IARC 60th Anniversary - 19-21 May 2026
Session : Early onset cancers, challenges and opportunities
Is cancer increasing in young adults in Spain? Incidence trends for the period 1993-2018 from the Spanish Network of Cancer Registries REDECAN
SÁNCHEZ M. 1,2,3, REDONDO-SÁNCHEZ D. 1,2,3, BIGORRA J. 4,5, AMEIJIDE A. 4,5, MADRID PÉREZ-ESPARZA B. 2, PALACIOS-CASTAÑO M. 6, MUNCUNILL FARRENY M. 7, CHIRLAQUE LÓPEZ M. 1,8, GUEVARA M. 1,9,10, MARIÀ C. 4,5, GUTIÉRREZ MELÉNDEZ P. 11, MERINO PERERA S. 12, GARRIDO MARTÍN C. 13, ÁLVAREZ DÍAZ X. 13, VIZCAÍNO BATLLÉS A. 14, MARTIN MUÑOZ I. 15, & REDECAN WORKING GROUP (. 15,16,17, GONZÁLEZ-FLORES E. 2,18, GALCERAN J. 4,5, PETROVA D. 1,2,3,18
1 CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; 2 Instituto de Investigación Biosanitaria de Granada ibs.GRANADA, Granada, Spain; 3 Escuela Andaluza de Salud Pública, Granada, Spain; 4 Tarragona Cancer Registry, Hospital Universitari Sant Joan de Reus, Reus, Spain; 5 Institut d'Investigació Sanitària Pere Virgili, Reus, Spain; 6 Responsable del Registro de cáncer. Servicio de Epidemiología y Prevención Sanitaria. Dirección General de Salud Pública, Consumo y Cuidados, Logroño, Spain; 7 Registro de Cáncer de Mallorca, Mallorca, Spain; 8 Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Murcia, Spain; 9 Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain; 10 Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; 11 Registro poblacional de Cáncer de Castilla y León, Castilla y León, Spain; 12 Registro de Cáncer de Asturias, Asturias, Spain; 13 Registro Poblacional de Cáncer de Canarias, Canarias, Spain; 14 Registro de tumores de Castellón (Castellón Cancer Registry), Castellón, Spain; 15 Registro de Cáncer de Euskadi, Euskadi, Spain; 16 Directorate Plan of Oncology, Epidemiology Unit and Girona Cancer Registry, Girona Biomedical Research Institute Dr. Josep Trueta (IDIBGI-CERCA), Catalan Institute of Oncology, Girona, Spain; 17 Josep Carreras Leukaemia Research Institute, Badalona, Spain; 18 Medical Oncology, Hospital Universitario Virgen de las Nieves, Granada, Spain
Background/Objectives
There is a growing public and medical concern about the increasing incidence of early-onset cancers in adults under 50 years worldwide. This collaborative study conducted by the Spanish Network of Cancer Registries (REDECAN) aimed to examine cancer incidence trends in young adults in Spain from 1993 to 2018.
Methods
We conducted a population-based cohort study using data from 15 Spanish cancer registries covering a total population of 9,227,640 in 2018. The study population comprised individuals aged 20 to 49 years, and the analyses included all newly cancer cases diagnosed between 1993 and 2018. For each sex and cancer site, we calculated truncated age-standardized incidence rates per 100,000 inhabitants-year (TASR-E) using the European standard population. Joinpoint regression was used to assess TASR-E trends and estimate annual percent change (APC) with 95% confidence intervals (CI).
Results
During the study period, a total of 153,599 new cancer cases were diagnosed (58% in women). Incidence trends were heterogeneous, with more increases observed in women. Incidence rose significantly for kidney cancer (+2.5%, 95% CI [0.8, 10.4]), thyroid cancer (4.0% [3.3, 4.7]), and Hodgkin lymphoma (+1.1 [0.3, 1.8]) in men and for pancreatic cancer (+2.0 [0.7, 3.3]), Hodgkin lymphoma (+2.1 [1.4, 2.8] and non-Hodgkin lymphoma (+1.7 [0.3, 6.1]) in women. Several cancers of the digestive system (stomach, colon, rectum) and breast and cervical cancer increased significantly among the youngest adults but decreased in young adults aged >40 years (stomach, colon, cervix), suggesting strong cohort effects. In contrast, incidence declined notably for larynx, lung, bladder, and liver cancers in both sexes (APCs statistically significant ranging between -3.1% to -8.7%), and for lip, oral cavity, and pharynx cancers in men.
Conclusions
The incidence of tobacco-related cancers has decreased substantially in young adults, while some metabolic and obesity-associated cancers are rising, particularly among those aged 20-39 years. These divergent trends indicate changing exposure patterns across birth cohorts and underscore the urgent need for population-wide prevention strategies targeting obesity, diet, physical inactivity and metabolic health, as well as strengthening tobacco control.
Funding: VICA subprogram of the CIBER of Epidemiology and Public Health (CIBERESP). Ibs.GRANADA (A_PI01_2024). Health Institute Carlos III (CP23/00024).