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Trends in cancer burden for adolescents and young adults in China from 1990 to 2021

Xing Xing¹, Lu Lan¹, Wenyu Yang¹

¹School of Public Health, Peking University, Beijing, 100191, China.

|October 11, 2025

Abstract

Background:

Cancer among adolescents and young adults (AYAs), defined as ages 15-39 years, is an increasing public health concern globally, characterized by unique epidemiological patterns and significant health and societal burdens. Despite rising evidence of its impact in China, a comprehensive assessment of the cancer burden remains Limited. This study aims to examine trends in the cancer burden among Chinese AYAs from 1990 to 2021.

Methods:

Data were extracted from the Global Burden of Disease (GBD) 2021 study. The age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life year (DALY) rate (ASDR) per 100,000 population were calculated and stratified by sex, alongside risk-attributable burdens. Trends were examined using the estimated annual percentage change (EAPC) and joinpoint regression, and projections were made using auto-regressive integrated moving average models.

Results:

From 1990 to 2021, the incidence of cancer among AYAs increased, with ASIR rising from 36.74 to 51.51 per 100,000 population. However, mortality decreased, with ASMR declining from 22.53 to 14.89 per 100,000 population, and the disability burden also decreased, with ASDR declining from 1,331.48 to 689.68 per 100,000 population. Breast cancer emerged as the leading contributor to incidence burden (ASIR: 6.03), while tracheal, bronchus, and lung cancers, along with leukemia, accounted for the highest mortality (ASMR: 1.73) and DALYs (ASDR: 98.73) burden among AYAs. Tobacco use and dietary risks were the largest contributors to the overall cancer burden, whereas unsafe sex remained the principal risk factor for cervical cancer.

Conclusions:

Our findings highlight a potentially increasing cancer burden among AYAs in China, primarily due to lifestyle, environmental, and infectious factors. Future prevention efforts should target both traditional risk factors and emerging lifestyle threats, with a focus on cancer prevention and screening for AYAs at high risk.

Keywords:

Adolescents and young adults Cancer burden Cancer epidemiology China Trend analysis

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