The Department of Surgery, Colorectal Cancer Center South, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark; The Danish HNPCC Register, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; The Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
The Department of Surgery, Colorectal Cancer Center South, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark; The Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; The Danish Colorectal Cancer Group (DCCG), Copenhagen, Denmark.
Cancer Epidemiol. 2020 Jun;66:101704. doi: 10.1016/j.canep.2020.101704. Epub 2020 Mar 29.
The incidence of early-onset colorectal cancer (eoCRC) has been reported to increase, and patients with eoCRC seem to be diagnosed at more advanced stages compared to elderly patients. The aim of this study was to describe patient and disease characteristics, symptomatology and the incidence of eoCRC in a national cohort.
521 eoCRC patients (≤40 years old) diagnosed with histologically verified colorectal cancer (CRC) during the years 2001-2013 were identified in national databases and compared to more than 15,000 CRC patients aged 66-75 years. Age-adjusted incidence was calculated for eoCRC patients and various sub-analyses were performed.
More advanced stages were seen in eoCRC patients compared to elderly patients (stage II: p < 0.001, III: p = 0.01 and IV: p < 0.01). Differences were statistically significant in colon cancer, but not in rectal cancer. A significant difference in sex distribution was seen between right and left-sided tumors in the eoCRC group. The age-adjusted incidence rate increased during the study period (1.60-2.55 per 100.000), and significant annual percent changes (APC) were seen in young females (APC = 4.73) and left-sided tumor localization (including rectal cancer) (APC = 4.54), respectively.
In this nationwide cohort of eoCRC patients, our results confirm that young patients are diagnosed at advanced stages, and that the incidence of eoCRC is increasing.
早发性结直肠癌（eoCRC）的发病率有所增加，与老年患者相比，eoCRC 患者似乎被诊断为更晚期。本研究旨在描述全国队列中患者和疾病特征、症状和 eoCRC 的发病率。
在全国数据库中，确定了 521 名在 2001-2013 年期间经组织学证实的结直肠癌（CRC）诊断为 eoCRC 的患者，并与 15000 多名年龄在 66-75 岁的 CRC 患者进行了比较。计算了 eoCRC 患者的年龄调整发病率，并进行了各种亚分析。
与老年患者相比，eoCRC 患者的分期更晚（II 期：p < 0.001，III 期：p = 0.01，IV 期：p < 0.01）。这种差异在结肠癌中具有统计学意义，但在直肠癌中没有。在 eoCRC 组中，左右侧肿瘤的性别分布存在显著差异。研究期间，年龄调整发病率呈上升趋势（1.60-2.55/每 10 万），年轻女性（APC = 4.73）和左侧肿瘤定位（包括直肠癌）（APC = 4.54）的年平均百分比变化（APC）显著。
在本全国 eoCRC 患者队列中，我们的结果证实，年轻患者被诊断为晚期，eoCRC 的发病率正在增加。
