Division of Hematology and Oncology, Mayo Clinic, Jacksonville, FL.
Division of Hematology and Oncology, Mayo Clinic, Jacksonville, FL.
Clin Colorectal Cancer. 2019 Mar;18(1):e87-e95. doi: 10.1016/j.clcc.2018.10.002. Epub 2018 Oct 17.
Recent trends have identified increasing number of young individuals with rectal and colon cancers. These individuals, who are younger than 50 years old, in most instances would not meet screening guidelines. We aimed to report the characteristics and trend of the rising proportion of young individuals being diagnosed with rectal and colon cancers at our institutions.
This study included 3381 rectal and colon cancer patients from the Mayo Clinic cancer registry from 1972 to 2017 who were diagnosed with rectal or colon cancer and who were < 50 years old. Patient and cancer characteristics are described. The Cochran-Armitage trend test was used to see if the change in percentage diagnosed at age < 50 years had a significant trend over the years. A linear regression model was fit to estimate the percentage change per year when the trend was approximately linear.
The percentage of patients diagnosed with rectal or colon cancer in different age categories over the years showed a rising trend for individuals aged < 50. Most of these tumors were distal (rectum, left-sided colon, and right-sided colon were 49.8%, 28.8%, and 21.4%, respectively). This was more so for patients < 50 diagnosed with rectal cancer, which showed a linear increase at a rate of 0.26% per year (P < .001).
Our study affirms the rising proportion of colorectal cancers found in young individuals, with a linear ongoing rise of rectal cancers in particular. This may have implications for the current screening recommendations for colorectal cancers, which are already being revised.
最近的趋势表明,越来越多的年轻人患有直肠和结肠癌。这些年龄在 50 岁以下的人,在大多数情况下不符合筛查指南。我们旨在报告在我们的机构中,年轻个体被诊断患有直肠和结肠癌的比例不断上升的特征和趋势。
这项研究纳入了 1972 年至 2017 年期间来自梅奥诊所癌症登记处的 3381 名患有直肠或结肠癌且年龄<50 岁的直肠和结肠癌患者。描述了患者和癌症特征。采用 Cochran-Armitage 趋势检验来观察在<50 岁时诊断出的百分比是否有随年份的显著趋势变化。当趋势大致呈线性时,拟合线性回归模型以估计每年的百分比变化。
多年来,不同年龄组中诊断为直肠或结肠癌的患者比例呈上升趋势,<50 岁的患者比例上升。这些肿瘤大多数位于远端(直肠、左半结肠和右半结肠分别为 49.8%、28.8%和 21.4%)。对于<50 岁被诊断为直肠癌的患者更是如此,其每年以 0.26%的速度线性增加(P<0.001)。
我们的研究证实了年轻个体中发现的结直肠癌比例不断上升,特别是直肠癌呈线性持续上升。这可能对目前已经在修订的结直肠癌筛查建议产生影响。