School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK.
Department of Colorectal Surgery, University Hospitals Bristol, Bristol Royal Infirmary, Bristol, UK.
Br J Surg. 2020 Apr;107(5):595-605. doi: 10.1002/bjs.11486. Epub 2020 Mar 9.
Evidence is emerging that the incidence of colorectal cancer is increasing in young adults, but the descriptive epidemiology required to better understand these trends is currently lacking.
A population-based cohort study was carried out including all adults aged 20-49 years diagnosed with colorectal cancer in England between 1974 and 2015. Data were extracted from the National Cancer Registration and Analysis Service database using ICD-9/10 codes for colorectal cancer. Temporal trends in age-specific incidence rates according to sex, anatomical subsite, index of multiple deprivation quintile and geographical region were analysed using Joinpoint regression.
A total of 56 134 new diagnoses of colorectal cancer were analysed. The most sustained increase in incidence rate was in the group aged 20-29 years, which was mainly driven by a rise in distal tumours. The magnitude of incident rate increases was similar in both sexes and across Index of Multiple Deprivation quintiles, although the most pronounced increases in incidence occurred in the southern regions of England.
Colorectal cancer should no longer be considered a disease of older people. Changes in incidence rates should be used to inform future screening policy, preventative strategies and research agendas, as well as increasing public understanding that younger people need to be aware of the symptoms of colorectal cancer.
越来越多的证据表明，结直肠癌在年轻人中的发病率正在上升，但目前缺乏更好地了解这些趋势所需的描述性流行病学资料。
本研究开展了一项基于人群的队列研究，纳入了 1974 年至 2015 年间在英格兰被诊断为结直肠癌的所有 20-49 岁成年人。数据通过 ICD-9/10 代码从国家癌症登记和分析服务数据库中提取。使用 Joinpoint 回归分析了按性别、解剖亚部位、多重剥夺五分位数指数和地理区域划分的特定年龄组发病率的时间趋势。
共分析了 56134 例新诊断的结直肠癌。发病率最持续上升的是 20-29 岁年龄组，这主要是由远端肿瘤的上升驱动的。在男性和多重剥夺五分位数指数中，发病率增加的幅度相似，但发病率的增加最明显发生在英格兰南部地区。
结直肠癌不应再被视为老年人的疾病。发病率的变化应被用于为未来的筛查政策、预防策略和研究议程提供信息，以及提高公众对年轻人需要了解结直肠癌症状的认识。
