Division of Primary Care, Public Health & Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Worsley Building, Clarendon Way, Leeds, LS2 9NL, UK.
Leeds Centre for Personalised Medicine and Health, University of Leeds, Worsley Building, Clarendon Way, Leeds, LS2 9NL, UK.
Br J Cancer. 2022 Jun;126(10):1374-1386. doi: 10.1038/s41416-022-01704-x. Epub 2022 Feb 7.
Many cancer referral guidelines use patient's age as a key criterium to decide who should be referred urgently. A recent rise in the incidence of colorectal cancer in younger adults has been described in high-income countries worldwide. Information on other cancers is more limited. The aim of this rapid review was to determine whether other cancers are also increasing in younger age groups, as this may have important implications for prioritising patients for investigation and referral. We searched MEDLINE, Embase and Web of Science for studies describing age-related incidence trends for colorectal, bladder, lung, oesophagus, pancreas, stomach, breast, ovarian, uterine, kidney and laryngeal cancer and myeloma. 'Younger' patients were defined based on NICE guidelines for cancer referral. Ninety-eight studies met the inclusion criteria. Findings show that the incidence of colorectal, breast, kidney, pancreas, uterine cancer is increasing in younger age groups, whilst the incidence of lung, laryngeal and bladder cancer is decreasing. Data for oesophageal, stomach, ovarian cancer and myeloma were inconclusive. Overall, this review provides evidence that some cancers are increasingly being diagnosed in younger age groups, although the mechanisms remain unclear. Cancer investigation and referral guidelines may need updating in light of these trends.
许多癌症转诊指南将患者的年龄作为决定哪些患者应紧急转诊的关键标准。全球高收入国家描述了年轻成年人中结直肠癌发病率的近期上升。关于其他癌症的信息则更为有限。本次快速审查的目的是确定其他癌症是否也在年轻人群中增加，因为这可能对优先考虑患者进行检查和转诊具有重要意义。我们在 MEDLINE、Embase 和 Web of Science 中搜索了描述结直肠癌、膀胱癌、肺癌、食管癌、胰腺癌、胃癌、乳腺癌、卵巢癌、子宫癌、肾癌和喉癌以及骨髓瘤的与年龄相关的发病趋势的研究。“年轻”患者的定义基于 NICE 癌症转诊指南。有 98 项研究符合纳入标准。研究结果表明，结直肠癌、乳腺癌、肾癌、胰腺癌和子宫癌的发病率在年轻人群中呈上升趋势，而肺癌、喉癌和膀胱癌的发病率则呈下降趋势。食管癌、胃癌、卵巢癌和骨髓瘤的数据尚无定论。总的来说，本综述提供了一些癌症在年轻人群中越来越多地被诊断出的证据，尽管其机制尚不清楚。鉴于这些趋势，癌症检查和转诊指南可能需要更新。
