Clinics and research in hepatology and gastroenterology · 2026
Mortality trends and disparities for the six leading causes of cancer death among individuals aged 15-45 years in the United States, 1999-2023.
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Tian Huanyong, Liu Yangjie, Chen Xia, Lv Tian, Wu Anwei
Аннотация
BACKGROUND: Cancer mortality among individuals aged 15-45 years is a critical metric for assessing progress in cancer control. This study examined long-term mortality trends and sociodemographic disparities for the six leading causes of cancer death among individuals aged 15-45 years in the United States from 1999 to 2023.
METHODS: Mortality data were obtained from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database (1999-2023). Death records for individuals aged 15-45, with any of the six cancers listed as the underlying cause, were included. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated. Temporal trends were analyzed using Joinpoint regression to compute the average annual percent change (AAPC) and 95% confidence interval (CI). Future mortality through 2035 was projected using autoregressive integrated moving average (ARIMA) modeling.
RESULTS: Between 1999 and 2023, Lung cancer mortality declined most sharply (AAPC: -4.79*; 95% CI: -5.45 to -4.13). Breast cancer mortality also exhibited a significant decrease. In contrast, colorectal cancer (CRC) mortality increased significantly (AAPC: 0.88*; 95% CI: 0.72 to 1.04), emerging as the only major cancer with a sustained upward trajectory in this age group. Mortality from leukemia, brain cancer, and cervical cancer remained stable or declined modestly. Pronounced disparities were observed across census regions, racial/ethnic groups, and sex. ARIMA projections indicated that CRC mortality among individuals aged 15-45 years is expected to increase further through 2035, whereas mortality from lung cancer and breast cancer is projected to continue declining.
CONCLUSION: Substantial reductions in lung cancer mortality among individuals aged 15-45 years in the United States have been offset by a concerning rise in colorectal cancer mortality in this age group. Strategic shifts toward risk-stratified screening, equitable care, and targeted interventions are imperative.
METHODS: Mortality data were obtained from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database (1999-2023). Death records for individuals aged 15-45, with any of the six cancers listed as the underlying cause, were included. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated. Temporal trends were analyzed using Joinpoint regression to compute the average annual percent change (AAPC) and 95% confidence interval (CI). Future mortality through 2035 was projected using autoregressive integrated moving average (ARIMA) modeling.
RESULTS: Between 1999 and 2023, Lung cancer mortality declined most sharply (AAPC: -4.79*; 95% CI: -5.45 to -4.13). Breast cancer mortality also exhibited a significant decrease. In contrast, colorectal cancer (CRC) mortality increased significantly (AAPC: 0.88*; 95% CI: 0.72 to 1.04), emerging as the only major cancer with a sustained upward trajectory in this age group. Mortality from leukemia, brain cancer, and cervical cancer remained stable or declined modestly. Pronounced disparities were observed across census regions, racial/ethnic groups, and sex. ARIMA projections indicated that CRC mortality among individuals aged 15-45 years is expected to increase further through 2035, whereas mortality from lung cancer and breast cancer is projected to continue declining.
CONCLUSION: Substantial reductions in lung cancer mortality among individuals aged 15-45 years in the United States have been offset by a concerning rise in colorectal cancer mortality in this age group. Strategic shifts toward risk-stratified screening, equitable care, and targeted interventions are imperative.