Cancer statistics for adolescents and young adults, 2020
Cancer statistics for adolescents and young adults, 2020
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DOI：
10.3322/caac.21637
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发表时间：
2020-09-17
影响因子：
254.7
通讯作者：
Siegel, Rebecca L.
中科院分区：
文献类型：
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作者：
Miller, Kimberly D.;Fidler-Benaoudia, Miranda;Siegel, Rebecca L.
青少年和年轻人（AYAs）（15-39岁）的癌症统计数据通常是汇总的，掩盖了重要的异质性。作者按年龄组（15-19岁、20-29岁和30-39岁）、性别和种族/民族分析了美国AYA人群的癌症发病率和死亡率。2020年，AYAs将新增约89，500例癌症病例和9270例癌症死亡。在最近十年（2007-2016年），所有AYA年龄组的总体癌症发病率都有所增加，主要是由甲状腺癌推动的，20至39岁的人群每年增长约3%，15至19岁的人群每年增长4%。与肥胖相关的几种癌症的发病率在大多数年龄组中也有所增加，包括肾癌（所有年龄组每年3%）、子宫体癌（20-39岁组3%）和结直肠癌（20-39岁组0.9%-1.5%）。年龄在15至29岁的人群中黑色素瘤的发病率急剧下降（每年4%-6%），但在30至39岁的人群中保持稳定。2008年至2017年期间，各年龄和性别组的总体癌症死亡率每年下降1%，但30至39岁的女性除外，由于女性乳腺癌的下降趋势平缓，这些女性的死亡率保持稳定。在30至39岁年龄组中，结肠直肠癌和子宫体癌的发病率增加，反映了发病率的趋势。AYA患者的五年相对生存率在所有癌症的年龄组中相似（范围为83%-86%），但在某些癌症中差异很大，如急性淋巴细胞白血病（15-19岁组为74%，30-39岁组为51%）和脑肿瘤（77%对66%），反映了组织学亚型分布和治疗的差异。在降低癌症发病率和死亡率方面取得的进展可以通过更公平地获得医疗保健，增加临床试验注册，扩大研究以及临床医生和患者对癌症早期症状和体征的警觉性来解决。进一步的进展可能会加速与监测，病因学，基础生物学和生存的研究增加按年龄分类。
Cancer statistics for adolescents and young adults (AYAs) (aged 15-39 years) are often presented in aggregate, masking important heterogeneity. The authors analyzed population-based cancer incidence and mortality for AYAs in the United States by age group (ages 15-19, 20-29, and 30-39 years), sex, and race/ethnicity. In 2020, there will be approximately 89,500 new cancer cases and 9270 cancer deaths in AYAs. Overall cancer incidence increased in all AYA age groups during the most recent decade (2007-2016), largely driven by thyroid cancer, which rose by approximately 3% annually among those aged 20 to 39 years and 4% among those aged 15 to 19 years. Incidence also increased in most age groups for several cancers linked to obesity, including kidney (3% annually across all age groups), uterine corpus (3% in the group aged 20-39 years), and colorectum (0.9%-1.5% in the group aged 20-39 years). Rates declined dramatically for melanoma in the group aged 15 to 29 years (4%-6% annually) but remained stable among those aged 30 to 39 years. Overall cancer mortality declined during 2008 through 2017 by 1% annually across age and sex groups, except for women aged 30 to 39 years, among whom rates were stable because of a flattening of declines in female breast cancer. Rates increased for cancers of the colorectum and uterine corpus in the group aged 30 to 39 years, mirroring incidence trends. Five-year relative survival in AYAs is similar across age groups for all cancers combined (range, 83%-86%) but varies widely for some cancers, such as acute lymphocytic leukemia (74% in the group aged 15-19 years vs 51% in the group aged 30-39 years) and brain tumors (77% vs 66%), reflecting differences in histologic subtype distribution and treatment. Progress in reducing cancer morbidity and mortality among AYAs could be addressed through more equitable access to health care, increasing clinical trial enrollment, expanding research, and greater alertness among clinicians and patients for early symptoms and signs of cancer. Further progress could be accelerated with increased disaggregation by age in research on surveillance, etiology, basic biology, and survivorship.