Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, 510060, China.
Int J Colorectal Dis. 2023 Feb 16;38(1):45. doi: 10.1007/s00384-023-04336-6.
Identifying the onset age of cancer is essential for its early intervention. The aim of this study was to characterize the features and investigate the variation tendency of first primary colorectal cancer (CRC) onset age in the USA.
For this retrospective population-based cohort analysis, data on patients diagnosed with first primary CRC (n = 330,977) between 1992 and 2017 were obtained from the Surveillance, Epidemiology, and End Results dataset. Annual percent changes (APC) and average APCs were calculated to examine the changes in average age at CRC diagnosis using the Joinpoint Regression Program.
From 1992 to 2017, the average age at CRC diagnosis decreased from 67.0 to 61.2 years, declining by 0.22% and 0.45% annually before and after 2000. The age at diagnosis was lower in the distal than in the proximal CRC cases and the age has the downward trends in all subgroups of sex, race, and stage. Over one-fifth of CRC patients were initially diagnosed with distantly metastatic CRC, with the age lower than that in localized CRC cases (63.5 vs 64.8 years).
The first primary CRC onset age has decreased significantly in the USA over the last 25 years and the modern lifestyle may be responsible for the decline. Specifically, the age of proximal CRC is invariably higher than that of distal CRC. Moreover, the age of advanced stage is lower than that of the early stage. Clinicians should adopt earlier screening age and more effective screening techniques for CRC.
确定癌症的发病年龄对于早期干预至关重要。本研究旨在描述美国首次原发性结直肠癌（CRC）发病年龄的特征，并探讨其变化趋势。
本回顾性基于人群的队列分析从监测、流行病学和最终结果数据库中获取了 1992 年至 2017 年间诊断为首次原发性 CRC（n=330977）的患者数据。使用 Joinpoint 回归程序计算每年的百分比变化（APC）和平均 APC，以检查 CRC 诊断平均年龄的变化。
从 1992 年到 2017 年，CRC 诊断的平均年龄从 67.0 岁降至 61.2 岁，2000 年前每年下降 0.22%，2000 年后每年下降 0.45%。远端 CRC 的诊断年龄低于近端 CRC，并且在所有性别、种族和分期亚组中，年龄均呈下降趋势。超过五分之一的 CRC 患者最初被诊断为远处转移性 CRC，其年龄低于局限性 CRC（63.5 岁 vs 64.8 岁）。
在过去的 25 年中，美国首次原发性 CRC 的发病年龄显著下降，现代生活方式可能是导致这种下降的原因。具体来说，近端 CRC 的年龄普遍高于远端 CRC。此外，晚期的年龄低于早期。临床医生应采用更早的 CRC 筛查年龄和更有效的筛查技术。
