Pediatric & Young Adult Oncology, Oregon Health & Science University, Bend, Oregon, USA.
McGovern Medical School, University of Texas, Houston, Texas, USA.
J Adolesc Young Adult Oncol. 2023 Jun;12(3):285-296. doi: 10.1089/jayao.2022.0134. Epub 2023 Apr 19.
This study aimed to identify cancer incidence trends in the United States and globally in adolescents and young adults (AYAs) 15-39 years of age, by sex, and to speculate on causes for trend changes. For the United States, SEER*Stat was used to obtain average annual percent change (AAPC) trends in cancer incidence during the period 2000-2019 among 395,163 AYAs. For global data, the source was the Institute of Health Metrics and Evaluation and its sociodemographic index (SDI) classification system. In the United States, the invasive cancer incidence increased during the period 2000-2019 in both females (AAPC: 1.05, 95% CI: 0.90-1.20, << 0.001) and males (AAPC: 0.56, 95% CI: 0.43-0.69, << 0.001). A total of 25 and 20 types of cancers increased statistically significantly in female and male AYAs, respectively. Among potential causes for the increases, the obesity epidemic in the United States strongly correlates with the overall cancer increase in both its female (Pearson correlation coefficient = 0.88, = 0.0007) and male ( = 0.83, = 0.003) AYAs, as does the most common malignancy in American AYAs, breast cancer ( = 0.83, = 0.003). Worldwide, cancer incidence in the age group increased steadily during the period 2000-2019 among high-middle, middle, and low-middle SDI countries, but not in low SDI countries and with slowing of increase in high SDI countries. The increases and their age-dependent profiles implicate several causations that are preventable, including obesity, overdiagnosis, unnecessary diagnostic radiation, human papilloma virus infection, and cannabis avoidance. The United States is beginning to reverse the increasing incidence, and prevention efforts should be augmented accordingly.
本研究旨在确定美国和全球青少年和青年（AYA）15-39 岁人群癌症发病率的趋势，按性别进行分类，并推测趋势变化的原因。对于美国，使用 SEER*Stat 获取了 2000 年至 2019 年期间 395,163 名 AYA 癌症发病率的平均年百分比变化（AAPC）趋势。对于全球数据，来源是健康计量与评估研究所及其社会人口指数（SDI）分类系统。在美国，2000 年至 2019 年期间，女性（AAPC：1.05，95%CI：0.90-1.20， << 0.001）和男性（AAPC：0.56，95%CI：0.43-0.69， << 0.001）的侵袭性癌症发病率均有所上升。在女性和男性 AYA 中，共有 25 种和 20 种癌症的发病率统计上显著增加。在可能导致发病率上升的原因中，美国的肥胖症流行与女性（皮尔逊相关系数=0.88，=0.0007）和男性（=0.83，=0.003）AYA 人群中所有癌症的总体增加密切相关，也与美国 AYA 中最常见的恶性肿瘤乳腺癌（=0.83，=0.003）密切相关。在全球范围内，2000 年至 2019 年期间，中高、中、低中 SDI 国家的该年龄段癌症发病率稳步上升，但在低 SDI 国家和高 SDI 国家发病率增长放缓。这种增长及其与年龄相关的模式暗示了几种可预防的病因，包括肥胖、过度诊断、不必要的诊断性辐射、人乳头瘤病毒感染和避免大麻。美国正在开始扭转发病率上升的趋势，相应地应加强预防措施。
