Murphy Caitlin C, Sanoff Hanna K, Stitzenberg Karyn B, Baron John A, Lund Jennifer L, Sandler Robert S
Division of Epidemiology, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
J Cancer Epidemiol. 2017;2017:4024580. doi: 10.1155/2017/4024580. Epub 2017 Jan 23.
As a first step toward understanding the increasing incidence of colorectal cancer (CRC) in younger (age < 50) populations, we examined demographic, clinicopathologic, and socioeconomic characteristics and treatment receipt in a population-based sample of patients newly diagnosed with stages II and III CRC. Patients were sampled from the National Cancer Institute's Patterns of Care studies in 1990/91, 1995, 2000, 2005, and 2010 ( = 6, 862). Tumor characteristics and treatment data were obtained through medical record review and physician verification. We compared sociodemographic and clinicopathologic characteristics and treatment patterns of younger (age < 50) and older (age 50-69, age ≥ 70) CRC patients. Younger patients were more likely to be black (13%) and Hispanic (15%) than patients aged 50-69 years (11% and 10%, resp.) and ≥70 years (7% each). A larger proportion of young white (41%) and Hispanic (33%) patients had rectal tumors, whereas tumors in the right colon were the most common in young black patients (39%). The majority of younger patients received chemotherapy and radiation therapy, although receipt of microsatellite instability testing was suboptimal (27%). Characteristics of patients diagnosed with young-onset CRC differ considerably by race/ethnicity, with a higher proportion of black and Hispanic patients diagnosed at the age of < 50 years.
作为了解年轻(年龄<50岁)人群中结直肠癌(CRC)发病率上升情况的第一步,我们在一个基于人群的新诊断为II期和III期CRC患者样本中,研究了人口统计学、临床病理和社会经济特征以及治疗情况。患者样本来自美国国立癌症研究所1990/91年、1995年、2000年、2005年和2010年的治疗模式研究(n = 6862)。通过病历审查和医生核实获得肿瘤特征和治疗数据。我们比较了年轻(年龄<50岁)和年长(年龄50 - 69岁、年龄≥70岁)CRC患者的社会人口统计学和临床病理特征以及治疗模式。与50 - 69岁(分别为11%和10%)和≥70岁(均为7%)的患者相比,年轻患者更有可能是黑人(13%)和西班牙裔(15%)。较大比例的年轻白人(41%)和西班牙裔(33%)患者患有直肠肿瘤,而右半结肠癌在年轻黑人患者中最为常见(39%)。大多数年轻患者接受了化疗和放疗,尽管微卫星不稳定性检测的接受情况不太理想(27%)。年轻发病的CRC患者特征因种族/族裔差异很大,50岁以下诊断为CRC的黑人及西班牙裔患者比例更高。