Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.
Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada.
J Natl Cancer Inst. 2021 Jul 1;113(7):863-868. doi: 10.1093/jnci/djaa220.
With recent evidence for the increasing risk of young-onset colorectal cancer (yCRC), we had the objective to evaluate the incidence of yCRC in 1-year age increments, particularly focusing around the screening age of 50 years.
We conducted a longitudinal study using linked administrative health databases in British Columbia, Canada, including a provincial cancer registry, inpatient and outpatient visits, and vital statistics from January 1, 1986, to December 31, 2016. We calculated incidence rates per 100 000 at every age from 20 to 60 years and estimated annual percent change in incidence (APCi) of yCRC using joinpoint regression analysis.
We identified 3614 individuals with yCRC (49.9% women). The incidence of CRC steadily increased from 20 to 60 years, with a marked increase from 49 to 50 years (incidence rate ratio = 1.19, 95% confidence interval [CI] = 1.04 to 1.34). Furthermore, there was a trend of increased incidence of yCRC among women (APCi = 0.79%, 95% CI = 0.22% to 1.36%) and men (APCi = 2.17%, 95% CI = 1.59% to 2.76%). Analyses stratified by age yielded APCis of 2.49% (95% CI = 1.36% to 3.63%) and 0.12% (95% CI = -0.54% to 0.79%) for women aged 30-39 years and 40-49 years, respectively, and 2.97% (95% CI = 1.65% to 4.31%) and 1.86% (95% CI = 1.19% to 2.53%) for men.
Our findings indicate a steady increase over 1-year age increments in the risk of yCRC during the years approaching and beyond screening age. These findings highlight the need to raise awareness as well as continue discussions regarding considerations of lowering the screening age.
最近有证据表明，年轻人患结直肠癌（yCRC）的风险增加，因此我们的目标是评估每增加 1 岁时 yCRC 的发病率，尤其关注 50 岁的筛查年龄。
我们在加拿大不列颠哥伦比亚省进行了一项纵向研究，使用了链接的行政健康数据库，包括省级癌症登记处、住院和门诊就诊以及 1986 年 1 月 1 日至 2016 年 12 月 31 日的人口统计数据。我们计算了 20 至 60 岁每个年龄段每 100000 人中的发病率，并使用 joinpoint 回归分析估计 yCRC 的年度百分比变化（APC）。
我们确定了 3614 例 yCRC 患者（49.9%为女性）。CRC 的发病率从 20 岁到 60 岁稳步上升，从 49 岁到 50 岁明显上升（发病率比=1.19，95%置信区间[CI]为 1.04 至 1.34）。此外，女性（APC=0.79%，95%CI=0.22%至 1.36%）和男性（APC=2.17%，95%CI=1.59%至 2.76%）中 yCRC 的发病率呈上升趋势。按年龄分层的分析显示，30-39 岁和 40-49 岁的女性 APC 分别为 2.49%（95%CI=1.36%至 3.63%）和 0.12%（95%CI=-0.54%至 0.79%），男性分别为 2.97%（95%CI=1.65%至 4.31%）和 1.86%（95%CI=1.19%至 2.53%）。
我们的研究结果表明，在接近和超过筛查年龄的年份中，yCRC 的发病风险每增加 1 岁就会稳步上升。这些发现强调需要提高认识，并继续讨论是否需要降低筛查年龄。
