The Lancet Oncology ( IF 41.6 ) Pub Date : 2021-12-03 , DOI: 10.1016/s1470-2045(21)00581-7 Elysia M Alvarez , Lisa M Force , Rixing Xu , Kelly Compton , Dan Lu , Hannah Jacqueline Henrikson , Jonathan M Kocarnik , James D Harvey , Alyssa Pennini , Frances E Dean , Weijia Fu , Martina T Vargas , Theresa H M Keegan , Hany Ariffin , Ronald D Barr , Yana Arturovna Erdomaeva , D Sanjeeva Gunasekera , Yetunde O John-Akinola , Tyler G Ketterl , Tezer Kutluk , Marcio Henrique Malogolowkin , Prashant Mathur , Venkatraman Radhakrishnan , Lynn Ann Gloeckler Ries , Carlos Rodriguez-Galindo , Garik Barisovich Sagoyan , Iyad Sultan , Behzad Abbasi , Mohsen Abbasi-Kangevari , Zeinab Abbasi-Kangevari , Hedayat Abbastabar , Michael Abdelmasseh , Sherief Abd-Elsalam , Amir Abdoli , Haimanot Abebe , Aidin Abedi , Hassan Abidi , Hassan Abolhassani , Hiwa Abubaker Ali , Eman Abu-Gharbieh , Basavaprabhu Achappa , Juan Manuel Acuna , Isaac Akinkunmi Adedeji , Oyelola A Adegboye , Qorinah Estiningtyas Sakilah Adnani , Shailesh M Advani , Muhammad Sohail Afzal , Mohamad Aghaie Meybodi , Bahman Ahadinezhad , Bright Opoku Ahinkorah , Sajjad Ahmad , Sepideh Ahmadi , Muktar Beshir Ahmed , Tarik Ahmed Rashid , Yusra Ahmed Salih , Wajeeha Aiman , Gizachew Taddesse Akalu , Hanadi Al Hamad , Fares Alahdab , Abdulhadi A AlAmodi , Fahad Mashhour Alanezi , Turki M Alanzi , Adugnaw Zeleke Alem , Dejene Tsegaye Alem , Yosef Alemayehu , Fadwa Naji Alhalaiqa , Robert Kaba Alhassan , Saqib Ali , Gianfranco Alicandro , Vahid Alipour , Syed Mohamed Aljunid , Motasem Alkhayyat , Sunitha Alluri , Nihad A Almasri , Sadeq Ali Al-Maweri , Sami Almustanyir , Rajaa M Al-Raddadi , Nelson Alvis-Guzman , Edward Kwabena Ameyaw , Saeed Amini , Hubert Amu , Robert Ancuceanu , Catalina Liliana Andrei , Tudorel Andrei , Fereshteh Ansari , Alireza Ansari-Moghaddam , Davood Anvari , Anayochukwu Edward Anyasodor , Jalal Arabloo , Morteza Arab-Zozani , Ayele Mamo Argaw , Muhammad Arshad , Judie Arulappan , Armin Aryannejad , Zatollah Asemi , Mohammad Asghari Jafarabadi , Mohammad Reza Atashzar , Prince Atorkey , Alok Atreya , Sameh Attia , Avinash Aujayeb , Marcel Ausloos , Leticia Avila-Burgos , Atalel Fentahun Awedew , Beatriz Paulina Ayala Quintanilla , Alemu Degu Ayele , Solomon Shitu Ayen , Mohammed A Azab , Sina Azadnajafabad , Hiva Azami , Mohammadreza Azangou-Khyavy , Amirhossein Azari Jafari , Ghasem Azarian , Ahmed Y Azzam , Saeed Bahadory , Jianjun Bai , Atif Amin Baig , Jennifer L Baker , Maciej Banach , Till Winfried Bärnighausen , Francesco Barone-Adesi , Fabio Barra , Amadou Barrow , Huda Basaleem , Abdul-Monim Mohammad Batiha , Masoud Behzadifar , Niguss Cherie Bekele , Rebuma Belete , Uzma Iqbal Belgaumi , Arielle Wilder Bell , Alemshet Yirga Berhie , Devidas S Bhagat , Akshaya Srikanth Bhagavathula , Nikha Bhardwaj , Pankaj Bhardwaj , Sonu Bhaskar , Krittika Bhattacharyya , Vijayalakshmi S Bhojaraja , Sadia