Age, period, and cohort effects in the population-level incidence and mortality of early onset cancers in Australia — The Association Specialists
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  3. Age, period, and cohort effects in the population-level incidence and mortality of early onset cancers in Australia

Age, period, and cohort effects in the population-level incidence and mortality of early onset cancers in Australia (23773)

Sithum Munasinghe 1 , Phuong Dung Nguyen 1 , Matthew J Spittal 2 , Andrew Page 1
  1. Western Sydney University, Campbelltown, NEW SOUTH WALES, Australia
  2. Melbourne School of Global and Population Health, University of Melbourne, Melbourne, Victoria, Australia

Background: The incidence of early-onset cancers has increased in recent decades, with inter-generational changes in overlapping environmental and behavioural risk factors implicated in changing trends. This study investigates the age, period, and cohort effects in population-level incidence and mortality of previously identified early-onset cancers in the Australian population, compared to selected non-early onset cancers.

 

Methods: Age-period-cohort modelling examined whether there were differences in temporal trends in Australian cancer incidence (1982-2021) and mortality (1971-2023) between early onset cancers (breast, colorectum, kidney, liver, pancreas, thyroid, prostate, uterus, oesophagus) and non-early onset cancers (lung, cervix, melanoma of the skin).

 

Results: For early onset cancer incidence, there was a significantly increasing cohort effect for both males and females in colorectal, liver, pancreatic, thyroid cancers, and for breast and uterine cancers among women, and for prostate cancer among men. The largest relative increase was in pancreatic cancer among females, and thyroid cancer among males. Significantly decreasing cohort effects were evident for melanoma of the skin and cervical cancer (among women), with no substantial differences across birth cohorts for lung cancer and oesophageal cancer. Period effects (adjusting for cohort effects) were relatively stable, except for prostate cancer for males and cervical cancer for females. Decreasing period and cohort effects for cancer mortality were evident for most cancers and for both males and females. The exceptions were an increasing period effect for thyroid cancer and pancreatic cancer, and cervical cancer and uterine cancer (for females).

 

Conclusion: This study found significantly higher population-level incidence of early onset cancers among later born cohorts, suggesting inter-generational changes in risk factors associated with these outcomes. Findings suggest differential approaches to prevention for specific age-cohorts may be important.