{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T20:52:24Z","timestamp":1789246344176,"version":"build-2803163510"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Rosalie and Harold Rea Brown Endowed Chair"},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R35CA274442"],"award-info":[{"award-number":["R35CA274442"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R50CA221836"],"award-info":[{"award-number":["R50CA221836"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recent increases in the diagnosis of certain cancers among younger individuals are generating intense concern. Many studies attribute the increase in the so-called \u201cyoung-onset\u201d cancer to an etiologic cause but questions have also arisen about the role of earlier diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We simulated incidence trends from a natural history model that includes healthy, preclinical, and clinical disease states, where the transition from the healthy to the preclinical state represents disease onset and the transition from the preclinical to the clinical state represents diagnosis. We superimposed birth-cohort effects on the rate of disease onset and period effects on the rate of disease diagnosis to identify those that match patterns of relative incidence by age group and 5-year calendar interval from 2000 to 2019 for 6 \u201cyoung-onset\u201d cancers (colon, rectum, female breast, stomach, pancreas, and kidney).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Two types of effects are broadly consistent with the observed increasing incidence trends in younger individuals: (1) a birth-cohort effect on disease onset that begins around 1970 and becomes more pronounced in later birth years or (2) a period effect consistent with progressive reduction over time in the duration of preclinical disease. An earlier, protective birth-cohort effect is consistent with recent declining trends in incidence in older individuals for colon, rectal, and stomach cancers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A disease model provides clues about the possible drivers of cancer incidence trends, suggests constraints on the patterns of exposures that might be implicated etiologically, and indicates that the role of diagnostic changes warrants consideration alongside potential etiologic explanations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djaf050","type":"journal-article","created":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T23:17:59Z","timestamp":1740525479000},"page":"1350-1359","source":"Crossref","is-referenced-by-count":13,"title":["Trends in young-onset cancer incidence: a modeling perspective"],"prefix":"10.1093","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5149-5379","authenticated-orcid":false,"given":"Lukas","family":"Owens","sequence":"first","affiliation":[{"name":"Division of Public Health Sciences, Fred Hutchinson Cancer Center , Seattle, WA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Fung","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Fred Hutchinson Cancer Center , Seattle, WA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4823-9581","authenticated-orcid":false,"given":"Jonathan","family":"Shuhendler","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Fred Hutchinson Cancer Center , Seattle, WA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Glick","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Fred Hutchinson Cancer Center , Seattle, WA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4990-0849","authenticated-orcid":false,"given":"Marc D","family":"Ryser","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Duke University , Durham, NC,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7592-6567","authenticated-orcid":false,"given":"Roman","family":"Gulati","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Fred Hutchinson Cancer Center , Seattle, WA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9164-6370","authenticated-orcid":false,"given":"Ruth","family":"Etzioni","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Fred Hutchinson Cancer Center , Seattle, WA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,3,4]]},"reference":[{"key":"2025070619570567000_djaf050-B1","doi-asserted-by":"publisher","first-page":"e2328171","DOI":"10.1001\/jamanetworkopen.2023.28171","article-title":"Patterns in cancer incidence among people younger than 50 years in the US, 2010 to 2019","volume":"6","author":"Koh","year":"2023","journal-title":"JAMA Netw Open"},{"key":"2025070619570567000_djaf050-B2","author":"Surveillance, Epidemiology, and End Results (SEER) Program","year":"2024"},{"key":"2025070619570567000_djaf050-B3","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1038\/s41571-022-00672-8","article-title":"Is early-onset cancer an emerging global epidemic? 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