This population-based study examined cancer incidence trends in young adults aged 20–49 in Spain using data from 15 REDECAN registries, covering 153,599 new cases diagnosed between 1993 and 2018, stratified by sex and 10-year age group.
Overall cancer incidence fell by 1.6%/year in young men but rose 0.4%/year in young women. Smoking-linked cancers (lung, larynx, bladder) dropped sharply in both sexes (APC −3.1% to −8.7%). Rising trends were seen for thyroid (APC +4.0%, men), kidney (APC +2.5%, men), pancreas (APC +2.0%, women), and Hodgkin lymphoma (both sexes). Colon cancer surged in adults under 30 (APC +5.5% men; +21.1% women), and cervical cancer rose sharply in women aged 20–29 (APC +4.2%) and 30–39 (APC +9.3%).
- Registry data extend only to 2018, limiting detection of more recent trends. - Registries cover less than one-third of Spain's national population. - Histological subtype and tumor-stage detail are not reported, making it difficult to distinguish true incidence changes from coding or classification shifts (e.g., colorectal neuroendocrine tumors).
Clinicians should lower the threshold for cancer workup in patients under 40 presenting with GI symptoms, abnormal cervical findings, or breast changes, as incidence of several typically 'older-adult' cancers is rising in this group. The steep drop in smoking-linked cancers affirms the real-world value of tobacco control, while rising obesity-linked cancers underscore the need to integrate metabolic risk counseling into routine young-adult care.
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