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The Rise in Early-Onset Cancer in the US Population-More Apparent Than Real.

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Rising early-onset cancer diagnoses may not indicate more disease. Increased screening and overdiagnosis likely explain many new cases, not a true cancer epidemic in young adults.

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Area of Science:

  • Oncology
  • Epidemiology
  • Public Health

Background:

  • Early-onset cancer rates are rising, causing public concern and shifting clinical guidelines.
  • It is unclear if these rising rates reflect true cancer occurrence or increased diagnostic scrutiny.

Purpose of the Study:

  • To analyze trends in early-onset cancer incidence and mortality.
  • To differentiate between true increases in cancer occurrence and those due to diagnostic factors.

Main Methods:

  • Analysis of cancer incidence and mortality data for adults younger than 50 years in the US.
  • Focus on cancers with the fastest-rising incidence rates and common early-onset cancers like breast cancer.

Main Results:

  • Eight fast-rising cancers doubled in incidence since 1992, with stable aggregate mortality.
  • Mortality for most fast-rising cancers remained flat, suggesting increased detection over more disease.
  • Breast cancer incidence rose, but mortality decreased significantly, indicating improved outcomes.

Conclusions:

  • The rise in early-onset cancer incidence does not consistently signal a rise in clinically meaningful disease.
  • Much of the observed increase appears attributable to increased diagnostic scrutiny and overdiagnosis.
  • Interpreting these trends as a disease epidemic may lead to unnecessary screening and divert attention from other health threats.