Prevalence of screen-detectable cancers among adults aged 18-49 years: Findings from HINTS-SEER

Background/Purpose: Over the past two decades, the incidence of cancers diagnosed among adults younger than age 50 (e.g., early-onset cancer) has risen globally. Emerging evidence indicates these trends span multiple cancer types, disproportionately burdening women, and racially and ethnically minoritized populations. However, population-level estimates of the burden of screen-detectable cancers among younger adults remain poorly characterized, limiting efforts to inform public health strategies. This study aims to quantify the prevalence and distribution of screen-detectable cancers among adults diagnosed before age 50. Methods: We utilized 2022 data from Health Information National Trends Survey-Surveillance, Epidemiology, and End Results (HINTS-SEER), a registry-linked national survey of cancer survivors. Weighted prevalence estimates of cancers survivors among adults aged 18-49 were calculated to describe screen-detectable cancers among adults diagnosed before age 50. Cancer sites were categorized as breast, colorectal, cervical, lung, prostate, and non-melanoma skin. Weighted estimates accounted for complex survey design. Findings were stratified by birth sex, race and ethnicity. Results: The analytic sample included 298 respondents (weighted N ≈ 119,131). Screen-detectable cancers accounted for 60.0% of diagnoses. By site, prevalence estimates were breast (29.0%), non-melanoma skin (16.1%), colorectal (7.2%), prostate (4.3%), lung (2.3%), and cervical (1.0%). Mean age varied by site, from 28.2 years for cervical cancer to 43.0 years for colorectal cancer. The sample was predominantly female (67.6%) and included respondents who were non-Hispanic White (73.6%), Hispanic (13.4%), non-Hispanic Asian (7.6%), non-Hispanic Black (3.2%), and non-Hispanic other (2.2%). Most participants (87.3%) reported at least one first- or second-degree relative with cancer, and one-third (31.6%) reported undergoing genetic testing. Conclusions (Interpretation/Implications): Screen-detectable cancers represent a substantial proportion of early-onset cancers, driven primarily by breast and non-melanoma skin cancers, with meaningful contributions from colorectal, prostate, lung, and cervical cancers. These findings highlight critical opportunities to refine screening initiation ages, improve awareness, and implement risk-based screening strategies for younger populations. Although subgroup estimates were limited by small sample sizes, overall patterns underscore the urgency of targeted prevention and early detection efforts. Registry-linked national surveys such as HINTS-SEER provide essential context to guide policy and resource allocation tin response to the growing burden of early-onset cancers.