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结直肠癌流行病学的简要更新。

Concise update on colorectal cancer epidemiology.

作者信息

Mattiuzzi Camilla, Sanchis-Gomar Fabian, Lippi Giuseppe

机构信息

Service of Clinical Governance, Provincial Agency for Social and Sanitary Services, Trento, Italy.

Department of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Valencia, Spain.

出版信息

Ann Transl Med. 2019 Nov;7(21):609. doi: 10.21037/atm.2019.07.91.

Abstract

Colorectal cancer is a type of gastrointestinal malignancy originating from either the colon or rectum. In this short report we provide a concise update on recent colorectal cancer statistics, especially concerning frequency, mortality, life expectancy and risk factors. Overall, colorectal cancer is the third more frequent malignant disease around the world (1.85 million of new cases/years; 10.2% of total malignancies), with 2.27% cumulative risk of onset between 0-74 years. The age-standardized rate increases by over 10-fold before the age of 50 up to ≥85 years, whilst men have ~50% enhanced risk compared to women (the 0-74 years risk is 2.75% in men and 1.83% in women, respectively). Although colorectal cancer screening has contributed to slightly reduce the number of diagnoses at advanced stages, most cases are only identified after symptoms onset. The number of worldwide deaths for colorectal cancer has been estimated at 0.88 million in 2018, representing ~1.4% of all-cause and ~8.9% of cancer-related deaths, with over 30% increase occurred during the past 15 years and a further 25% growth expected by the year 2030. The cumulative risk of dying for colorectal cancer is 0.92% between 0-74 years (1.14% in men and 0.72% in women, respectively). The 5-year cumulative survival is 64-67%, being 89-90% in patients with localized cancer, 70-71% in those with regional cancer, decreasing to 14-15% in those with distant cancer. The leading risk factors include familial history, pre-cancerous conditions, tall stature, physical inactivity, overweight, large intake of alcoholic beverages, high consumption of red or processed meat, as well as modest intake of dairy products and foods containing wholegrains or dietary fibre. The association between colorectal cancer and human development index suggests that reinforcement or timely establishment of preventive measures and accurate screening programs may be advisable, especially in countries undergoing considerable societal and economic changes.

摘要

结直肠癌是一种起源于结肠或直肠的胃肠道恶性肿瘤。在本简短报告中,我们简要介绍了近期结直肠癌的统计数据,特别是关于发病率、死亡率、预期寿命和风险因素。总体而言,结直肠癌是全球第三大常见恶性疾病(每年新增病例185万;占所有恶性肿瘤的10.2%),0至74岁人群的累积发病风险为2.27%。年龄标准化发病率在50岁之前至85岁及以上增加了10倍以上,男性的风险比女性高约50%(0至74岁男性的风险为2.75%,女性为1.83%)。尽管结直肠癌筛查有助于略微减少晚期诊断的数量,但大多数病例在出现症状后才被发现。2018年全球结直肠癌死亡人数估计为88万,占所有死因的约1.4%,占癌症相关死亡的约8.9%,在过去15年中增加了30%以上,预计到2030年还将进一步增长25%。0至74岁人群因结直肠癌死亡的累积风险为0.92%(男性为1.14%,女性为0.72%).5年累积生存率为64%至67%,局限性癌症患者为89%至90%,区域性癌症患者为70%至71%,远处癌症患者则降至14%至15%。主要风险因素包括家族病史、癌前病变、身材高大、缺乏身体活动、超重、大量饮用酒精饮料、大量食用红肉或加工肉类,以及适度摄入乳制品和含有全谷物或膳食纤维的食物。结直肠癌与人类发展指数之间的关联表明,加强或及时建立预防措施和准确的筛查项目可能是可取的,特别是在经历重大社会和经济变革的国家。

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