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美国罕见癌症负担。

The burden of rare cancers in the United States.

机构信息

Director, Breast and Gynecological Cancer Surveillance, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA.

Assistant Professor of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA.

出版信息

CA Cancer J Clin. 2017 Jul 8;67(4):261-272. doi: 10.3322/caac.21400. Epub 2017 May 19.

Abstract

There are limited published data on the burden of rare cancers in the United States. By using data from the North American Association of Central Cancer Registries and the Surveillance, Epidemiology, and End Results program, the authors provide information on incidence rates, stage at diagnosis, and survival for more than 100 rare cancers (defined as an incidence of fewer than 6 cases per 100,000 individuals per year) in the United States. Overall, approximately 20% of patients with cancer in the United States are diagnosed with a rare cancer. Rare cancers make up a larger proportion of cancers diagnosed in Hispanic (24%) and Asian/Pacific Islander (22%) patients compared with non-Hispanic blacks (20%) and non-Hispanic whites (19%). More than two-thirds (71%) of cancers occurring in children and adolescents are rare cancers compared with less than 20% of cancers diagnosed in patients aged 65 years and older. Among solid tumors, 59% of rare cancers are diagnosed at regional or distant stages compared with 45% of common cancers. In part because of this stage distribution, 5-year relative survival is poorer for patients with a rare cancer compared with those diagnosed with a common cancer among both males (55% vs 75%) and females (60% vs 74%). However, 5-year relative survival is substantially higher for children and adolescents diagnosed with a rare cancer (82%) than for adults (46% for ages 65-79 years). Continued efforts are needed to develop interventions for prevention, early detection, and treatment to reduce the burden of rare cancers. Such discoveries can often advance knowledge for all cancers. CA Cancer J Clin 2017. © 2017 American Cancer Society. CA Cancer J Clin 2017;67:261-272. © 2017 American Cancer Society.

摘要

美国罕见癌症负担的相关数据有限。通过使用北美癌症登记协会和监测、流行病学和最终结果计划的数据,作者提供了美国 100 多种罕见癌症(定义为每年每 10 万人少于 6 例)的发病率、诊断时的分期和生存率信息。总体而言,约 20%的美国癌症患者被诊断为罕见癌症。与非西班牙裔黑人和非西班牙裔白人(分别为 20%和 19%)相比,西班牙裔(24%)和亚洲/太平洋岛民(22%)患者诊断出的癌症中,罕见癌症占更大比例。与 65 岁及以上患者诊断出的癌症相比,超过三分之二(71%)的儿童和青少年癌症为罕见癌症。在实体肿瘤中,59%的罕见癌症被诊断为局部或远处阶段,而 45%的常见癌症被诊断为局部或远处阶段。部分由于这种分期分布,男性(55%比 75%)和女性(60%比 74%)罕见癌症患者的 5 年相对生存率比常见癌症患者差。然而,与成年人(65-79 岁为 46%)相比,罕见癌症患者(儿童和青少年为 82%)的 5 年相对生存率显著更高。需要继续努力制定预防、早期发现和治疗干预措施,以减轻罕见癌症的负担。这些发现通常可以为所有癌症的研究提供更深入的了解。CA 癌症临床杂志 2017;67:261-272。CA 癌症临床杂志 2017;67:261-272。

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