High constant incidence of second primary colorectal cancer
High constant incidence of second primary colorectal cancer
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DOI：
10.1002/ijc.27780
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发表时间：
2013-04-01
影响因子：
6.4
通讯作者：
La Vecchia, Carlo
中科院分区：
文献类型：
--
作者：
Levi, Fabio;Randimbison, Lalao;La Vecchia, Carlo
与一般人群相比，患有结直肠癌的患者患第二次结直肠癌的风险高出 1.5 至 2 倍，且诊断时年龄较小的患者风险更高。为了进一步调查第二原发结直肠癌发病率的风险和年龄关系，我们研究了 1974 年至 2008 年间在瑞士沃州癌症登记处登记的 9,389 例首次结直肠癌，并随访至 2008 年底，总计 44,113 人年。第二次结直肠癌为 136 例，而预期为 90.5 例，对应的标准化发病率 (SIR) 为 1.5（95% 置信区间，CI，1.31.8）。男性和女性之间以及诊断时的历年、随访持续时间和亚位点的 SIR 没有异质性。然而，50 岁以下诊断的受试者的 SIR 为 7.5 (95% CI 4.212.4)，此后下降至 80 岁或以上时达到 1.0 (95% CI 0.61.6)。因此，在 3039 岁至 70 岁或以上期间，第二原发性结直肠癌的发病率稳定且极高，约为 300400/100,000。这种年龄模式与高度易感人群中存在单一突变事件一致。
Patients who had a colorectal cancer have a 1.5- to 2-fold excess risk of a second colorectal cancer as compared to the general population, the excess being higher at younger age at diagnosis. To further investigate the risk and the age-relation of the incidence of second primary colorectal cancer, we considered 9,389 first colon and rectal cancers registered in the Vaud Cancer Registry, Switzerland, between 1974 and 2008, and followed-up to the end of 2008 for a total of 44,113 person-years. There were 136 second colorectal cancers versus 90.5 expected, corresponding to a standardized incidence ratio (SIR) of 1.5 (95% confidence interval, CI, 1.31.8). The SIRs were not heterogeneous between men and women, and in strata of calendar year at diagnosis, duration of follow-up, and subsite. However, the SIR was 7.5 (95% CI 4.212.4) for subjects diagnosed below age 50 and declined thereafter to reach 1.0 (95% CI 0.61.6) at age 80 or over. Consequently, the incidence of second primary colorectal cancer was stable, and exceedingly high, around 300400/100,000 between age 3039 and 70 or over. This age pattern is consistent with the existence of a single mutational event in a population of highly susceptible individuals.