispanics), pancreas, and NHL.
- White men and non-Hispanic men had the highest death rates for brain and other nervous system cancer, esophagus cancer, and melanoma of the skin; Asian-Pacific Islander (API) men had the highest death rates for liver cancer and oral cavity and pharynx cancer; AI/AN men had the highest rates for kidney cancer; and Hispanic men had the highest rates for leukemia and stomach cancer.
- Non-Hispanic women had the highest death rates for lung and bronchus cancer; white women and Non-Hispanic women had the highest rates for brain and other nervous system cancer; and American Indian/Alaska Native (AI/AN) women had the highest rates for corpus and uterus cancer.
Rates of New Cancer Cases Among Adults Ages 20-49
Long Term Overall Trends
Among men age 20–49 years, cancer incidence rates increased an average of 0.6% per year during 1999 to 2008 and decreased an average of 0.7% per year during 2008 to 2015. Among women age 20–49 years, rates increased an average of 1.1% per year during 1999 to 2009, were stable during 2009 to 2012, then increased 1.8% per year during 2012 to 2015.
Recent Overall Trends
Among people of all ages, overall cancer incidence (2011–2015) and death (2012–2016) rates were higher in men than in women, whereas among adults age 20–49 years, incidence and death rates were lower among men than women.
Unlike the pattern in incidence rates for all ages, the incidence rate for all invasive cancers among individuals age 20–49 years during 2011 to 2015 was lower among men (115.3) than women (203.3). During 2011 to 2015, the incidence of all invasive cancers combined decreased among men age 20–49 (5-year AAPC = –0.7%) and increased among women (1.3%)
Recent Trends for Most Common Cancers
During 2011 to 2015, Invasive cancers with the highest incidence rates among men were colon and rectum (13.1), testis (10.7) and melanoma of the skin (9.8) and among women were breast (73.2), thyroid (28.4) and melanoma of the skin (14.1). In addition to breast and thyroid cancer, cancers of the female genital organs contributed to the greater cancer burden in younger women compared to men.
Among the 11 most common invasive cancers in men that also occur in women, incidence among men during 2011 to 2015 was higher for 8 sites, lower for 3.
Unlike thyroid cancer trends for all ages, incidence during 2011 to 2015 increased 2.2% among women age 20–49 and was stable among men.
Variations in ranking by decade of age reflected marked differences in age-specific incidence trends across cancer sites. Among men age 30–39 during 2011 to 2015, the most common invasive cancers were testis, melanoma of the skin and colorectal, and among men age 40–49 they were colorectal, prostate, and kidney and renal pelvis. Among women age 20–29 during this time period, the most common invasive cancers were thyroid, melanoma of the skin, and breast. Among women age 30–39 they were breast, thyroid and melanoma of the skin, and among women age 40–49 they were breast, thyroid, and colorectal.
Declines in lung and bronchus cancer incidence and death rates among men and women age 20‒49 reflect substantial progress in comprehensive tobacco control.
Modest declines in cervical cancer incidence were observed among women age 20‒29, the first age cohort that could be impacted by HPV vaccination.
Declines in melanoma incidence rates among men age 20‒49 and among women age 20‒29 may reflect skin cancer prevention efforts among children and young adults.
Trends by Race
Several cancers in young adults age 20–49 years (2011–2015) had pronounced variations in incidence by race and ethnicity.
During 2011 to 2015, incidence rates for testicular cancer among men age 20–49 were highest (12.5) among whites. Incidence rates for prostate cancer among men age 20–49 were highest (18.6) among blacks.
Selected Cancers in Adults Ages 20-49
Younger women tend to have more aggressive breast cancer, including higher stage at diagnosis. Alcohol consumption is a risk factor for breast cancer among women of all ages, and specifically for younger women.
Differences in breast cancer survival by molecular subtype likely play a role in the lower survival rates among non-Hispanic black women, who have higher incidence of the HR‒/HER2‒ subtype.
Recent 5-year data show that for men ages 20 to 49, malignant brain and other nervous system cancers were the 11th most common cancer type and 3rd leading cause of cancer death; for women ages 20-49, this cancer type was the 12th most common and the 6th leading cause of cancer death.
Based on recent 5-year data, colorectal cancer is the second most common cancer and cause of cancer death among men and women age 20‒49. The authors attributed the increased risk in recent birth cohorts to changes in exposures, including increasing prevalence of overweight and obesity, low levels of physical activity and, to some extent, increasing utilization of colonoscopy for screening and diagnosis among individuals under age 50.
Based on recent 5-year data, testicular cancer is the second most common cancer among men age 20-49, and the incidence is rising. This cancer shows wide variability in incidence rates by race, with the highest incidence in white (12.5) and AI/AN (10.5) men and the lowest in black (2.8) and API (3.6) men, as has also been noted in previous studies. Testicular cancer is highly curable, with a 10-year relative survival approaching 95%.
Targeted research and cancer control efforts are warranted to reduce mortality and morbidity associated with certain cancers and treatments in younger adults.