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Adolescent and young adult (AYA) Americans have unique health challenges, including suicide, firearm access, substance access and abuse, and opioid and other drug overdose. Cancer in AYAs has also not had the attention, research, and progress that younger and older persons have had.
In the U.S., AYAs, cancer has declined from the #2 cause of death in 1969 to #4 in 2014, tied with homicides. After firearm deaths, accidents still kill far more AYAs than any other cause, and since 1992 has not improved. Suicide in AYAs has increased from the 5th most common cause to the 2nd, and is the only common cause that has increased since 2000. HIV deaths, which reach epidemic levels in 1994, was the 2nd most common cause from 1992 to 1996. Homicides in males also peaked during the HIV epidemic, during which it was the 2nd most common cause of death in AYA males. Heart disease, which was the 2nd most common cause of death due to disease for a few years, has been the 5th or 6th most common cause of death in AYAs since 1975.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2015 on CDC WONDER Online Database, released December, 2016. Data are from the Multiple Cause of Death Files, 1999-2015, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Jun 25, 2017 10:36:28 AM
Why has the number of gun deaths accelerated in the U.S.?
• It’s not the population increase for which the AYA population has increased only 12% since 19993 while the gun sales have increased >200% (Fig. 6).
• In part, it’s the availability and access to guns (Figs. 7 & 8).
• The U.S. has more guns per capita in citizen hands than any other country.
• In 2015 the average monthly purchase in the U.S. was 2.2 million guns, more than 3x the average of 700,000 per month in 2007 (Fig. 5).
The sites within the longitudinal axis of the GI tract from the esophagus to the anus that are least likely to develop adenocarcinoma in AYAs are the small intestine and the anus/anorectum/anal canal. Approximately 50 cases of each gastric adenocarcinoma and 10 of anal adenocarcinoma occur in AYAs on an average annual basis in the U.S..
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