Recent trends in childhood, teenage and young adult cancer incidence in England (2001-2020)

Introduction Cancer remains a leading cause of death among children, teenagers and young adults (CTYAs) in England with a distinct incidence profile compared to older adults. We examined trends in cancer incidence among individuals aged <25 years in England from 2001-2020 using openly available National Disease Registration Service (NDRS) data. Materials and Methods All malignancies (ICD-10 C00–C97) diagnosed between 2001 and 2020 were extracted from published NDRS official registration statistics. Analyses were stratified into children (0-14 years) and TYAs (15–24 years), with subanalyses by gender. Joinpoint regression analysis (SEER v5.4.0) was used to calculate annual percentage change (APC) in age-specific incidence and identify trend changes. 2020 data were excluded from trend analyses due to COVID-19 related disruption. Instant rate ratios (IRRs) directly compared rates in 2020 to 2019. Results Between 2001-2020, cancer incidence was 147 and 273 per million person-years in children and TYAs, respectively. In children, lymphoid leukaemia and brain/CNS tumours accounted for 46% of diagnoses. Among TYAs, Hodgkin lymphoma (15%) and malignant melanoma (9%) were most common, and 24% of male cancers were testicular. TYA colorectal cancer incidence increased until 2015, then declined from 2015-19 (APC −37.59%, p<0.001). Thyroid cancer incidence rose throughout the study period (APC +5.49%, p<0.001), while cervical cancer incidence declined from 2015-19 (APC −21.9%, p=0.03). Cervical cancer incidence fell the most from 2019 to 2020 (IRR 0.38, p=0.09). Conclusions Overall cancer incidence in CTYAs remains low. Trends in colorectal and cervical cancer may reflect appendiceal carcinoid reclassification, HPV vaccination, and COVID-19 related disruption to diagnostic and screening services.