Use of 2-Stage Modeling to Identify How Colorectal Cancer Risk Changes With Period and Cohort.
Use of 2-Stage Modeling to Identify How Colorectal Cancer Risk Changes With Period and Cohort.
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使用两阶段模型来确定结直肠癌风险如何随时期和队列变化。
DOI：
10.1093/aje/kwac177
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发表时间：
2023
影响因子：
5
通讯作者：
Lee,SaritaD
中科院分区：
文献类型：
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作者：
DeYoreo,Maria;Rutter,CarolynM;Lee,SaritaD
50 岁或以上成年人的结直肠癌 (CRC) 发病率有所下降，而 50 岁以下成年人的发病率则有所上升。由于年龄、诊断时期和出生队列的多个相关时间尺度，理解这些趋势具有挑战性。我们分析了 1978 年至 2017 年诊断的监测、流行病学和最终结果计划中 20 岁或以上个体的直肠癌、远端结肠癌和近端结肠癌的发病率。我们使用两阶段广义线性模型来确定年龄、时期和队列对 CRC 发病率的影响。我们首先估计了 45 岁以下人群的出生队列效应。我们使用这些结果指定贝叶斯模型中队列效应的先验分布，以估计 45 岁或以上人群的时期效应。没有证据表明经期对 45 岁以下人群有影响。较晚出生的人群患直肠癌和远端结肠癌的风险增加。与1943-1952年出生队列相比，1983-1992年出生队列患直肠癌的风险是2.2倍，患远端结肠癌的风险是1.9倍，患近端结肠癌的风险是1.3倍。对于年龄≥45 岁的人，时期效应显示 CRC 风险下降，这归因于筛查。
Colorectal cancer (CRC) incidence rates have decreased among adults aged 50 years or older while increasing in adults under age 50 years. Understanding these trends is challenging because of the multiple related time scales of age, diagnosis period, and birth cohort. We analyzed incidence rates of rectal, distal colon, and proximal colon cancer for individuals aged 20 years or more from the Surveillance, Epidemiology, and End Results Program for diagnosis years 1978–2017. We used a 2-stage generalized linear model to determine age, period, and cohort effects for CRC incidence. We first estimated birth cohort effects among people under age 45 years. We used these results to specify prior distributions for cohort effects in a Bayesian model to estimate period effects among people aged 45 years or more. There was no evidence of period effects for people under age 45 years. Risks of rectal and distal colon cancer increased for later birth cohorts. Compared with the 1943–1952 birth cohort, the 1983–1992 birth cohort had 2.2 times the risk of rectal cancer, 1.9 times the risk of distal colon cancer, and 1.3 times the risk of proximal colon cancer. For people aged ≥45 years, period effects showed declines in CRC risk that were attributable to screening.