Temporal trends of adolescents and young adults (AYA) with gynecologic malignancy in the United States

In this retrospective cohort study examining 13,763,447 patients with 16 different malignancies, including 1,232,841 patients with five gynecologic malignancies (uterus [n = 690,590], ovary [n = 276,812], cervix [n = 166,779], vulva [n = 81,575], and vagina [n = 17,085]), identified in the Commission-on-Cancer's National Cancer Database from 2004 to 2020, cervical cancer (25.3 %) had the highest rate of adolescent and young adult (AYA) patients among 27 gender-stratified cancer groups. There were eight groups that the annual rates of AYA patients statistically increased during the study period at a P < .05 level, of which 7 (87.5 %) groups were for female malignancies. Among these seven female malignancies, the annual percentage rate increase in AYA patients was largest for colorectal cancer (4.1 %, 95 % confidence interval 3.6–4.6), followed by malignancies in the ovary (3.1 %, 95 % confidence interval 1.6–4.5 in 2014–2020), pancreas (2.1 %, 95 % confidence interval 1.0–3.2), uterus (1.2 %, 95 % confidence interval 0.3–2.0 in 2013–2020), breast (0.8 %, 95 % confidence interval 0.2–1.4 in 2012–2020), cervix (0.8 %, 95 % confidence interval 0.2–1.5 in 2011–2020), and kidney (0.4 %, 95 % confidence interval 0.1–0.9). In conclusion, these data suggested that proportion of cancers attributable to AYA patients is increasing in several obesity-related female malignancies and in the three most common gynecologic malignancies.