Diverging global incidence trends of early-onset cancers: comparisons with incidence trends of later-onset cancers and mortality trends of early-onset cancers

Miyu Terashima; Kota Nakayama; Sora Shirai; Satoko Ugai; Hwa-Young Lee; Haruna Matsui; Hiroki Mizuno; Shiori Tanaka; Minkyo Song; Naoko Sasamoto; Ichiro Kawachi; Edward L. Giovannucci; Tomotaka Ugai

doi:10.1186/s40779-025-00670-8

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Diverging global incidence trends of early-onset cancers: comparisons with incidence trends of later-onset cancers and mortality trends of early-onset cancers

RESEARCH | Updated：2026-08-20

- Diverging global incidence trends of early-onset cancers: comparisons with incidence trends of later-onset cancers and mortality trends of early-onset cancers
- Diverging global incidence trends of early-onset cancers: comparisons with incidence trends of later-onset cancers and mortality trends of early-onset cancers
- Military Medical Research 2026年13卷第6期页码：869-880
- Affiliations：
  
  Division of Integrative Cancer Research, National Cancer Center Research Institute, Tokyo 104-0045, Japan
  Present Address: Okayama University Medical School, Okayama 700-8558, Japan
  Present Address: Depart-ment of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA 02215, USA
  Present Address: Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
  Present Address: Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
  Graduate School of Public Health and Healthcare Management, the Catholic University of Korea, Seoul 06591, Republic of Korea
  Present Address: Catholic Institute for Public Health and Healthcare Management, the Catholic University of Korea, Seoul 06591, Republic of Korea
  Division of Prevention, Institute for Cancer Control, National Cancer Center, Tokyo 104-0045, Japan
  Labora-tory of Epidemiology and Population Sciences, National Institute On Aging, National Institutes of Health, Baltimore, MD 21224, USA
  Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
  Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
  Department of Pathology, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA 02115, USA
  Zhu Family Center for Global Cancer Prevention, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
- Author bio：
  
  * Tomotaka Ugai tugai@hsph.harvard.edu
- Funds：
  
  the Prevent Cancer Foundation Grant, Harvey V. Fineberg Cancer Prevention Fellowship, Brigham and Women’s Hospital Faculty Career Development Award, an Investigator Initiated Grant from the American Institute for Cancer Research (AICR) , Grants-in-Aid for Scientific Research(23K20052);the National Cancer Center Research and Develop-ment Fund(2025-A-02);the Uehara Memorial Foundation;American Cancer Society Clinical Research Professor
- DOI：10.1186/s40779-025-00670-8
  中图分类号：
- 收稿：2025-06-15，
  
  录用：2025-11-03，
  
  网络首发：2025-11-14，
  
  纸质出版：2026-06
- Accepted：
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Miyu Terashima, Kota Nakayama, Sora Shirai, 等. Diverging global incidence trends of early-onset cancers: comparisons with incidence trends of later-onset cancers and mortality trends of early-onset cancers[J]. Military Medical Research, 2026,13(6):869-880.

Miyu Terashima, Kota Nakayama, Sora Shirai, et al. Diverging global incidence trends of early-onset cancers: comparisons with incidence trends of later-onset cancers and mortality trends of early-onset cancers[J]. Military Medical Research, 2026, 13(6): 869-880.
Miyu Terashima, Kota Nakayama, Sora Shirai, 等. Diverging global incidence trends of early-onset cancers: comparisons with incidence trends of later-onset cancers and mortality trends of early-onset cancers[J]. Military Medical Research, 2026,13(6):869-880. DOI： 10.1186/s40779-025-00670-8.

Miyu Terashima, Kota Nakayama, Sora Shirai, et al. Diverging global incidence trends of early-onset cancers: comparisons with incidence trends of later-onset cancers and mortality trends of early-onset cancers[J]. Military Medical Research, 2026, 13(6): 869-880. DOI： 10.1186/s40779-025-00670-8.

