Temporal Trends in Six Major Cancers: Implications for Lifestyle-Based Cancer Prevention and Early Detection Across the Life Course.

Abstract

Background/objectives: Cancer remains a serious public health challenge in the United States. Six major cancers (female breast, colorectal, liver, lung/bronchus, pancreas, and prostate) account for a substantial proportion of the national cancer burden. Understanding the changes in the incidence of these cancers over time can provide insights for prevention and control. This study examined temporal trends in the cancer incidence according to age at onset and stage at diagnosis.

Methods: This population-based study analyzed data from the United States Cancer Statistics database for 2001-2023, including all 50 states and the District of Columbia. Joinpoint regression was used to estimate annual percent changes (APCs) and average annual percent changes (AAPCs), with corresponding 95% confidence intervals (CIs), based on age-adjusted incidence rates per 100,000 people. Of note, incidence rates from 2020 data were excluded from the Joinpoint models because COVID-19 pandemic disruptions affected cancer screening, diagnosis, and reporting.

Results: From 2001 to 2023, the incidence of lung and colorectal cancers declined, particularly among older adults (aged ≥50 years) (lung cancer: AAPC -2.09; 95% CI: -2.27, -1.90; colorectal cancer AAPC -2.70; 95% CI: -2.83, -2.56). In contrast, the incidence of colorectal, pancreatic, and breast cancers increased among younger adults (aged <50 years), whereas the incidence of liver and lung cancer declined. Moreover, prostate cancer incidence declined over time despite modest rebound in recent years (AAPC 1.83; 95% CI: 0.53, 3.14). Stage-specific analyses revealed increasing rates of early-stage diagnoses for several cancers, while late-stage cancer incidence increased for pancreatic and colorectal cancers (especially among younger adults).

Conclusions: Cancer incidence varied substantially by cancer type, age, and stage at diagnosis. The rising incidence of colorectal, pancreatic, and breast cancers among younger adults underscores the need for continued research into risk factors, early detection, and prevention strategies.