Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Department of Pharmacy, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Cancer Epidemiol. 2022 Jun;78:102144. doi: 10.1016/j.canep.2022.102144. Epub 2022 Mar 23.
Previous studies have not examined young adult cancer incidence trends in Taiwan, or comprehensively compared these trends at two nations with different population genetics, environmental exposures, and health care. Therefore, we compared the incidence rates and trends of the most common young adult cancers diagnosed at 20-39 years of age in Taiwan and the U.S.
Incidence rates from 2002 to 2016 were calculated from the Taiwan National Health Insurance Research Datasets and the U.S. Surveillance, Epidemiology, and End Results Program. For trend assessment, average annual percent change (AAPC) values were calculated from 15 years of data using Joinpoint Regression Program. We also obtained sex or age of diagnosis stratified estimates.
The age-standardized overall young adult cancer incidence rate significantly increased from 2002 to 2016 in both Taiwan (AAPC=1.1%, 95% CI: 0.8-1.5%) and the U.S. (AAPC=1.8%, 95% CI: 1.1-2.4%). Cancers with significantly decreasing trends in Taiwan included cancers of the nasopharynx, liver, and tongue, which were not among the most common young adult cancers in the U.S. Cancers with significantly increasing trends in both Taiwan and the U.S. included colorectal, thyroid, and female breast cancers. Lymphoma, ovarian cancer, and lung and bronchus cancer had significantly increasing trends in Taiwan but not in the U.S. Although cervical cancer had significantly decreasing trends in both nations among those 30-39 years of age, its trend was significantly increasing in Taiwan but decreasing in the U.S. among those 20-29 years of age.
The types of common young adult cancers as well as their incidence rates and trends differed in Taiwan and the U.S. Future studies should further understand the etiological factors driving these trends.
之前的研究并未考察台湾地区青年癌症的发病率趋势，也未全面比较两个具有不同人口遗传学、环境暴露和医疗保健的国家的这些趋势。因此，我们比较了台湾和美国 20-39 岁年龄组最常见的青年癌症的发病率和趋势。
发病率数据来自 2002 年至 2016 年的台湾全民健康保险研究数据集和美国监测、流行病学和最终结果计划。为了评估趋势，使用 Joinpoint 回归程序从 15 年的数据中计算了平均年百分变化（AAPC）值。我们还获得了按性别或诊断年龄分层的估计值。
在台湾和美国，年龄标准化的青年癌症整体发病率从 2002 年到 2016 年均显著增加（台湾 AAPC=1.1%，95%CI：0.8-1.5%；美国 AAPC=1.8%，95%CI：1.1-2.4%）。在台湾，发病率呈显著下降趋势的癌症包括鼻咽癌、肝癌和舌癌，这些癌症并非美国青年癌症中最常见的癌症。在台湾和美国，发病率呈显著上升趋势的癌症包括结直肠癌、甲状腺癌和女性乳腺癌。在台湾，淋巴瘤、卵巢癌、肺癌和支气管癌的发病率呈显著上升趋势，但在美国并非如此。虽然宫颈癌在台湾和美国 30-39 岁年龄组的发病率呈显著下降趋势，但在台湾 20-29 岁年龄组的发病率呈显著上升趋势，而在美国的发病率呈下降趋势。
在台湾和美国，常见青年癌症的类型以及发病率和趋势均有所不同。未来的研究应进一步了解导致这些趋势的病因因素。