摘要

Abstract

Background

The global increase in the incidence of early-onset cancers (defined as cancers diagnosed at 20–49 years old) is a serious public health problem. We investigated 1) whether the incidence trend of early-onset cancers differs from that of later-onset cancers and 2) whether both the incidence and mortality of early-onset can-cers have increased concurrently.

Methods

We utilized age-standardized incidence and mortality rates for early-onset and later-onset cancers diag-nosed between 2000 and 2017 from the Cancer Incidence in Five Continents and World Health Organization (WHO)mortality databases. The national obesity prevalence among adults aged 20–49 years was obtained from the National Clinical Database. Using joinpoint regression models

we calculated average annual percentage changes (AAPCs)for cancer incidence and mortality by cancer types and countries. We additionally conducted human development index (HDI)-stratified analyses and assessed the correlation between the obesity prevalence in younger populations and early-onset cancer incidence by country. To investigate the more recent trend of early-onset cancer mortality

we extended our mortality analysis after 2017 for cancer types and countries with statistically significant positive AAPCs in both incidence and mortality of early-onset cancers between 2000 and 2017.

Results

Our analysis showed that 10 early-onset cancer types (thyroid cancer

breast cancer

melanoma

uterine cancer

colorectal cancer

kidney cancer

cervical cancer

pancreatic cancer

multiple myeloma

Hodgkin lymphoma)in females and 7 early-onset cancer types (thyroid cancer

kidney cancer

testis cancer

prostate cancer

colorectal cancer

melanoma

leukemia) in males had statistically significant positive AAPCs in at least 10 countries. Among these

the following early-onset cancer types had significantly higher AAPCs than later-onset cancer types in females: colorectal cancer (6 countries; AAPC range: 1.8–3.8%)

cervical cancer (6 countries; AAPC range: 1.2–3.3%)

pancreatic cancer (5 countries; AAPC range: 2.3–13.0%)

and multiple myeloma (5 countries; AAPC range: 3.1–9.8%); in males: prostate cancer (12 countries; AAPC range: 3.9–18.4%)

colorectal cancer (8 countries; AAPC range: 1.8–3.2%)

and kidney cancer (6 countries; AAPC range: 2.0–6.0%). We observed statistically significant positive AAPCs in both the incidence and mortality of the following early-onset cancer types: uterine cancer (5 countries) and colorectal cancer (3 countries in females and 5 countries in males). The steeper increases in early-onset cancers compared with later-onset cancers were mainly observed in the very high-HDI country group

including early-onset colorectal cancer (AAPC = 2.4%

95% CI 2.1–2.6 in females; AAPC = 2.0%

95% CI 1.7–2.4 in males) to later-onset colorectal cancer (AAPC= −0.1%

95% CI −0.2 to 0 in females; AAPC = −0.2%

95% CI −0.3 to 0 in males). We observed strong positive cor-relations between the increasing obesity prevalence and the rising incidence of early-onset obesity-related cancers in several countries

including Australia (7 cancer types)

United Kingdom (7 cancer types)

Canada (7 cancer types)

Republic of Korea (7 cancer types)

and USA (6 cancer types) in females and United Kingdom (7 cancer types)

Canada (6 cancer types)

Australia (5 cancer types)

Sweden (5 cancer types)

and Republic of Korea (4 cancer types) in males. Although we did not observe an apparent spike after 2017 in many countries

we observed continued increases in the mortality of certain cancer types

such as uterine cancer (Japan

Republic of Korea

United Kingdom

USA

and Ecuador) in females and colorectal cancer (Argentina

Canada

United Kingdom

and USA) in males.

Conclusions

The increase in many early-onset cancer types was significantly higher than that of later-onset cancers

and the incidence and mortality of certain early-onset cancer types (such as colorectal cancer) increased simultane-ously. Our study highlights global differences in cancer incidence and mortality trends of early-onset and later-onset cancers.

关键词

Keywords

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