Trends In Cancer Incidence Among Adolescents And Young Adults (AYA) In São Paulo, Brazil, 1997-2010

Iza SCONZA, Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo, Brazil
LATORRE M. 2,3 , RIBEIRO K. 1

1 Department of Collective Health, Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo, Sao Paulo, Brazil
2 Population Based Cancer Registry of Sao Paulo, Sao Paulo, Brazil
3 Department of Epidemiology, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil

Purpose: This study aimed to analyze trends in cancer incidence among adolescents and young adults (AYA) (15-29 years) in São Paulo, Brazil, in the period from 1997 to 2010. Methods: This was an ecological time-series study, which used cases reported to the population-based Cancer Registry of São Paulo, Brazil, classified according to Birch & Alston classification. Age-standardized (world population) were reported for every 100,000 inhabitants, according to group and gender. Annual percentage changes (APC) were calculated using the Joinpoint method, with the calendar year as regressor variable. The null hypothesis that APC = 0 was rejected when p<0.05. Results: During the study period, 14,011 cases of cancer among AYA were registered in São Paulo. There was a non-significant decline in the incidence of all malignancies in men (APC=-1.04%, 95% CI -2.76;0.71%) and a significant increase in women (APC =2.55%, 95% CI 0.71;4.42%). Among males, there was a significant increase in the incidence of carcinomas (except skin) (APC=4.60%, 95% CI 1.95;7.33%) and a significant decline for leukemias (APC=-8.46%, 95% CI -11.36;-5.46%), CNS tumors (APC=-6.77%, 95% CI -10.05;-3.36%), and bone tumors (APC=-6.42%, 95% CI -10.16;-2.53%). Among females, there was a significant increase in the incidence of carcinomas (except skin) (APC=4.95%, 95% CI 2.27;7.70%) and unspecified malignant neoplasms (APC=8.32%, 95% CI 4.04;12.76%), and a significant decline in the incidence of CNS tumors (APC=-6.87%, 95% CI -10.76;-2.81%), bone tumors (APC=-7.30%, 95% CI -10.99;-3.45%) and soft tissue sarcomas (APC=-4.74%, 95% CI -8.00;-1.37%). No significant trends in incidence were observed for lymphomas and skin cancers. Conclusions: Distinct trends in cancer incidence among AYA were observed in São Paulo, Brazil, including increasing rates of carcinomas among women. These patterns and trends must be analyzed in order to tailor better strategies for cancer prevention and control in adolescents and young adults, more adequate their specific needs.