Global trends of early onset cancers (15-49 years) 1990-2021 and projection to 2040.

e22584 Background: The global burden of early onset cancer (EOC)(15–49 years) is increasing, and understudied. We aim to investigate the incidence and mortality rates of EOC at global and regional levels. Methods: The study analyzed data from 1990-2021, obtained from Global Health Data Exchange 2021 database. This study described the incidence (IR) and death rates (DR) of EOC per 100,000 person-years for 27 solid and hematological cancers (table 1). Regions were stratified by Sociodemographic Index (SDI) ranged from 0 (minimal development) to 1 (maximal development): high ( &gt; 0.71), high-middle (0.62 to .071), middle (0.55 to 0.62), low-middle (0.37 to .055), and low ( &lt; 0.37) SDI regions. We used ARIMA modeling for forecasting to 2040. Results: In 2021, breast cancer had the highest global incidence and mortality among EOCs, with 567,903 new cases and 131,024 deaths. In 2021, among males, the leading EOCs by IR were non-melanoma skin cancer (11.35), colorectal cancer (6.33), and stomach cancer (4.09). The top EOCs by DR were tracheal, bronchus, and lung cancer (3.21), stomach cancer (2.49), and colorectal cancer (2.37). Among females, the highest IRs of EOC were for breast cancer (28.81), cervical cancer (15.77), and non-melanoma skin cancer (14.41), while the leading EOCs by DR were breast cancer (6.64), cervical cancer (4.19), and tracheal, bronchus, and lung cancer (1.79). In high-SDI region, non-melanoma skin cancer had the highest IR (65.17), while breast cancer led to highest DR (2.96). Middle-SDI region saw breast cancer as the leading cause of both IR (14.83) and DR (3.49). In low-SDI region, cervical cancer ranked highest for IR (8.69) and DR (3.42). Table 1 represents the annual percentage change (APC) in EOC globally from 1990-2021. Forecasting to 2040 revealed increase in incidence in most of the EOC except for a few cancers including stomach and esophageal cancer. Conclusions: Breast cancer remains the leading cause of both IR and DR worldwide, particularly in high and middle-SDI region, while cervical cancer has the highest IR and DR in low-SDI region. The incidence of most EOC cases is projected to increase by 2040. Trends from 1990-2040 highlighted regional disparities, the need for targeted prevention, early detection, and treatment. Cancer type APC of IR APC of DR Prostate 0.87 0.13 Thyroid 0.85 0.13 Multiple myeloma 0.66 0.47 Non-melanoma skin 0.64 0.02 Testicular 0.55 -0.08 Breast 0.51 0.14 Uterine 0.45 -0.13 Kidney 0.43 0.06 Lip and oral cavity 0.43 0.23 Colon and rectum 0.36 -0.08 Non-Hodgkin lymphoma 0.25 -0.08 Ovarian 0.23 0.12 Brain &amp; CNS 0.21 0.01 bone and articular cartilage 0.2 0.04 Pancreatic 0.12 0.08 Bladder 0.11 -0.21 Gallbladder and biliary tract 0.1 -0.1 Nasopharynx 0.05 -0.4 Cervical 0.03 -0.18 Malignant skin melanoma 0.02 -0.23 Liver 0 -0.13 Larynx -0.18 -0.3 Leukemia -0.19 -0.32</jats