International Trends in the Incidence of Cancer Among Adolescents and Young Adults
International Trends in the Incidence of Cancer Among Adolescents and Young Adults
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DOI：
10.1093/jnci/djaa007
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发表时间：
2020-11-01
影响因子：
10.3
通讯作者：
Fidler-Benaoudia, Miranda M.
中科院分区：
文献类型：
--
作者：
Gupta, Sumit;Harper, Andrew;Fidler-Benaoudia, Miranda M.
背景：尽管青少年和年轻人 (AYA) 癌症代表了一系列独特的恶性肿瘤，但癌症发病率的流行病学研究通常将 AYA 与年轻或老年人群体归为一类，从而模糊了该人群特有的模式。方法：我们使用 CI5plus 数据库检查了 41 个国家 15 年来 AYA 癌症发病率趋势。计算截断的年龄标准化发病率并评估年度百分比变化，统计显着性对应于不包括零的 95% 置信区间。结果：从 1998 年到 2012 年，41 个国家总共贡献了 1 846 588 例癌症病例和 31 亿人年的 AYA。尽管在 23 个国家中观察到总体癌症负担在统计上显着增加，但幅度差异很大，其中韩国的发病率增幅最大（年度百分比变化（2002）（-）（2012）= 8.5 %，95 % 置信区间 = 7.6% 至 9.4%），归因于甲状腺癌。值得注意的趋势包括 AYA 中与肥胖相关的恶性肿瘤发病率急剧增加；事实上，在美国和英国，AYA 中 11 个肥胖相关癌症部位中的 10 个和 11 个肥胖相关癌症部位中的 9 个分别观察到统计显着增加，其中在加拿大、日本、韩国、澳大利亚和荷兰，至少有 5 种与肥胖相关的癌症有统计显着增加。甲状腺癌和睾丸癌也出现了其他显着趋势，分别在 33 个和 22 个国家观察到发病率在统计上显着增加，而在许多国家，与吸烟相关的癌症、宫颈癌和卡波西肉瘤的发病率在统计上显着下降。结论：：我们的结果强调了与治疗相关的未来医疗保健需求以及可以减轻 AYA 中日益增加的癌症负担的公共卫生举措的紧迫性。
Background: Although adolescent and young adult (AYA) cancers represent a unique spectrum of malignancies, epidemiological studies of cancer incidence often group AYAs together with younger or older populations, obscuring patterns specific to this population. Methods: We examined AYA cancer incidence trends in 41 countries over a 15-year period using the CI5plus database. Truncated age-standardized incidence rates were calculated and the annual percentage change was assessed, with statistical significance corresponding to a 95% confidence interval that does not include zero. Results: From 1998 to 2012, the 41 included countries contributed a total of 1 846 588 cancer cases and 3.1 billion person-years among AYAs. Although statistically significant increases in the overall cancer burden were observed in 23 countries, the magnitude varied considerably, with the greatest increase in incidence observed in South Korea (annual percentage change(2002)(-)(2012) = 8.5 %, 95 % confidence interval = 7.6% to 9.4%) due to thyroid cancer. Notable trends included sharp increases in the incidence of obesity-related malignancies among AYAs; indeed, statistically significant increases were observed among AYAs for 10 of 11 and 9 of 11 obesity-related cancer sites in the US and UK, respectively, with at least five obesity-related cancers statistically significantly increasing in Canada, Japan, South Korea, Australia, and the Netherlands. Other striking trends were noted for thyroid and testicular cancer, with statistically significantly increasing rates observed in 33 and 22 countries, respectively, whereas statistically significant declines in incidence were observed for smoking-related cancers, cervical cancer, and Kaposi sarcoma in many countries. Conclusions: : Our results highlight the future health-care needs related to treatment as well as the urgency for public health initiatives that can mitigate the increasing burden of cancer in AYAs.