MedicalResearch.com Interview with:
Dr Miranda M Fidler, PhD
Section of Cancer Surveillance
International Agency for Research on Cancer
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The burden of cancer among young adults has been rarely studied in depth. To our knowledge, we describe for the first time the scale and profile of cancer incidence and mortality worldwide among 20-39 year-olds, highlighting major patterns by age, sex, development level, and geographic region.
Although cancer is less frequent than that observed at older ages, its impact remains considerable because these individuals have a large proportion of their expected lifespans remaining, contribute substantially to the economy, and play a major role in caring for their families. Worldwide, almost 1 million new cases of cancer and 400 000 cancer-related deaths occurred among young adults aged 20–39 years in 2012.
Overall, the most common cancer types in terms of new cases were female breast cancer, cervical cancer, thyroid cancer, leukemia, and colorectal cancer, and the most common types of cancer-related deaths were those due to female breast cancer, liver cancer, leukemia, and cervical cancer. The burden was disproportionately greater among women, with an estimated 633 000 new cancer cases (65% of all new cancer cases in that age group) and 194 000 cancer-related deaths (54% of all cancer-related deaths in that age group) in 2012.
MedicalResearch.com: What should readers take away from your report?
Response: Given the particularly heavy burden of breast and cervical cancers, increasing awareness of cancer in young women at both the public and professional levels, as well as timely treatment, is of key importance. National human papillomavirus (HPV) vaccination programs, early detection, and, in women older than 30 years, screening, could significantly reduce the global burden of cervical cancer in young women, at a limited cost.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research should continue to investigate the appropriateness of early detection and screening programs in this age group in order to determine the benefits and potential risks, and develop recommendations supported by evidence.
Further, research efforts to expand the young adult cancer agenda beyond high-income countries is of great importance. As individuals in this age group are the most financially productive members of their societies, it is clear that improving equity in prevention, diagnosis, and care will not only have a large societal impact, but may be cost-effective as well. Studies undertaking cost benefit analyses of improving young adult cancer care, particularly in low- and middle-income countries, are needed in order to inform policymakers and advocates, and expand the young adult cancer agenda beyond high-income countries.
Finally, additional descriptive research should be undertaken using available population-based cancer registry data through Cancer Incidence in Five Continents (http://ci5.iarc.fr), which would allow an assessment of histologically defined cancers, including those that we were not able to address in this paper (e.g. bone cancer and soft tissue sarcomas), and trends, albeit for a limited number of countries or sub-national regions.
MedicalResearch.com: Is there anything else you would like to add?
Response: Increasing awareness of cancer in this age group is needed in order to bring attention to the risks of cancer in this relatively young age group. As young adult cancer patients exhibit a combination of features observed in younger and older patients, it is crucial that progress is achieved through a combination of the methods that led to improvements in these other groups – that is: advancement of risk stratification and treatment protocols through clinical trials in children and implementation of effective prevention and early detection at older ages.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Disclosures? No potential conflicts of interest.
Dr Miranda M Fidler, PhD, Sumit Gupta, MD, Isabelle Soerjomataram, PhD,
Jacques Ferlay, MSc, Eva Steliarova-Foucher, PhD, Freddie Bray, PhD
Published: 27 October 2017 DOI: http://dx.doi.org/10.1016/S1470-2045(17)30677-0
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