Bibi , Ali Bijani , Antonio Biondi , Setognal Birara , Tone Bjørge , Obasanjo 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Sha , Omid Shafaat , Masood Ali Shaikh , Erfan Shamsoddin , Mohammed Shannawaz , Rajesh Sharma , Sara Sheikhbahaei , Adithi Shetty , B Suresh Kumar Shetty , Pavanchand H Shetty , Jae Il Shin , Reza Shirkoohi , K M Shivakumar , Parnian Shobeiri , Soraya Siabani , Migbar Mekonnen Sibhat , Sudeep K Siddappa Malleshappa , Negussie Boti Sidemo , Diego Augusto Santos Silva , Guilherme Silva Julian , Achintya Dinesh Singh , Jasvinder A Singh , Jitendra Kumar Singh , Surjit Singh , Abiy H Sinke , Yitagesu Sintayehu , Valentin Yurievich Skryabin , Anna Aleksandrovna Skryabina , Lee Smith , Ahmad Sofi-Mahmudi , Mohammad Sadegh Soltani-Zangbar , Suhang Song , Emma Elizabeth Spurlock , Paschalis Steiropoulos , Kurt Straif , Ranjeeta Subedi , Mu'awiyyah Babale Sufiyan , Rizwan Suliankatchi Abdulkader , Saima Sultana , Viktória Szerencsés , Miklós Szócska , Seidamir Pasha Tabaeian , Rafael Tabarés-Seisdedos , Mohammadreza Tabary , Takahiro Tabuchi , Hooman Tadbiri , Majid Taheri , Amir Taherkhani , Ken Takahashi , Mircea Tampa , Ker-Kan Tan , Vivian Y Tat , Ahmad Tavakoli , Abdelghani Tbakhi , Arash Tehrani-Banihashemi , Mohamad-Hani Temsah , Fisaha Haile Tesfay , Bekele Tesfaye , Jarnail Singh Thakur , Rekha Thapar , Aravind Thavamani , Arulmani Thiyagarajan , Nihal Thomas , Ruoyan Tobe-Gai , Munkhsaikhan Togtmol , Seyed Abolfazl Tohidast , Hamid Reza Tohidinik , Musliu Adetola Tolani , Daniel Nigusse Tollosa , Mathilde Touvier , Marcos Roberto Tovani-Palone , Eugenio Traini , Bach Xuan Tran , Mai Thi Ngoc Tran , Jaya Prasad Tripathy , Biruk Shalmeno Tusa , Gebresilasea Gendisha Ukke , Irfan Ullah , Saif Ullah , Krishna Kishore Umapathi , Bhaskaran Unnikrishnan , Era Upadhyay , Tolassa Wakayo Ushula , Marco Vacante , Sahel Valadan Tahbaz , Shoban Babu Varthya , Massimiliano Veroux , Paul J Villeneuve , Francesco S Violante , Vasily Vlassov , Giang Thu Vu , Yasir Waheed , Ning Wang , Paul Ward , Adisu Birhanu Weldesenbet , Yi Feng Wen , Ronny Westerman , Andrea Sylvia Winkler , Befikadu Legesse Wubishet , Suowen Xu , Seyed Hossein Yahyazadeh Jabbari , Lin Yang , Sanni Yaya , Vahid Yazdi-Feyzabadi , Taklo Simeneh Yazie , Sisay Shewasinad Yehualashet , Alex Yeshaneh , Yigizie Yeshaw , Birhanu Wubale Yirdaw , Naohiro Yonemoto , Mustafa Z Younis , Zabihollah Yousefi , Chuanhua Yu , Ismaeel Yunusa , Vesna Zadnik , Mazyar Zahir , Telma Zahirian Moghadam , Mohammad Zamani , Maryam Zamanian , Hamed Zandian , Fariba Zare , Mikhail Sergeevich Zastrozhin , Anasthasia Zastrozhina , Jianrong Zhang , Zhi-Jiang Zhang , Arash Ziapour , Mohammad Zoladl , Christopher J L Murray , Christina Fitzmaurice , Archie Bleyer , Nickhill Bhakta
Background
In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15–39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults.
