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Is early-onset cancer an emerging global epidemic? Current evidence and future implications.

Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA. tugai@bwh.harvard.edu. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. tugai@bwh.harvard.edu. Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, USA. Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA, USA. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Institute of Convergence Science, Convergence Science Academy, Yonsei University, Seoul, Republic of Korea. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA. Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA. International Agency for Research on Cancer, Lyon, France. Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA. Zhu Family Center for Global Cancer Prevention, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA. sogino@bwh.harvard.edu. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. sogino@bwh.harvard.edu. Broad Institute of MIT and Harvard, Cambridge, MA, USA. sogino@bwh.harvard.edu. Cancer Immunology and Cancer Epidemiology Programs, Dana-Farber Harvard Cancer Center, Boston, MA, USA. sogino@bwh.harvard.edu.

Nature reviews. Clinical oncology. 2022;(10):656-673
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Abstract

Over the past several decades, the incidence of early-onset cancers, often defined as cancers diagnosed in adults <50 years of age, in the breast, colorectum, endometrium, oesophagus, extrahepatic bile duct, gallbladder, head and neck, kidney, liver, bone marrow, pancreas, prostate, stomach and thyroid has increased in multiple countries. Increased use of screening programmes has contributed to this phenomenon to a certain extent, although a genuine increase in the incidence of early-onset forms of several cancer types also seems to have emerged. Evidence suggests an aetiological role of risk factor exposures in early life and young adulthood. Since the mid-20th century, substantial multigenerational changes in the exposome have occurred (including changes in diet, lifestyle, obesity, environment and the microbiome, all of which might interact with genomic and/or genetic susceptibilities). However, the effects of individual exposures remain largely unknown. To study early-life exposures and their implications for multiple cancer types will require prospective cohort studies with dedicated biobanking and data collection technologies. Raising awareness among both the public and health-care professionals will also be critical. In this Review, we describe changes in the incidence of early-onset cancers globally and suggest measures that are likely to reduce the burden of cancers and other chronic non-communicable diseases.

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Publication Type : Review

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