Croucher C, Whelan J S, Møller H, Davies E A
King's College London, Thames Cancer Registry, London SE1 3QD, UK.
Clin Oncol (R Coll Radiol). 2009 Jun;21(5):417-24. doi: 10.1016/j.clon.2009.02.006. Epub 2009 Apr 17.
This study aimed to describe trends in the incidence and survival of cancer in teenagers and young adults in South East England between 1960 and 2002, and the influence of socioeconomic status upon survival.
Data on 1788 patients aged 15-24 years were extracted from the Thames Cancer Registry, assigning each to a diagnostic group using the Birch and Marsden classification. Age-specific incidence rates in 5-year periods for the age groups 15-19 and 20-24 years were calculated for each diagnosis. Five-year relative survival estimates by diagnostic group were calculated for both age groups using 5-year periods of follow-up and non-overlapping years of diagnosis. To calculate overall survival estimates by socioeconomic group, the 10-year follow-up period 1993-2002 was used.
Overall incidence rates were 162 per million person-years in 15-19 year olds and 261 in 20-24 year olds. We found a higher overall incidence in males, in 20-24 year olds and an increasing incidence over the last four decades, particularly in this age group. In both the 15-19 and 20-24 years age groups lymphomas were most common. The 5-year relative survival improved for all diagnostic groups, except bone tumours in the older age group, particularly for leukaemia and slightly more for the 20-24 than 15-19 years age group. Teenagers aged 15-19 years and living in more deprived areas had a significantly lower survival than those in more affluent areas.
These findings confirm the increased incidence and improved outcome of cancer in teenagers and young adults. Future analyses should investigate trends in bone tumour survival across regions, survival by socioeconomic status and the influence of specialised care on further improvements in survival.
本研究旨在描述1960年至2002年间英格兰东南部青少年和青年癌症的发病率及生存率趋势，以及社会经济地位对生存率的影响。
从泰晤士癌症登记处提取了1788例年龄在15 - 24岁患者的数据，采用伯奇和马斯登分类法将每位患者归入一个诊断组。计算每个诊断组在15 - 19岁和20 - 24岁年龄组5年期间的年龄别发病率。使用5年的随访期和不重叠的诊断年份，计算两个年龄组各诊断组的5年相对生存率估计值。为计算社会经济组的总体生存率估计值，采用了1993年至2002年的10年随访期。
15 - 19岁年龄组的总体发病率为每百万人口年162例，20 - 24岁年龄组为261例。我们发现男性、20 - 24岁年龄组的总体发病率较高，且在过去四十年中发病率呈上升趋势，尤其是在该年龄组。在15 - 19岁和20 - 24岁年龄组中，淋巴瘤最为常见。除老年组的骨肿瘤外，所有诊断组的5年相对生存率均有所提高，尤其是白血病，20 - 24岁年龄组的提高幅度略大于15 - 19岁年龄组。15 - 19岁且生活在较贫困地区的青少年的生存率显著低于较富裕地区的青少年。
这些发现证实了青少年和青年癌症发病率的增加及预后的改善。未来的分析应调查各地区骨肿瘤生存率的趋势、社会经济地位对生存率的影响以及专科护理对生存率进一步提高的影响。
