Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, T6G 1Z2, Canada.
Future Oncol. 2022 Jan;18(1):47-54. doi: 10.2217/fon-2021-0592. Epub 2021 Nov 12.
To review the patterns of early-onset (<50 years old) colorectal cancer (CRC) in Alberta across the past 15 years among different socioeconomic and demographic patient subgroups. This is a retrospective, population-based study based on Alberta administrative databases. Income level was identified via income information from the 2006 Canadian census. Patients with colorectal adenocarcinoma diagnosed 2004-2018 were included. Frequency analyses were used to examine the percentage of early-onset CRC cases among different subgroups over the period studied. Multivariable logistic regression analysis was used to examine factors associated with the development of early-onset CRC. A total of 24,912 patients were included, of whom 2096 (8.4%) were diagnosed at age <50 years and 22,816 (91.6%) at age ≥50 years. The percentage of patients diagnosed at age <50 years increased over time (10.2% in 2018 vs 7.9% in 2004; p < 0.003). Higher income was associated with younger age at diagnosis of CRC (odds ratio [OR] for quartile 1 vs quartile 4: 0.54; 95% CI: 0.47-0.62). Other factors associated with younger age at diagnosis included female sex (OR for male vs female: 0.85; 95% CI: 0.78-0.94), distal CRC (OR: 1.66; 95% CI: 1.50-1.84) and North zone (OR for South zone vs North zone: 0.74; 95% CI: 0.60-0.92). The proportion of patients (out of the overall CRC population) with early-onset CRC, increased in Alberta throughout the study duration (particularly left-sided CRC). There is a need to reassess the current age limits for CRC screening in Canada in view of these findings.
回顾过去 15 年艾伯塔省（Alberta）不同社会经济和人口统计学亚组中 50 岁以下（<50 岁）结直肠癌（CRC）的发病模式。这是一项基于艾伯塔省行政数据库的回顾性、基于人群的研究。收入水平通过 2006 年加拿大人口普查的收入信息确定。纳入 2004-2018 年诊断为结直肠腺癌的患者。频率分析用于检查研究期间不同亚组中早发性 CRC 病例的百分比。多变量逻辑回归分析用于检查与早发性 CRC 发生相关的因素。共纳入 24912 例患者，其中 2096 例（8.4%）在<50 岁时诊断，22816 例（91.6%）在≥50 岁时诊断。<50 岁诊断的患者比例随时间增加（2018 年为 10.2%，2004 年为 7.9%；p<0.003）。较高的收入与 CRC 诊断时的年龄较小相关（四分位 1 与四分位 4 的比值比 [OR]：0.54；95%CI：0.47-0.62）。与诊断时年龄较小相关的其他因素包括女性（男性与女性的 OR：0.85；95%CI：0.78-0.94）、远端 CRC（OR：1.66；95%CI：1.50-1.84）和北部区域（南部区域与北部区域的比值比 [OR]：0.74；95%CI：0.60-0.92）。在研究期间，艾伯塔省（Alberta）总体 CRC 人群中早发性 CRC 的比例（特别是左侧 CRC）增加。鉴于这些发现，有必要重新评估加拿大目前的 CRC 筛查年龄限制。
