Incidence Trends in Upper Gastrointestinal Cancer in Young Adults: A Nationwide Time-Trend Analysis Using 2001-2019...

Area of Science:

• Oncology
• Epidemiology
• Public Health

Background:

• Upper gastrointestinal (UGI) cancers are a leading cause of cancer mortality in the US.
• Recent data indicate a concerning rise in UGI cancers, especially pancreatic and stomach cancers, among young adults.
• Significant comorbidities are often associated with UGI cancers.

Purpose of the Study:

• To evaluate the aggregate incidence trend of all UGI cancers nationwide.
• To examine demographic, histologic, and tumor stage factors influencing UGI cancer incidence in young adults.
• To compare incidence trends between young and older adults, and between sexes.

Main Methods:

• Utilized the Surveillance, Epidemiology, and End Results-National Program of Cancer Registries database (2001-2019).
• Calculated age-adjusted incidence rates per 100,000 population, stratified by sex and age (<55 years vs. ≥55 years).
• Employed parametric methods to determine trends and annual percentage changes, with sensitivity analyses for site, histology, race, and stage.

Main Results:

• Identified 2,333,161 UGI cancer cases; 14.3% were in individuals <55 years.
• The most significant incidence increase was observed in women younger than 55 years, primarily due to pancreatic and stomach cancers.
• Neuroendocrine tumors and gastrointestinal stromal tumors, African American race, and advanced tumor stage contributed to the rise in young women.

Conclusions:

• Overall UGI cancer incidence is significantly increasing in young women compared to men.
• Factors such as increased endoscopic surveillance and differential exposure to risk factors may explain these trends.
• While incidence rises, UGI cancer mortality rates have not significantly changed in young adults.