Swartjes Hidde, Brouwer Nelleke P M, de Nes Lindsey C F, van Erning Felice N, Verhoeven Rob H A, Vissers Pauline A J, de Wilt Johannes H W
Department of Surgery, Radboud university medical center, Nijmegen, the Netherlands.
Department of Pathology, Radboud university medical center, Nijmegen, the Netherlands.
Eur J Cancer. 2022 May;166:134-144. doi: 10.1016/j.ejca.2022.01.029. Epub 2022 Mar 12.
Previous studies showed that the incidence of early-onset colorectal cancer (EO-CRC, diagnosis <50 years) is rising in Western countries. Additionally, young patients present with more advanced disease. Integrated nationwide assessment of epidemiologically and clinically relevant trends would provide more insight into this specific group of patients with CRC. We aimed to provide an analysis of trends in age- and stage-specific incidence, characteristics, treatment and relative survival of patients with EO-CRC in the Netherlands and compare these with 50- to 59-year-old patients.
Data from 1989 to 2018 were retrieved from the Netherlands Cancer Registry. Non-standardised age-specific incidence rates were calculated, and trends were assessed using Joinpoint regression. Treatment and 5-year relative survival trends were provided and compared between EO-CRC and 50- to 59-year-old patients.
The EO-CRC incidence annually increased with 0.7-2.1% over the last decades. CRC incidence for the 50- to 59-year-old population annually increased with 0.8-1.7% until 2006 and showed a major increase in incidence after the introduction of nationwide screening in 2014. Stage III and Stage IV CRC primarily increased across the studied age groups, while Stage I and Stage II CRC did not. Patients with EO-CRC received multimodal treatment more often than 50- to 59-year-old patients, but differences were minor. Relative survival increased over time and showed little differences between EO-CRC and 50- to 59-year-old patients.
Only few epidemiological and clinical differences were found between EO-CRC and 50- to 59-year-old patients; hence, the urge for a specific approach of EO-CRC in screening and treatment guidelines might be tempered.
既往研究表明，西方国家早发性结直肠癌（EO-CRC，诊断年龄<50岁）的发病率正在上升。此外，年轻患者的疾病往往更为晚期。对流行病学和临床相关趋势进行全国性综合评估，将有助于更深入地了解这一特定的结直肠癌患者群体。我们旨在分析荷兰EO-CRC患者的年龄和分期特异性发病率、特征、治疗及相对生存率趋势，并将这些与50至59岁的患者进行比较。
从荷兰癌症登记处获取1989年至2018年的数据。计算非标准化的年龄特异性发病率，并使用Joinpoint回归评估趋势。提供EO-CRC患者与50至59岁患者之间的治疗和5年相对生存率趋势，并进行比较。
在过去几十年中，EO-CRC的发病率每年以0.7%-2.1%的速度增长。50至59岁人群的结直肠癌发病率在2006年前每年以0.8%-1.7%的速度增长，在2014年全国性筛查引入后发病率大幅上升。III期和IV期结直肠癌在各研究年龄组中主要呈上升趋势，而I期和II期结直肠癌则不然。与50至59岁的患者相比，EO-CRC患者更常接受多模式治疗，但差异较小。相对生存率随时间增加，EO-CRC患者与50至59岁患者之间差异不大。
在EO-CRC患者与50至59岁患者之间仅发现很少的流行病学和临床差异；因此，在筛查和治疗指南中对EO-CRC采取特定方法的紧迫性可能会有所缓和。
