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[法国青少年及青年成年人的癌症发病率与生存率(1978 - 1997年)]

[Cancer incidence and survival among adolescents and young adults in France (1978-1997)].

作者信息

Desandes Emmanuel, Lacour Brigitte, Belot Aurélien, White-Koning Mélanie, Velten Michel, Tretarre Brigitte, Sauleau Erik-André, Maarouf Nabil, Guizard Anne-Valérie, Delafosse Patricia, Danzon Arlette, Cotte Christine, Boutreux Sébastien, Brugières Laurence

机构信息

Registre national des tumeurs solides de l'enfant, Université Henri Poincaré Nancy 1, Faculté de Médecine, 9, avenue de la Forêt-de-Haye, BP 184, 54505 Vandoeuvre-lès-Nancy Cedex.

出版信息

Bull Cancer. 2007 Apr;94(4):331-7.

Abstract

Malignancies are rare young French adults but represent the third significant cause of death in the cohort of 15-24 years of age. The aim of this study was to investigate incidence and survival rates of French adolescents and young adults with cancer. All cases of cancer occuring over a 20-year period (1978-1997) in the cohort of patients aged 15 to 24, were obtained from nine population-based registries (10 % of the French population). Basal cell carcinomas of the skin were excluded. 1161 and 1884 cases were recorded in adolescents and young adults, respectively. Overall incidence rates (IR) were 161.4/10(6) in adolescents aged 15-19 years (M/F ratio = 1.3), and 252.6/10(6) in young adults aged 20-24 years (M/F ratio : 1.2). During the 1978-97 period, the IRs appeared stable over the years, +0.4 % [CI95 % = -2.3 ; +3.1] (p = 0.79) for adolescents and +1.7 % [CI95 % = -4.0 ; +7.3] (p = 0.57) for young adults. Five-year overall survival rates were 69.1 % [CI95 % = 66.4-71.8] for adolescents and 74.5 % [CI95 % = 72.3-76.7] for young adults. The 5-year survival rate for patients 15-24 years improved from 62.0 % (CI95 % = 57.5-66.5) in 1978-82 to 80.2 % (IC95 % = 77.7-82.8) in 1993-97. Noteworthy, results in adolescents and young adults are poor compared to the ones from their younger counterparts, especially in patients with acute lymphoblastic leukemia, non-Hodgkin lymphoma, Ewing's sarcoma, osteosarcoma, rhabdomyosarcoma, and astrocytoma. Further studies are warranted to elucidate whether these differences are due to intrinsic biological properties of the tumor or to differences in clinical practices in the two populations.

摘要

恶性肿瘤在法国年轻成年人中较为罕见,但却是15至24岁人群中第三大主要死因。本研究旨在调查法国青少年和年轻成年人癌症的发病率和生存率。15至24岁患者队列中20年期间(1978 - 1997年)发生的所有癌症病例,均来自九个基于人群的登记处(占法国人口的10%)。皮肤基底细胞癌被排除在外。青少年和年轻成年人分别记录了1161例和1884例病例。15 - 19岁青少年的总体发病率(IR)为161.4/10⁶(男/女比例 = 1.3),20 - 24岁年轻成年人的总体发病率为252.6/10⁶(男/女比例:1.2)。在1978 - 97年期间,多年来发病率似乎稳定,青少年的发病率年增长率为 +0.4% [95%置信区间 = -2.3;+3.1](p = 0.79),年轻成年人的发病率年增长率为 +1.7% [95%置信区间 = -4.0;+7.3](p = 0.57)。青少年的五年总体生存率为69.1% [95%置信区间 = 66.4 - 71.8],年轻成年人的五年总体生存率为74.5% [95%置信区间 = 72.3 - 76.7]。15 - 24岁患者的5年生存率从1978 - 1982年的62.0%(95%置信区间 = 57.5 - 66.5)提高到1993 - 1997年的80.2%(95%置信区间 = 77.7 - 82.8)。值得注意的是,与年龄较小的同龄人相比,青少年和年轻成年人的结果较差,尤其是急性淋巴细胞白血病、非霍奇金淋巴瘤、尤因肉瘤、骨肉瘤、横纹肌肉瘤和星形细胞瘤患者。有必要进一步研究以阐明这些差异是由于肿瘤的内在生物学特性还是由于这两个人群临床实践的差异。

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