Cancer Incidence Trends in Successive Social Generations in the US
JAMA Netw Open. 2024;7(6):e2415731. doi:10.1001/jamanetworkopen.2024.15731
Philip S. Rosenberg, PhD1; Adalberto Miranda-Filho, PhD1
Key Points
- Question Is cancer incidence in successive social generations in the US slowing or growing?
- Findings In this cohort study of 3.8 million patients with cancer ascertained by the Surveillance, Epidemiology, and End Results Program, members of Generation X born between 1965 and 1980 have been experiencing larger per-capita increases in the incidence of leading cancers combined than any prior generation born between 1908 and 1964.
- Meaning These findings suggest that based on current trajectories, cancer incidence in the US might remain high for decades.
Importance The incidence of some cancers in the US is increasing in younger age groups, but underlying trends in cancer patterns by birth year remain unclear.
Objective To estimate cancer incidence trends in successive social generations.
Design, Setting, and Participants In this cohort study, incident invasive cancers were ascertained from the Surveillance, Epidemiology, and End Results (SEER) program’s 13-registry database (November 2020 submission, accessed August 14, 2023). Invasive cancers diagnosed at ages 35 to 84 years during 1992 to 2018 within 152 strata were defined by cancer site, sex, and race and ethnicity.
Exposure Invasive cancer.
Main Outcome and Measures Stratum-specific semiparametric age-period-cohort (SAGE) models were fitted and incidence per 100 000 person-years at the reference age of 60 years was calculated for single-year birth cohorts from 1908 through 1983 (fitted cohort patterns FCPs). The FCPs and FCP incidence rate ratios (IRRs) were compared by site for Generation X (born between 1965 and 1980) and Baby Boomers (born between 1946 and 1964).
Results A total of 3.8 million individuals with invasive cancer (51.0% male; 8.6% Asian or Pacific Islander, 9.5% Hispanic, 10.4% non-Hispanic Black, and 71.5% non-Hispanic White) were included in the analysis.
In Generation X vs Baby Boomers, FCP IRRs among women increased significantly for
- thyroid (2.76; 95% CI, 2.41-3.15),
- kidney (1.99; 95% CI, 1.70-2.32),
- rectal (1.84; 95% CI, 1.52-2.22),
- corpus uterine (1.75; 95% CI, 1.40-2.18),
- colon (1.56; 95% CI, 1.27-1.92), and
- pancreatic (1.39; 95% CI, 1.07-1.80) cancers;
- non-Hodgkins lymphoma (1.40; 95% CI, 1.08-1.82); and
- leukemia (1.27; 95% CI, 1.03-1.58).
Among men, IRRs increased for
- thyroid (2.16; 95% CI, 1.87-2.50),
- kidney (2.14; 95% CI, 1.86-2.46),
- rectal (1.80; 95% CI, 1.52-2.12),
- colon (1.60; 95% CI, 1.32-1.94), and
- prostate (1.25; 95% CI, 1.03-1.52) cancers and
- leukemia (1.34; 95% CI, 1.08-1.66).
- Lung (IRR, 0.60; 95% CI, 0.50-0.72)
and cervical (IRR, 0.71; 95% CI, 0.57-0.89) cancer incidence decreased among women, and lung (IRR, 0.51; 95% CI, 0.43-0.60), liver (IRR, 0.76; 95% CI, 0.63-0.91), and gallbladder (IRR, 0.85; 95% CI, 0.72-1.00) cancer and non-Hodgkins lymphoma (IRR, 0.75; 95% CI, 0.61-0.93) incidence decreased among men. For all cancers combined, FCPs were higher in Generation X than for Baby Boomers because gaining cancers numerically overtook falling cancers in all groups except Asian or Pacific Islander men.
Conclusions and Relevance In this model-based cohort analysis of incident invasive cancer in the general population, decreases in lung and cervical cancers in Generation X may be offset by gains at other sites. Generation X may be experiencing larger per-capita increases in the incidence of leading cancers than any prior generation born in 1908 through 1964. On current trajectories, cancer incidence could remain high for decades.
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Possible reasons: worse food, increased toxins, vitamin D crashing, less sun, microplastics, obesity, etc.
- 23 Cancers in the US are associated with low UVB - Grant April 2024
- Vitamin D and Cancer - Jan 2024
- 79% increase in cancer under age 50 in 3 decades - Sept 2023
- 13 Cancers are helped by Vitamin D – Biobank July 2023
- Air pollution, toxins, heavy metals and smoking each result in lower Vitamin D levels – Nov 2018
- 4 Reasons why Vitamin D levels are crashing
- Microplastics now causing problems in most life forms - many studies
- Obesity increases Cancer - perhaps due to low vitamin D - many articles