Trends in the disease burden of early-onset cancers in China from 1990 to 2021: a systematic analysis of the 2021 Global Burden of Disease study

BMC Cancer. 2025 Jul 12;25(1):1168. doi: 10.1186/s12885-025-14578-y.

Abstract

Background: In recent years, the incidence of early-onset cancers among individuals under 50 years of age has been on the rise. We aimed to analyze the disease burden and temporal trends of early-onset cancers in China, providing a basis for policymakers to develop appropriate strategies.

Methods: We utilized data from the 2021 Global Burden of Disease (GBD) study to describe the changes in early-onset cancers in China from 1990 to 2021, including incidence, mortality and disability-adjusted life years (DALYs). The age-standardized average annual percentage change (AAPC) was estimated using the Joinpoint regression program.

Results: From 1990 to 2021, the incidence rate of all early-onset cancers in China increased by 150.72 per 100,000, while the mortality and DALY rates decreased by 4.30 per 100,000 and 279.34 per 100,000, respectively. In 2021, early-onset breast cancer had the highest incidence rate (17.14 per 100,000), and trachea/bronchus/lung cancer had the highest mortality rate (6.15 per 100,000) and DALY rate (292.48 per 100,000). The standardized DALY rate of all early-onset cancers decreased (AAPC = -1.49%, 95% CI: -1.51% to -1.46%), while multiple myeloma, neuroblastoma and other peripheral nervous cell tumors, malignant neoplasm of bone and articular cartilage, kidney cancer, and mesothelioma showed significant increases with AAPC of 4.14% (4.01-4.28%), 3.83% (3.77-3.88%), 1.20% (1.16-1.25%), 0.65% (0.58-0.73%), and 0.33% (0.29-0.37%), respectively. Tobacco consumption (23.01%) was the primary contributor to the disease burden of early-onset cancers in males, whereas unsafe sexual behavior (10.53%) was the primary contributor in females.

Conclusion: The mortality and DALY rate of early-onset cancers in China decreased, while the incidence rate increased. Trachea/bronchus/lung cancer is one of the most severe early-onset cancers, and effective measures need to be taken against the main risk factors.

Keywords: Burden of disease; Cancer; China; Early-onset; Trend.

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Child
  • Child, Preschool
  • China / epidemiology
  • Cost of Illness
  • Disability-Adjusted Life Years
  • Female
  • Global Burden of Disease* / trends
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neoplasms* / epidemiology
  • Neoplasms* / mortality
  • Young Adult