TCR Investigates Early-Onset Cancer Trends

Evaluation of Trends

In the Spring of 2024, the Texas Department of State Health Services (DSHS) leadership informed Texas Cancer Registry (TCR) staff about a Texas Senate Health and Human Services (HHS) Committee interim hearing on cancer prevention. DSHS leadership was invited to speak about potential increasing rates of cancer diagnoses among younger Texans. Cancer diagnoses that occur in adults younger than 50 years of age are termed “early-onset” cancers.

TCR staff were asked to create a presentation for this Senate hearing that included the most recent data on cancer incidence trends, focusing on younger Texans, with a comparison to national data. In addition, DSHS leadership recommended including information on TCR’s history and its role in cancer surveillance. In a span of less than two weeks, TCR epidemiologists planned and conducted needed analyses, evaluated and interpreted the results, prepared a presentation that included data visualizations appropriate for a legislative audience, and wrote detailed notes that included information to address anticipated or potential questions and topics (as TCR staff would not be present during the Senate interim hearing).

TCR epidemiologists examined cancer incidence trends over the past decade, using SEER*Stat and JoinPoint (excluding 2020 diagnosis year). They evaluated sex-specific trends for the most common cancer types for men and women, separately, by age groups. The team closely examined trends in early-onset cancers.

Presentation to HHS Committee

In the presentation, TCR included background information on TCR, information about TCR data use, and a graph showing that while incidence rates of cancers overall have decreased in recent years, the total number of new cancer cases in Texas has increased and remains a significant public health problem. After providing incidence trend data for the top ten most common cancers in women and men, separately, for all ages combined and interpreting those trends according to NCI methodology (stable, falling, rising, or non-significant change), the remainder of the presentation focused on early-onset cancer trends in Texas.

A key finding was that rates of early-onset cancers in Texas have increased for several common cancer types. Colorectal, uterine, and kidney cancers each had fairly large and statistically significant increases in early-onset cancer rates, ranging from a 2.3% increase per year for colorectal cancers among younger women and men to a 3.5% increase in uterine cancer rates per year among younger women. A smaller percentage increase was seen in early-onset breast cancer rates over the past decade as well. The message emphasized that both colorectal cancer and female breast cancer are very common cancers that can be caught earlier, at a more treatable stage, with recommended population-based cancer screening. TCR later turned this presentation into a data brief published on their website.

This narrative is an example of how the public health and cancer registry workforce mobilizes to directly support informed decisions on crucial legislation related to cancer control and prevention.

Co-authors:
Erin Gardner, MPH
Natalie Archer, PhD