关注全球结直肠癌发病年轻化趋势
创作:Lexi 审核:Lexi 2019年09月16日
  • 2008-2012年,全球<50岁(年轻)结直肠癌(CRC)发病率为3.5/100000到12.9/100000;
  • 近十年,被统计的36个国家中,14个国家年轻CRC发病率保持稳定,3个国家下降,19个国家上升;
  • 9个国家50岁及以上(年长)CRC发病率保持稳定或下降趋势;
  • 在塞浦路斯、荷兰、挪威,年轻CRC患者发病率年平均变化百分比(AAPC)是年长患者的两倍以上,如挪威AAPC为1.9 vs 0.5;
  • 90年代起,高收入国家早发型CRC发病率小幅增加,韩国和新西兰增速最快。
主编推荐语
Lexi
早发型(20-49岁)结直肠癌在包括美国、澳大利亚、加拿大等的多个国家呈上升趋势。近期发表在Gut上的研究提取了五大洲癌症发病率的长期数据,全面分析总结了青壮年结直肠癌发病率的全球模式及趋势。该研究表明分布在三大洲的九个高收入国家中,结直肠癌发病率在青壮年群体中正在快速增长。意识到这个问题对于全球结直肠癌预防及筛查具有重要意义,有助于初级保健临床医生对有癌症家族史的青壮年进行更细致的评估,以及增加对这些青壮年相关症状的随访。该研究也强调了对与结直肠癌发生相关的早期暴露研究的必要性。
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Gut [IF:19.819]

Global patterns and trends in colorectal cancer incidence in young adults

青壮年结直肠癌发病率全球模式及趋势

10.1136/gutjnl-2019-319511

2019-09-05, Article

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Abstract:收起
Objective : Early-onset colorectal cancer (CRC) is increasing in the USA despite rapid declines in older ages. Similar patterns are reported in Australia and Canada, but a comprehensive global analysis of contemporary data is lacking.
Design : We extracted long-term data from Cancer Incidence in Five Continents and supplemental sources to report on worldwide CRC incidence rates and trends by age (20–49 years and ≥50 years) through diagnosis year 2012 or beyond (Australia, Finland, New Zealand, Norway, Sweden, USA).
Results : During 2008–2012, age-standardised CRC incidence rates in adults <50 ranged from 3.5 per 100 000 (95% CI 3.2 to 3.9) in India (Chennai) to 12.9 (95% CI 12.6 to 13.3) in Korea. During the most recent decade of available data, incidence in adults <50 was stable in 14 of 36 countries; declined in Austria, Italy and Lithuania; and increased in 19 countries, nine of which had stable or declining trends in older adults (Australia, Canada, Denmark, Germany, New Zealand, Slovenia, Sweden, UK and USA). In Cyprus, Netherlands and Norway, inclines in incidence in young adults were twice as rapid as those in older adults (eg, Norway average annual per cent change (AAPC), 1.9 (95% CI 1.4 to 2.5) vs 0.5 (95% CI 0.3 to 0.7)). Among most high-income countries with long-term data, the uptick in early-onset disease began in the mid-1990s. The steepest increases in young adults were in Korea (AAPC, 4.2 (95% CI 3.4 to 5.0)) and New Zealand (AAPC, 4.0 (95% CI 2.1 to 6.0)).
Conclusion : CRC incidence increased exclusively in young adults in nine high-income countries spanning three continents, potentially signalling changes in early-life exposures that influence large bowel carcinogenesis.

First Authors:
Rebecca L Siegel

Correspondence Authors:
Rebecca L Siegel

All Authors:
Rebecca L Siegel,Lindsey A Torre,Isabelle Soerjomataram,Richard B Hayes,Freddie Bray,Thomas K Weber,Ahmedin Jemal

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