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The article discusses research which focused on social inequalities in cancer between high and low Human Development Index (HDI) countries. Topics explored include the interaction between sociodemographic factors and disease patterns, the recorded increase in cancer-related cases and deaths worldwide, and the decline in colorectal cancer incidence in countries with very high HDI levels.

Background: To date, the burden of cancer among young adults has rarely been studied in depth. Our aim was to describe the scale and profile of cancer incidence and mortality worldwide among 20-39 year-olds, highlighting major patterns by age, sex, development level, and geographical region.Methods: We did a population-based study to quantify the burden of young adult cancers worldwide. We defined young adult cancers as those occurring between the ages of 20 and 39 years because these individuals will have passed puberty and adolescence, but not yet experienced the effects of hormonal decline, immune response deterioration, or organ dysfunction associated with chronic health conditions. Global, regional, and country-specific (n=184) data estimates of the number of new cancer cases and cancer-associated deaths that occurred in 2012 among young adults were extracted in four 5-year bands from the International Agency for Research on Cancer's GLOBOCAN 2012 for all cancers combined and for 27 major types as defined by the International Classification of Disease, tenth revision. We report the number of new cancer cases and cancer-associated deaths overall and by sex alongside corresponding age-standardised rates (ASR) per 100 000 people per year. We also present results using four levels of the Human Development Index (HDI; low [least developed], medium, high, and very high [most developed]), which is a composite indicator for socioeconomic development comprising life expectancy, education, and gross national income.Findings: 975 396 new cancer cases and 358 392 cancer-associated deaths occurred among young adults worldwide in 2012, which equated to an ASR of 43·3 new cancer cases per 100 000 people per year and 15·9 cancer-associated deaths per 100 000 people per year. The burden was disproportionally greater among women and the most common cancer types overall in terms of new cases were female breast cancer, cervical cancer, thyroid cancer, leukaemia, and colorectal cancer; in terms of deaths, female breast cancer, liver cancer, leukaemia, and cervical cancer were the main contributors. When assessed by development level and geographical region, the cancer profile varied substantially; generally, the burden of infection-associated cancers was greater in regions under transition. Cancer incidence was elevated in very high-HDI regions compared with low-HDI regions (ASR 64·5 vs 46·2 cancer cases per 100 000 people per year); however, the mortality burden was 3 times higher in low-HDI regions (ASR 25·4 vs 9·2 cancer-associated deaths per 100 000 people per year), reflecting differences in cancer profiles and inferior outcomes.Interpretation: The global cancer burden among 20-39 year-olds differs from that seen in younger or older ages and varies substantially by age, sex, development level, and geographical region. Although the cancer burden is lower in this age group than that observed in older ages, the societal and economic effects remain great given the major effects of premature morbidity and mortality. Targeted surveillance, prevention, and treatment are needed to reduce the cancer burden in this underserved age group.Funding: International Agency for Research on Cancer (IARC) and European Commission's FP-7 Marie Curie Actions-People-COFUND. [ABSTRACT FROM AUTHOR]

Background: Increased risks of cardiac morbidity and mortality among childhood cancer survivors have been described previously. However, little is known about the very long-term risks of cardiac mortality and whether the risk has decreased among those more recently diagnosed. We investigated the risk of long-term cardiac mortality among survivors within the recently extended British Childhood Cancer Survivor Study.Methods: The British Childhood Cancer Survivor Study is a population-based cohort of 34 489 five-year survivors of childhood cancer diagnosed from 1940 to 2006 and followed up until February 28, 2014, and is the largest cohort to date to assess late cardiac mortality. Standardized mortality ratios and absolute excess risks were used to quantify cardiac mortality excess risk. Multivariable Poisson regression models were used to evaluate the simultaneous effect of risk factors. Likelihood ratio tests were used to test for heterogeneity and trends.Results: Overall, 181 cardiac deaths were observed, which was 3.4 times that expected. Survivors were 2.5 times and 5.9 times more at risk of ischemic heart disease and cardiomyopathy/heart failure death, respectively, than expected. Among those >60 years of age, subsequent primary neoplasms, cardiac disease, and other circulatory conditions accounted for 31%, 22%, and 15% of all excess deaths, respectively, providing clear focus for preventive interventions. The risk of both overall cardiac and cardiomyopathy/heart failure mortality was greatest among those diagnosed from 1980 to 1989. Specifically, for cardiomyopathy/heart failure deaths, survivors diagnosed from 1980 to 1989 had 28.9 times the excess number of deaths observed for survivors diagnosed either before 1970 or from 1990 on.Conclusions: Excess cardiac mortality among 5-year survivors of childhood cancer remains increased beyond 50 years of age and has clear messages in terms of prevention strategies. However, the fact that the risk was greatest in those diagnosed from 1980 to 1989 suggests that initiatives to reduce cardiotoxicity among those treated more recently may be having a measurable impact. [ABSTRACT FROM AUTHOR]

The article offers information on priorities for reducing social inequalities in cancer. Topics discussed include gathering high-quality scientific evidence on the social inequalities in cancer and increasing knowledge to prevent risk of overall cancer mortality; expanding cancer research focused on prevention; and requirement of innovative strategies, political commitment, and public policies to deliver measures supporting a reduction in inequalities.

Although overall colorectal cancer (CRC) incidence rates in the United States are declining, rates among younger persons (age < 55 years) are increasing, particularly among US whites. We assessed how these trends will impact the future burden (up to 2040) of CRC among US blacks and whites using an age-period-cohort model. Over the last four decades (1973 to 2014), CRC incidence rates for all ages (both sexes) have dropped by 6.6% and 33.9% in US blacks and whites, respectively. Yet we predict an upward turn in CRC cancer incidence rates over the next quarter century, particularly among US whites. The age-standardized rates of CRC were 55.4 and 43.2 per 100 000 among US blacks and whites in 2014, respectively, and are projected to be 49.5 and 43.1 in 2040, respectively. Future interventions are needed to reduce the striking differences in CRC incidence between blacks and whites. [ABSTRACT FROM AUTHOR]