Methods
Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15–39 years to define adolescents and young adults.
Findings
There were 1·19 million (95% UI 1·11–1·28) incident cancer cases and 396 000 (370 000–425 000) deaths due to cancer among people aged 15–39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59·6 [54·5–65·7] per 100 000 person-years) and high-middle SDI countries (53·2 [48·8–57·9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14·2 [12·9–15·6] per 100 000 person-years) and middle SDI (13·6 [12·6–14·8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23·5 million (21·9–25·2) DALYs to the global burden of disease, of which 2·7% (1·9–3·6) came from YLDs and 97·3% (96·4–98·1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally.
Interpretation
Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts.
Funding
Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities, St Baldrick's Foundation, and the National Cancer Institute.
中文翻译：
2019 年全球青少年和年轻人癌症负担：2019 年全球疾病负担研究的系统分析
背景
在估计全球癌症负担时，患有癌症的青少年和年轻人经常被忽视，尽管他们是一个具有独特流行病学、临床护理需求和社会影响的独特亚组。目前缺乏对青少年和年轻人（15-39 岁）全球癌症负担的全面估计。为了弥补这一差距，我们分析了 2019 年全球疾病、伤害和风险因素负担研究 (GBD) 的结果，重点关注伤残调整生命年 (DALY) 的结果，为全球癌症控制措施提供信息青少年和年轻人。
方法
使用 GBD 2019 方法，从人口动态登记系统、口头尸检和以死亡率与发病率 (MIR) 为模型的基于人群的癌症登记输入中收集国际死亡率数据。发病率是根据死亡率估计值和相应的 MIR 来计算的。使用模型生存率计算患病率估计值，并乘以残疾权重以获得残疾寿命 (YLD)。生命损失年数 (YLL) 的计算方法为特定年龄的癌症死亡人数乘以死亡年龄时的标准预期寿命。主要结果是 DALY（YLL 和 YLD 之和）。估计值按社会人口指数 (SDI) 五分位数（国家排名并分为五个相等的 SDI 组）给出，所有估计值均以相应的 95% 不确定性区间 (UI) 表示。在本次分析中，我们使用 15-39 岁的年龄范围来定义青少年和年轻人。
发现
2019 年，全球 15-39 岁人群中有 1·1900 万（95% UI 1·11–1·28）癌症病例和 396 000 人（370 000–425 000）人因癌症死亡。标准化发病率发生在高 SDI（每 10 万人年 59·6 [54·5–65·7]）和中高 SDI 国家（每 10 万人年 53·2 [48·8–57·9] - 年），而年龄标准化死亡率最高的是中低 SDI（每 10 万人年 14·2 [12·9–15·6]）和中 SDI（13·6 [12·6– 14·8]每10万人年）国家。 2019 年，青少年和青年癌症对全球疾病负担贡献了 23·5 百万 (21·9–25·2) DALY，其中 2·7% (1·9–3·6) 来自 YLD，97% 来自 YLD。 ·3% (96·4–98·1) 来自 YLL。癌症是全球青少年和年轻人第四大死亡原因，也是导致伤残调整生命年 (DALY) 的第十大原因。
解释
青少年和年轻人癌症在 2019 年全球青少年和年轻人疾病负担中占了很大比重。这些结果为了解世界各地青少年和年轻人癌症负担的分布和严重程度提供了新的见解。由于在 SDI 环境中观察到显着差异，这些估计可以为全球和国家层面的癌症控制工作提供信息。
资金
比尔及梅琳达·盖茨基金会、美国黎巴嫩叙利亚联合慈善机构、圣鲍德里克基金会和国家癌症研究所。
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