Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Cancer Epidemiol Biomarkers Prev. 2023 Jun 1;32(6):834-839. doi: 10.1158/1055-9965.EPI-22-1354.
Young adult cancer incidence has been increasing in Taiwan, but no studies have examined their survival trends.
We analyzed data from the Taiwan National Health Insurance Research Database and the U.S. Surveillance, Epidemiology, and End Results Program. We obtained the five-year survival estimates and trends for primary invasive cancers diagnosed at 20-39 years of age from 2002 to 2014. When analyzing specific cancers, we focused on the common young adult cancers in Taiwan. For the trend analysis, the average annual percent change (AAPC) was calculated using joinpoint Regression Program. We also obtained estimates stratified by sex or age at cancer diagnosis.
The five-year age-standardized relative survival for all young adult cancers combined significantly increased in Taiwan [AAPC = 1.4%; 95% confidence interval (CI), 1.3%-1.5%] and the United States (AAPC = 0.4%; 95% CI, 0.3%-0.6%). Cancers occurring in both sexes had similar trend directions for both sexes. Lung and bronchus cancer, liver cancer, and leukemia had the most survival improvement in both regions. However, the five-year relative survival for cervical cancer declined in Taiwan (AAPC = -0.6%; 95% CI, -1.0% to -0.1%) and did not improve in the United States (AAPC = -0.1%; 95% CI, -0.4%-0.2%).
Survival has improved for most but not all of the common young adult cancer types in Taiwan. Additional studies can understand why survival has not improved for certain cancer types, and examine subtype-specific survival trends.
This is the first study of five-year survival trends for young adult cancers in Taiwan and the United States stratified by sex or age at diagnosis.
台湾地区青年癌症发病率呈上升趋势，但目前尚无研究对其生存趋势进行分析。
我们分析了来自台湾全民健康保险研究数据库和美国监测、流行病学和最终结果计划的数据。我们获得了 2002 年至 2014 年期间 20-39 岁诊断出的原发性浸润性癌症的 5 年生存率估计值和趋势。在分析特定癌症时，我们重点关注台湾常见的青年癌症。对于趋势分析，使用 joinpoint Regression Program 计算平均年度百分比变化（AAPC）。我们还按性别或癌症诊断时的年龄进行分层，获得估计值。
所有青年癌症的 5 年年龄标准化相对生存率在台湾[AAPC=1.4%（95%置信区间，1.3%-1.5%）]和美国[AAPC=0.4%（95%置信区间，0.3%-0.6%）]均显著提高。两性发生的癌症在两性中具有相似的趋势方向。肺癌、肝癌和白血病在两个地区的生存改善最大。然而，台湾的宫颈癌 5 年相对生存率下降（AAPC=-0.6%（95%置信区间，-1.0%至-0.1%）），而美国没有改善（AAPC=-0.1%（95%置信区间，-0.4%-0.2%））。
在台湾，大多数但不是所有常见青年癌症类型的生存率都有所提高。进一步的研究可以了解为什么某些癌症类型的生存率没有提高，并检查亚型特异性的生存趋势。
这是第一项对台湾和美国青年癌症的 5 年生存率趋势进行的研究，按性别或诊断时的年龄进行分层。
