Department of Radiation Oncology, Penn State Cancer Institute, Hershey, Pennsylvania.
Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania.
JAMA Netw Open. 2020 Dec 1;3(12):e2027738. doi: 10.1001/jamanetworkopen.2020.27738.
Previous studies have demonstrated that adolescents and young adults (AYAs) with cancer are a distinct cancer population; however, research on long-term epidemiological trends and characteristics of cancers in AYAs is lacking.
To characterize the epidemiology of cancer in AYAs aged 15 to 39 years with respect to (1) patient demographic characteristics, (2) frequencies of cancer types, and (3) cancer incidence trends over time.
DESIGN, SETTING, AND PARTICIPANTS: This retrospective, serial cross-sectional, population-based study used registry data from the Surveillance, Epidemiology, and End Results (SEER) database from January 1, 1973, to December 31, 2015 (SEER 9 and SEER 18). The study population was from geographically distinct US regions, chosen to represent the racial and ethnic heterogeneity of the country. Initial analyses were performed from January 1 to August 31, 2019.
Incidence rates and descriptive epidemiological statistics for patients aged 15 to 39 years with invasive cancer.
A total of 497 452 AYAs diagnosed from 1973 to 2015 were included in this study, with 293 848 (59.1%) female and 397 295 (79.9%) White participants. As AYAs aged, an increase in the relative incidence of carcinomas and decrease in the relative incidence of leukemias, lymphomas, germ cell and trophoblastic neoplasms, and neoplasms of the central nervous system occurred. Among the female AYAs, 72 564 (24.7%) were diagnosed with breast carcinoma; 48 865 (16.6%), thyroid carcinoma; and 33 828 (11.5%), cervix and uterus carcinoma. Among the male AYAs, 37 597 (18.5%) were diagnosed with testicular cancer; 20 850 (10.2%), melanoma; and 19 532 (9.6%), non-Hodgkin lymphoma. The rate of cancer in AYAs increased by 29.6% from 1973 to 2015, with a mean annual percentage change (APC) per 100 000 persons of 0.537 (95% CI, 0.426-0.648; P < .001). Kidney carcinoma increased at the greatest rate for both male (APC, 3.572; 95% CI, 3.049-4.097; P < .001) and female (APC, 3.632; 95% CI, 3.105-4.162; P < .001) AYAs.
In this cross-sectional, US population-based study, cancer in AYAs was shown to have a unique epidemiological pattern and is a growing health concern, with many cancer subtypes having increased in incidence from 1973 to 2015. Continued research on AYA cancers is important to understanding and addressing the distinct health concerns of this population.
先前的研究表明，患有癌症的青少年和年轻人（AYAs）是一个独特的癌症群体；然而，关于 AYAs 癌症的长期流行病学趋势和特征的研究还很缺乏。
从（1）患者人口统计学特征、（2）癌症类型的频率和（3）随时间推移的癌症发病率趋势三个方面，描述 15 至 39 岁 AYA 癌症的流行病学特征。
设计、设置和参与者：这项回顾性、系列横断面、基于人群的研究使用了来自监测、流行病学和最终结果（SEER）数据库的数据，时间范围为 1973 年 1 月 1 日至 2015 年 12 月 31 日（SEER9 和 SEER18）。研究人群来自地理位置不同的美国地区，旨在代表该国的种族和民族多样性。最初的分析于 2019 年 1 月 1 日至 8 月 31 日进行。
15 至 39 岁患有浸润性癌症的患者的发病率和描述性流行病学统计数据。
本研究共纳入 1973 年至 2015 年间诊断的 497452 名 AYA，其中 293848 名（59.1%）为女性，397295 名（79.9%）为白人。随着 AYA 的年龄增长，癌的相对发病率增加，白血病、淋巴瘤、生殖细胞和滋养层肿瘤以及中枢神经系统肿瘤的相对发病率下降。在女性 AYA 中，72564 名（24.7%）被诊断为乳腺癌；48865 名（16.6%）为甲状腺癌；33828 名（11.5%）为宫颈癌和子宫癌。在男性 AYA 中，37597 名（18.5%）被诊断为睾丸癌；20850 名（10.2%）为黑色素瘤；19532 名（9.6%）为非霍奇金淋巴瘤。1973 年至 2015 年间，AYA 的癌症发病率增加了 29.6%，每 100000 人平均每年百分比变化（APC）为 0.537（95%CI，0.426-0.648；P<.001）。男性（APC，3.572；95%CI，3.049-4.097；P<.001）和女性（APC，3.632；95%CI，3.105-4.162；P<.001）AYA 的肾癌发病率增长最快。
在这项横断面、基于美国人群的研究中，AYA 的癌症表现出独特的流行病学模式，并且是一个日益严重的健康问题，许多癌症亚型的发病率从 1973 年到 2015 年都有所增加。对 AYA 癌症的持续研究对于了解和解决这一人群的独特健康问题非常重要。
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