Cancer Among Adolescents and Young Adults Between 2000 and 2016 in France: Incidence and Improved Survival
Cancer Among Adolescents and Young Adults Between 2000 and 2016 in France: Incidence and Improved Survival
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DOI：
10.1089/jayao.2020.0017
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发表时间：
2020-05-15
影响因子：
2
通讯作者：
Desandes, Emmanuel
中科院分区：
文献类型：
--
作者：
Raze, Thomas;Lacour, Brigitte;Desandes, Emmanuel
目的：本研究旨在确定法国青少年和年轻成人（AYA）人群的癌症生存率并描述癌症诊断谱。方法：纳入2000-2016年期间所有法国人口登记处记录的15-24年内诊断出的所有癌症病例（占法国人口的18%）。计算年龄标准化发病率、常规年发病率随时间变化百分比（cAPC）和5年总生存率（5yOS）。结果：我们分析了2734例青少年和4199例年轻人的癌症诊断。15-19岁的总发病率为231.9/10(6)，20-24岁的总发病率为354.0/10(6)。男性AYA中最常诊断的癌症是恶性性腺生殖细胞瘤（GCT）、霍奇金淋巴瘤（HL）和恶性黑色素瘤，女性中最常诊断的癌症是HL、甲状腺癌和恶性黑色素瘤。随着时间的推移，癌症发病率稳定，cAPC为0.8% （p = 0.72）。对于所有癌症，5yOS为86.6% (95% CI: 85.8-87.4)， HL、非霍奇金淋巴瘤（NHL）、GCT、甲状腺癌和恶性黑色素瘤的5yOS为85%，骨肉瘤、尤文氏瘤、肝癌和横纹肌肉瘤的5yOS约为60%或更低。从2000年至2007年至2008年至2015年期间，所有癌症的5年生存率都有了显著改善，15-19岁和20-24岁年龄组的生存率分别大幅提高了4%和3%。结论：尽管在治疗某些癌症方面取得了令人鼓舞的结果，但总的来说，与急性淋巴细胞白血病、骨肉瘤、尤因瘤、横纹肌肉瘤和恶性肝肿瘤相比，AYA患者的生存率持续较低。这些差异需要进一步调查，以确定和解决这些不良结果的原因。
Purpose: This study was undertaken to determine cancer survival and describe the spectrum of cancers diagnosed among French adolescent and young adult (AYA) population.Methods: All cases of cancer diagnosed in 15-24 years, recorded by all French population-based registries (18% of the French population), over the 2000-2016 period, were included. Age-standardized incidence rates, conventional annual percentage change (cAPC) of incidence over time, and 5-year overall survival (5yOS) were calculated.Results: We analyzed 2734 cancer diagnoses in adolescents and 4199 in young adults. Overall incidence rates were 231.9/10(6) in 15-19 year olds and 354.0/10(6) in 20-24 year olds. The most frequently diagnosed cancers in male AYA were malignant gonadal germ-cell tumors (GCT), Hodgkin lymphoma (HL), and malignant melanoma and were HL, thyroid carcinoma, and malignant melanoma in females. Cancer incidence was stable over time with a cAPC of 0.8% (p = 0.72). For all cancers combined, 5yOS was 86.6% (95% CI: 85.8-87.4), >85% for HL, non-Hodgkin lymphomas (NHL), GCT, thyroid carcinomas, and malignant melanomas, and around 60% and lower for osteosarcomas, Ewing tumors, hepatic carcinomas, and rhabdomyosarcomas. The 5yOS has significantly improved from 2000-2007 to 2008-2015 for all cancers pooled, with a substantial gain of 4% for 15-19 year olds and 3% for 20-24 year olds.Conclusion: Notwithstanding the encouraging results for some cancers, and overall, persistent poorer survivals in AYA were shown compared to children for acute lymphoblastic leukemia, osteosarcoma, Ewing tumor, rhabdomyosarcoma, and malignant hepatic tumors. These disparities require further investigation to identify and address the causes of these inferior outcomes.