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Trends in young-onset cancer incidence: a modeling perspective
Lukas Owens1, Allison Fung1, Jonathan Shuhendler1
1Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States.
Rising young-onset cancer rates may stem from birth cohort effects or earlier diagnosis. Earlier diagnosis, particularly for colorectal and gastric cancers, shows protective birth cohort effects in older populations.
Area of Science:
- Epidemiology
- Oncology
- Biostatistics
Background:
- Increasing concern over rising young-onset cancer diagnoses.
- Previous studies focused on etiologic causes, overlooking diagnostic advancements.
Purpose of the Study:
- To model cancer incidence trends using a natural history framework.
- To differentiate between etiologic factors and diagnostic changes in young-onset cancers.
Main Methods:
- Simulated incidence trends using a natural history model (healthy, preclinical, clinical states).
- Incorporated birth cohort effects (disease onset) and period effects (diagnosis).
- Analyzed 2000-2019 data for six young-onset cancers (colon, rectum, breast, gastric, pancreas, kidney).
Main Results:
- Observed increasing incidence aligns with either a birth cohort effect (post-1970) or reduced preclinical disease duration.
- Declining incidence in older individuals for certain cancers suggests protective birth cohort effects.
Conclusions:
- Disease modeling offers insights into cancer incidence drivers.
- Highlights the need to consider diagnostic changes alongside etiologic factors.
- Suggests constraints on potential exposure patterns implicated in young-onset cancers.
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