青年结直肠癌的流行病学趋势：一项全球性系统评价。

Trends in the epidemiology of young-onset colorectal cancer: a worldwide systematic review.

机构信息

Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC Canada, V6T 1Z3, Canada.

Collaboration for Outcomes Research and Evaluation, 2405 Wesbrook Mall, Vancouver, BC Canada, V6T 1Z3, Canada.

出版信息

BMC Cancer. 2020 Apr 6;20(1):288. doi: 10.1186/s12885-020-06766-9.

DOI:10.1186/s12885-020-06766-9

PMID:32252672

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7137305/

Abstract

BACKGROUND

Recent data suggest that the risk of young-onset colorectal cancer (yCRC), in adults less than 50 years of age, is increasing. To confirm findings and identify contemporary trends worldwide, we conducted a systematic review of studies examining population-level trends in yCRC epidemiology.

METHODS

We searched MEDLINE (1946-2018), EMBASE (1974-2018), CINAHL (1982-2018), and Cochrane Database of Systematic Reviews (2005-2018) for studies that used an epidemiologic design, assessed trends in yCRC incidence or prevalence, and published in English. Extracted information included country, age cut-off for yCRC, and reported trends in incidence or prevalence (e.g. annual percent change [APC]). We pooled similarly reported trend estimates using random effects models.

RESULTS

Our search yielded 8695 articles and after applying our inclusion criteria, we identified 40 studies from 12 countries across five continents. One study assessed yCRC prevalence trends reporting an APCp of + 2.6 and + 1.8 among 20-39 and 40-49 year olds, respectively. 39 studies assessed trends in yCRC incidence but with substantial variability in reporting. Meta-analysis of the most commonly reported trend estimate yielded a pooled overall APCi of + 1.33 (95% CI, 0.97 to 1.68; p < 0.0001) that is largely driven by findings from North America and Australia. Also contributing to these trends is the increasing risk of rectal cancer as among 14 studies assessing cancer site, nine showed an increased risk of rectal cancer in adults less than 50 years with APCi up to + 4.03 (p < 0.001).

CONCLUSIONS

Our systematic review highlights increasing yCRC risk in North America and Australia driven by rising rectal cancers in younger adults over the past two decades.

摘要

背景

最近的数据表明，50 岁以下成年人的早发性结直肠癌（yCRC）风险正在增加。为了证实这一发现并确定全球范围内的当代趋势，我们对研究人群中 yCRC 流行病学趋势的研究进行了系统回顾。

方法

我们检索了 MEDLINE（1946-2018 年）、EMBASE（1974-2018 年）、CINAHL（1982-2018 年）和 Cochrane 系统评价数据库（2005-2018 年），以获取使用流行病学设计、评估 yCRC 发病率或患病率趋势且以英文发表的研究。提取的信息包括国家、yCRC 的年龄截止值以及报告的发病率或患病率趋势（例如，年百分比变化[APC]）。我们使用随机效应模型汇总了类似报告的趋势估计值。

结果

我们的搜索共产生了 8695 篇文章，在应用纳入标准后，我们从五个大陆的 12 个国家中确定了 40 项研究。一项研究评估了 yCRC 流行率趋势，报告 20-39 岁和 40-49 岁人群的 APCp 分别为+2.6 和+1.8。39 项研究评估了 yCRC 发病率趋势，但报告存在很大差异。最常报告的趋势估计值的荟萃分析得出总体 APCi 为+1.33（95%CI，0.97 至 1.68；p<0.0001），主要由北美和澳大利亚的研究结果驱动。对评估癌症部位的 14 项研究中，有 9 项研究表明，在过去二十年中，50 岁以下成年人的直肠癌风险增加，直肠癌症 APCi 高达+4.03（p<0.001），这也导致了这些趋势的发生。