Changes in colorectal cancer incidence in seven high-income countries: a population-based study
Changes in colorectal cancer incidence in seven high-income countries: a population-based study
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DOI：
10.1016/s2468-1253(19)30147-5
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发表时间：
2019-07-01
影响因子：
35.7
通讯作者：
Arnold, Melina
中科院分区：
文献类型：
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作者：
Araghi, Marzieh;Soerjomataram, Isabelle;Arnold, Melina
背景 在许多高收入国家，结直肠癌的总体发病率正在下降，但美国和澳大利亚、加拿大和挪威等其他高收入国家的分析表明，50 岁以下成年人的结直肠癌发病率正在上升。我们的目的是研究七个高收入国家结肠癌和直肠癌发病率的纵向和代际变化。方法我们从澳大利亚、加拿大、丹麦、挪威、新西兰、爱尔兰和英国的 21 个基于人口的癌症登记处获得了截至 2014 年最早可用年份的结肠癌和直肠癌发病率数据。我们使用年龄-时期-队列模型来评估按年龄组、时期、年龄组划分的发病率趋势。 和出生队列。我们根据第十版国际疾病分类按肿瘤亚位点对病例进行分层。年龄标准化发病率是根据世界标准人口计算的。调查结果 在所有研究国家中，结肠癌和直肠癌的发病率总体下降或稳定。然而，在有数据可查的最近 10 年期间，丹麦（3.1%）、新西兰（2.9%）、澳大利亚（2.9%）和英国（1.8%）50 岁以下人群的结肠癌发病率显着增加。在加拿大（增加 3.4%）、澳大利亚（2.6%）和英国（1.4%），该年龄组的直肠癌发病率也显着增加。与此同时，在 50-74 岁人群中，澳大利亚（下降 1.6%）、加拿大（1.9%）和新西兰（3.4%）的结肠癌发病率显着下降，澳大利亚（2.4%）、加拿大（1.2%）和英国（1.2%）的直肠癌发病率显着下降。 50 岁以下人群结直肠癌发病率的增加主要是由于结肠远端（左侧）肿瘤的增加所致。在所有国家中，我们都注意到非线性队列效应，直肠癌比结肠癌更为明显。 解释 我们注意到，在本研究的一些国家中，50 岁以下人群的结直肠癌发病率大幅增加。未来的研究需要确定发病率上升的根本原因，以便制定潜在的预防和早期检测策略。版权所有 (C) 2019。世界卫生组织。由 Elsevier Ltd/Inc/BV 出版。版权所有。
Background The overall incidence of colorectal cancer is decreasing in many high-income countries, yet analyses in the USA and other high-income countries such as Australia, Canada, and Norway have suggested increasing incidences among adults younger than 50 years. We aimed to examine longitudinal and generational changes in the incidence of colon and rectal cancer in seven high-income countries.Methods We obtained data for the incidence of colon and rectal cancer from 21 population-based cancer registries in Australia, Canada, Denmark, Norway, New Zealand, Ireland, and the UK for the earliest available year until 2014. We used age-period-cohort modelling to assess trends in incidence by age group, period, and birth cohort. We stratified cases by tumour subsite according to the 10th edition of the International Classification of Diseases. Age-standardised incidences were calculated on the basis of the world standard population.Findings An overall decline or stabilisation in the incidence of colon and rectal cancer was noted in all studied countries. In the most recent 10-year period for which data were available, however, significant increases were noted in the incidence of colon cancer in people younger than 50 years in Denmark (by 3.1%), New Zealand (2.9%), Australia (2.9%), and the UK (1.8%). Significant increases in the incidence of rectal cancer were also noted in this age group in Canada (by 3.4%), Australia (2.6%), and the UK (1.4%). Contemporaneously, in people aged 50-74 years, the incidence of colon cancer decreased significantly in Australia (by 1.6%), Canada (1.9%), and New Zealand (3.4%) and of rectal cancer in Australia (2.4%), Canada (1.2%), and the UK (1.2%). Increases in the incidence of colorectal cancer in people younger than 50 years were mainly driven by increases in distal (left) tumours of the colon. In all countries, we noted non-linear cohort effects, which were more pronounced for rectal than for colon cancer.Interpretation We noted a substantial increase in the incidence of colorectal cancer in people younger than 50 years in some of the countries in this study. Future studies are needed to establish the root causes of this rising incidence to enable the development of potential preventive and early-detection strategies. Copyright (C) 2019. World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved.