# Epidemiology of adolescent and young adult cancer and associated disparities in cancer pattern and care in India: findings from Varanasi’s population-based cancer registry, 2017–2019

## TL;DR

This study examines cancer patterns and care disparities among adolescents and young adults in Varanasi, India, revealing high rates of oral and breast cancers and the need for targeted interventions.

## Contribution

The study provides the first detailed analysis of AYA cancer epidemiology and disparities in Varanasi using population-based registry data.

## Key findings

- AYAs accounted for 16.2% of cancer cases, with oral and breast cancers being most common.
- Male AYAs had the highest rates of oral cancers, while females faced higher risks of stomach and thyroid cancers.
- AYAs accessed more treatment but faced income and employment challenges compared to older adults.

## Abstract

Adolescents and Young Adults (AYAs) aged 15–39 represent a unique oncology demographic due to their distinct developmental needs. However, there is limited data on cancer burden and care disparities among the Indian AYAs. This study examines the burden, pattern, and disparities among AYAs in Varanasi, Uttar Pradesh.

This study collected data from Varanasi's population-based cancer registry (PBCR) between 2017 and 2019. Data were analyzed for demographic, clinical, and cancer-related variables. Sex and site-specific crude, age-adjusted, and truncated rates for incidence and mortality per 100,000 population were calculated. Disparities in cancer pattern for age, sex, cancer site, and geographical region, sociodemographic and cancer care characteristics were assessed using standardized rate ratios and multivariable regression. Adjusted ratios with 95% confidence intervals were calculated. AAIR of the leading cancer site was compared with 24 Indian PBCRs from Cancer Incidence Five data and GLOBOCAN (2022) data.

Of 6821 cancer patients, 1105 (16.2%) were AYAs. The truncated age-adjusted incidence rate (AAIR) was 21 per 100,000 population, with mouth (16.5%), breast (12.2%), and tongue (6.2%) cancers leading. Oral cancer was most common cancer in male AYAs, with truncated AAIR of 9.2 per 100,000, ranking third highest among Indian PBCRs. Females had higher risks of stomach, gallbladder, and thyroid cancers. AYAs were more likely to access diagnostic and definitive treatment but faced income and employment vulnerabilities when compared with adults aged ≥ 40 years.

This study highlights significant cancer burden and disparities among AYAs in Varanasi. Targeted screening, tobacco control policies, and region-specific interventions, especially social support schemes, are crucial to addressing these inequities and improving outcomes.

The online version contains supplementary material available at 10.1007/s10552-025-02030-2.