Fewer young men in Canada are being diagnosed with cancer while the number for young women is stable, according to the Cancer in Young Adults in Canada report released today by Cancer Care Ontario in collaboration with the Public Health Agency of Canada.
"This is the most sweeping study ever undertaken of cancer in this important age group," says Terrence Sullivan, President and CEO, Cancer Care Ontario. "Until now, young adults with cancer have been a vastly understudied group. Greater insight into the risk factors for young adults could help in our overall understanding of cancer risk factors for all ages and is important in projecting the future cancer burden in Canada."
The report identifies and interprets trends in incidence and mortality in young Canadian adults aged 20 to 44 from 1983 to 1999 and recommends priorities for future research, surveillance and policy. Trends in both incidence and mortality were projected through 2005.
The Government of Canada recognizes the importance of this report and the research that will help us learn more about risk factors for young adults says Canada's Chief Public Health Officer, Dr. David Butler-Jones. "Cancer is a major health issue for Canadians of all ages and the federal government is providing significant new resources towards implementation of the Canadian Strategy for Cancer Control," he added. "As part of Budget 2006, the federal government committed $260-million over five years that will help improve screening, prevention and research activities."
"The consequences of a cancer diagnosis in a young person are far-reaching," says Dr. Loraine Marrett, Director of the Surveillance Unit at Cancer Care Ontario and chair of the national working group that developed Cancer in Young Adults in Canada. "A young adult with cancer faces physical and emotional changes and the fact that their lives may be shortened. They may still be completing their education, getting jobs and building their own families when they are diagnosed and treated. They may spend decades living with the effects of the disease and treatment."
Incidence Rates in Young Men Declining
The report shows incidence rates for young men have declined significantly since 1992, after rising throughout the 1970s and 1980s. This drop reflects declining rates in a number of the more common cancers for men in this age group, such as melanoma, lung and colorectal cancer. However, testicular cancer - the most common cancer for young men - increased 2.2% per year.
"These statistics show a significant reversal in cancer trends for young Canadian men," says Marrett. "We're encouraged to see the first sustained decline in overall incidence rates for young Canadian men."
Lung Cancer Incidence Increasing in Young Women
Despite minor fluctuations, overall incidence rates for young women did not change substantially from the 1970s to the 1990s, largely as a result of lung cancer trends. The report reveals - for the first time ever - more young women than young men are being diagnosed with, and dying from, lung cancer.
The report also finds drops in incidence rates for some of the most common cancers affecting young women, including cervical, colorectal and ovarian cancer.
"Incidence in a number of more common cancers is increasing, for example, thyroid cancer incidence is increasing in both men and women more rapidly than any other cancer, yet we don't have a clear understanding of why this is happening," says Marrett.
Impact of Prevention and Improved Treatments
The decline in incidence rates for cervical, melanoma and lung cancer suggests that young Canadians are increasingly heeding three main prevention recommendations - having regular Pap tests, minimizing sun exposure and avoiding smoking. However, the report stresses smoking rates are still unacceptably high, especially in adolescent girls.
The report also shows death rates for some cancers, in both sexes, fell during the 1980s and 1990s, largely due to treatment improvements.
"This first-ever report makes a valuable contribution to our understanding of cancer in young adults," says Heather Logan, Director, Cancer Control Policy, Canadian Cancer Society. "It's heartening to see incidence rates for young men falling and stabilizing for young women. However, it's discouraging to see that for the first time more young women than young men are being diagnosed with lung cancer. This tells us that we must continue our advocacy and education efforts to encourage Canadians to not smoke, especially young people."
"With death rates dropping and survival good for many cancers in this age group, it's also important to study and monitor the later effects of a cancer diagnosis and treatment in young adulthood," says Dr. Brent Schacter, CEO of the Canadian Association of Provincial Cancer Agencies. "We need to know more about long-term treatment risks, and to develop therapies that reduce possible late effects, such as reproductive problems or a second cancer."
The report was produced by Cancer Care Ontario with the support of the Cancer in Young Adults in Canada Working Group, established in 2000 to start systematically surveying cancer patterns and trends of young adults with cancer in Canada. The group, which in 2002 released preliminary results for an earlier time period, is comprised mostly of epidemiologists and clinicians associated with cancer registries across the country. The report analyzes data provided by federal, provincial and territorial agencies, cancer registries and other sources.
Cancer Care Ontario is an umbrella organization that steers and coordinates Ontario's cancer services and prevention efforts so that fewer people get cancer and patients receive the highest quality of care.