Oregon Health and Science Center, Portland, Oregon.
McGovern Medical School, University of Texas, Houston, Texas.
Cancer. 2020 Jan 1;126(1):46-57. doi: 10.1002/cncr.32498. Epub 2019 Sep 25.
Recent observations suggest that prostate cancer is an increasing disease among older adolescents and young adults.
Incidence, mortality, and survival data were obtained from the US National Cancer Institute Surveillance, Epidemiology, and End Results program and the Institute for Health Metrics and Evaluation Global Burden of Disease database.
Worldwide, the incidence of prostate cancer has increased in all groups between ages 15 and 40 years and increased globally at a steady rate averaging 2% per year since 1990 (P < .01). In the United States, this age group was >6 times more likely than older men to have distant disease at diagnosis. Stage for stage, their survival rate improved less than in older men. Whereas the overall 5-year relative survival rate in the United States for men diagnosed between ages 40 and 80 years was between 95% and 100%, it was 30% in those aged 15 to 24 years, 50% in those aged 20 to 29 years, and 80% in those aged 25 to 34 years.
Prostate cancer in older adolescent and young adult men has increased in most countries. There is some evidence that this may be caused in part by underdiagnosis, prostate-specific antigen screening, and overdiagnosis. It also may be caused by trends in obesity, physical inactivity, HPV infection, substance exposure, environmental carcinogens, and/or referral patterns. How the biology of these cancers differs from that in older men and how the etiologies vary from country to country remain to be determined.
最近的观察结果表明，前列腺癌在老年青少年和年轻成年人中发病率不断上升。
发病率、死亡率和生存率数据来自美国国家癌症研究所监测、流行病学和最终结果计划以及国际健康计量与评估研究所全球疾病负担数据库。
全球范围内，15 岁至 40 岁人群中前列腺癌的发病率在所有人群中均有所上升，自 1990 年以来以每年 2%的稳定速度在全球范围内上升（P<.01）。在美国，这个年龄段的人被诊断出患有远处疾病的可能性是老年男性的 6 倍以上。分期相同，他们的生存率改善不及老年男性。在美国，诊断年龄在 40 岁至 80 岁之间的男性的 5 年相对生存率总体在 95%至 100%之间，而 15 岁至 24 岁的男性为 30%，20 岁至 29 岁的男性为 50%，25 岁至 34 岁的男性为 80%。
在大多数国家，老年青少年和年轻成年男性的前列腺癌发病率有所增加。有证据表明，这可能部分归因于漏诊、前列腺特异性抗原筛查和过度诊断。肥胖、缺乏运动、HPV 感染、物质暴露、环境致癌物和/或转诊模式的趋势也可能是导致这种情况的原因。这些癌症的生物学特征与老年男性有何不同，以及其病因在不同国家有何差异，仍有待确定。
