At what age can cancer be diagnosed?

Youngest Age for Cancer Diagnosis

Cancer can be diagnosed at any age, including in newborns, with documented cases of neonatal cancer occurring within the first 28 days of life. 1

Age Distribution of Cancer Diagnosis

Cancer can affect individuals across the entire lifespan, with certain types more common at specific ages:

Neonatal and Infant Cancers (0-12 months)

• Neuroblastoma is the most common malignancy in infants, representing 47% of neonatal cancers 2
• Other common neonatal cancers include:
  • Retinoblastoma (17%)
  • Soft tissue sarcomas (12%)
  • Central nervous system tumors (9%)
  • Leukemia (8%)
  • Teratomas/germ cell tumors 1

Childhood Cancers

• In children with Bloom's Syndrome (a DNA repair disorder), cancers diagnosed during pediatric years include:
  • Gastrointestinal carcinomas
  • Genital and urinary tract carcinomas
  • Lymphomas
  • Acute lymphoblastic leukemia
  • Acute myeloid leukemia
  • Sarcomas
  • Wilms tumor
  • Medulloblastoma
  • Retinoblastoma 3

Adolescent and Young Adult Cancers (15-39 years)

• The spectrum of cancer types affecting AYAs differs from both pediatric and older adult populations 3
• Common cancers in this age group include:
  • Lymphomas
  • Melanoma (5.0 per 100,000 in men aged 15-39)
  • Testicular cancer (11.2 per 100,000 in men aged 15-39)
  • Female genital tract malignancies
  • Thyroid cancer
  • Bone and soft tissue sarcomas
  • Leukemias
  • Central nervous system cancers
  • Breast cancer (21.0 per 100,000 in women aged 15-39)
  • Non-gonadal germ cell tumors 3

Genetic Predisposition to Early-Onset Cancer

Certain genetic conditions significantly increase the risk of early cancer development:

Li-Fraumeni Syndrome (TP53 mutation)

• Predisposes to early-onset cancers including:
  • Sarcomas
  • Brain tumors
  • Adrenocortical carcinoma
  • Early-onset breast cancer (before age 30) 3

Hereditary Nonpolyposis Colorectal Cancer (HNPCC/Lynch Syndrome)

• Average age of colorectal cancer diagnosis is 44 years
• Cancers before age 25 are unusual but possible 3

Peutz-Jeghers Syndrome

• Significantly increases risk of early-onset cancers:
  • Colorectal cancer (earliest reported at teenage years)
  • Pancreatic cancer (reported as early as age 16)
  • Stomach and small intestinal cancers (reported in first and second decades of life) 3

Clinical Implications

1. Screening in High-Risk Populations:

   • For children with Bloom's Syndrome: awareness of leukemia/lymphoma symptoms and prompt evaluation 3
   • For Peutz-Jeghers Syndrome: baseline upper endoscopy and small bowel series at age 8 3
   • For Li-Fraumeni Syndrome: individualized screening based on family history 3

2. Diagnostic Considerations:

   • Congenital abnormalities are associated with increased neuroblastoma risk (OR 6.86) 4
   • Maternal gestational diabetes shows borderline association with neuroblastoma (OR 1.84) 4

3. Treatment Approaches:

   • Neonatal cancer treatment must balance cure with minimizing long-term effects
   • Radiation therapy is used infrequently in neonates due to susceptibility to late effects 1
   • Overall mortality from neonatal cancers is approximately 41%, with best prognosis for retinoblastoma, Wilms' tumor, and neuroblastoma 2

Key Points to Remember

• Cancer can occur at any age, including in newborns
• The distribution of cancer types varies significantly across age groups
• Genetic predisposition syndromes can lead to very early cancer onset
• Early diagnosis improves outcomes, especially for pediatric cancers
• Treatment approaches must be tailored to the unique needs of each age group
• Long-term surveillance is essential for survivors of early-life cancers

When evaluating patients with concerning symptoms, age should never be used as the sole criterion to rule out malignancy, as cancer can occur at any point in the lifespan.