Elucidating the Drivers for the Rising Incidence of Early-Onset Colorectal Cancer: How Ecologic Studies Could Help and What Is Next.
Elucidating the Drivers for the Rising Incidence of Early-Onset Colorectal Cancer: How Ecologic Studies Could Help and What Is Next.
复制标题
阐明早发性结直肠癌发病率上升的驱动因素：生态学研究如何提供帮助以及下一步。
DOI：
10.1158/1055-9965.epi-22-1126
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Cao,Yin
中科院分区：
文献类型：
--
作者：
Ni,Peiyun;Lansdorp-Vogelaar,Iris;Zauber,AnnG;Cao,Yin
50岁以前诊断出的结直肠癌，通常被称为早发性结直肠癌，发病率一直在上升，而结直肠癌的总体发病率却在下降。阐明早发性结直肠癌负担上升的驱动因素是癌症流行病学和预防的重点。在这一期的《癌症流行病学、生物标志物与预防》杂志上，Chen和他的同事们证明了生态学研究是揭示人群水平上新出现的危险因素的一种有用的方法，并得出结论，饮酒可能是早发性结直肠癌发病率上升的一个潜在因素。展望未来，由于在早发性结直肠癌中观察到的出生队列效应，其中年轻一代的发病率增加更快，因此对最近几代人，特别是在生命早期出现的风险因素进行假设驱动的调查是有必要的。最终，确定的风险因素可以与完善的结直肠癌微观模拟模型相结合，这是一种强大的工具，可以同时捕获人群水平上风险因素的长期变化，每个风险因素的相对风险估计以及结直肠癌的自然历史。这将使我们能够定量地估计按日历时期和出生队列划分的早发性结直肠癌发病率上升的可解释和不可解释部分，并有助于确定病因研究、预防和早期发现的优先事项。参见陈等人的相关文章，第217页
The incidence of colorectal cancer diagnosed before age 50, often referred to as early-onset colorectal cancer, has been increasing, whereas the overall colorectal cancer incidence has declined. Elucidating the drivers for the rising burden of early-onset colorectal cancer is a priority in cancer epidemiology and prevention. In this issue ofCancer Epidemiology, Biomarkers & Prevention, Chen and colleagues demonstrated that ecologic studies are a helpful method to reveal emerging risk factors at the population level and concluded that alcohol use might be a potential contributor to the rising incidence of early-onset colorectal cancer. Moving forward, because of the observed birth cohort effect in early-onset colorectal cancer, where younger generations have a steeper increase, hypothesis-driven investigations on emerging risk factors in recent generations, especially during early life, are warranted. Ultimately, the identified risk factors could be integrated with well-established microsimulation models of colorectal cancer, powerful tools that can simultaneously capture population-level secular changes in risk factors, relative risk estimates for each risk factor, and the natural history of colorectal cancer. This would allow us to quantitatively estimate the explained and unexplained portion of the rising incidence of early-onset colorectal cancer by calendar period and birth cohorts, and to help identify priorities in etiologic research, prevention, and early detection.See related article by Chen et al., p. 217