Memorial Sloan Kettering Cancer Center, Department of Medicine, New York, NY.
J Clin Oncol. 2022 Aug 20;40(24):2662-2680. doi: 10.1200/JCO.21.02708. Epub 2022 Jul 15.
The incidence of early-onset (EO) GI cancers occurring in individuals younger than age 50 years has been rising at an alarming rate over the past two decades. Although this rise in incidence among young patients correlates with increased rates of obesity, changes in diet, and alterations in the environment, the effects of these environmental factors on carcinogenesis, metastasis, and treatment response are unknown. Although several unique clinical trends exist among EO-GI cancers and their average-onset GI cancer counterparts, GI cancers are molecularly indistinct between younger and older patients, and no data support distinct treatment paradigms for patients with EO disease. The majority of EO-GI cancers are not explained by germline changes. There remains a critical need for further research to understand the pathogenesis and optimal management of EO-GI cancers. In addition, current screening strategies are not adequate to identify EO-GI cancers, and early biomarkers are needed. Specialized centers, with a focus on psychosocial aspects of cancer management, can address the unique care needs of patients with EO-GI cancers.
在过去的二十年中，50 岁以下人群中早发性（EO）胃肠道癌症的发病率呈惊人的速度上升。尽管年轻患者发病率的上升与肥胖率的增加、饮食变化和环境改变有关，但这些环境因素对致癌作用、转移和治疗反应的影响尚不清楚。尽管 EO-GI 癌症及其平均发病 GI 癌症的患者存在一些独特的临床趋势，但年轻和老年患者的胃肠道癌症在分子上没有区别，也没有数据支持 EO 疾病患者的不同治疗方案。大多数 EO-GI 癌症不能用种系变化来解释。进一步研究以了解 EO-GI 癌症的发病机制和最佳管理仍然是至关重要的。此外，目前的筛查策略不足以发现 EO-GI 癌症，需要早期生物标志物。专注于癌症管理的社会心理方面的专业中心可以满足 EO-GI 癌症患者的独特护理需求。
