Trends in the incidence of early-onset colorectal cancer in all 50 United States from 2001 through 2017
Trends in the incidence of early-onset colorectal cancer in all 50 United States from 2001 through 2017
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DOI：
10.1002/cncr.33916
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发表时间：
2021-09-16
期刊：
影响因子：
6.2
通讯作者：
Thrift, Aaron P.
中科院分区：
文献类型：
--
作者：
Shah, Rajesh R.;Millien, Valentine O.;Thrift, Aaron P.
背景：美国50岁以下人群中结直肠癌（CRC）发病率的变化率似乎因人口统计学、肿瘤位置和地理而异。本研究分析了所有50个州的数据，以检查50岁以下人群中CRC发病率的最新变化，并确定风险不成比例的关键亚组。方法从2001-2017年美国癌症统计数据中提取20 - 49岁人群中结直肠癌、结肠癌和直肠癌的年发病率。对长期趋势进行了总体调查，并按年龄组、性别、种族/民族、阶段和州进行了调查。采用连接点回归计算年变化百分比和平均年变化百分比（AAPCs）以及相应的95%置信区间（95% ci）。结果2001 - 2012年结直肠癌发病率每年增加1.27% (95% CI, 0.95% ~ 1.60%)， 2012 - 2017年每年增加3.00% （95% CI, 2.06% ~ 3.95%）。2001-2017年期间，20 - 24岁人群的AAPC （AAPC, 6.62%; 95% CI, 3.86%-9.45%）高于其他年龄组，非西班牙裔白人（AAPC, 2.38%; 95% CI, 1.98%-2.79%）高于其他种族/族裔群体。2001-2002年，只有1个州的年龄标准化发病率为13.0 / 10万，但到2016-2017年，这一数字增加到32个州。结论2001年至2017年，美国20 - 49岁成年人的CRC发病率呈上升趋势，其中2012年至2017年增长最快。在最年轻的年龄组、非西班牙裔白人以及西部、中西部和落基山脉地区的州中，发病率都有所上升。所有肿瘤分期的发病率增加表明CRC的发病率确实增加了。
Background The rate of change in the incidence of colorectal cancer (CRC) among persons younger than 50 years in the United States appears to vary by demographics, tumor location, and geography. This study analyzed data from all 50 states to examine recent changes in the incidence of CRC among persons younger than 50 years and to identify key subgroups with disproportionate risk. Methods Annual incidence rates for CRC, colon cancer, and rectal cancer in persons aged 20 to 49 years were extracted from the US Cancer Statistics for the period 2001-2017. Secular trends were examined overall and by age group, sex, race/ethnicity, stage, and state. Joinpoint regression was used to compute annual percent changes and average annual percent changes (AAPCs) as well as corresponding 95% confidence intervals (95% CIs). Results The incidence of CRC increased by 1.27% (95% CI, 0.95%-1.60%) annually from 2001 to 2012 and by 3.00% (95% CI, 2.06%-3.95%) annually from 2012 to 2017. AAPCs for the period 2001-2017 were higher among persons aged 20 to 24 years (AAPC, 6.62%; 95% CI, 3.86%-9.45%) in comparison with other age groups and higher among non-Hispanic Whites (AAPC, 2.38%; 95% CI, 1.98%-2.79%) in comparison with other racial/ethnic groups. In 2001-2002, only 1 state had an age-standardized incidence rate > 13.0 per 100,000, but this number increased to 32 states by 2016-2017. Conclusions CRC rates among US adults aged 20 to 49 years increased from 2001 to 2017, with the fastest increases observed from 2012 to 2017. Increases were observed among the youngest age groups, among non-Hispanic Whites, and in states in the West, Midwest, and Rocky Mountain regions. Increasing rates across all tumor stages suggest a real increase in CRC incidence.