Alsakarneh Saqr, Jaber Fouad, Beran Azizullah, Aldiabat Mohammad, Abboud Yazan, Hassan Noor, Abdallah Mohamed, Abdelfattah Thaer, Numan Laith, Clarkston Wendell, Bilal Mohammad, Shaukat Aasma
Department of Internal Medicine, University of Missouri, Kansas City, MO 64110, USA.
Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Cancers (Basel). 2024 Jan 1;16(1):205. doi: 10.3390/cancers16010205.
CRC accounts for approximately a tenth of all cancer cases and deaths in the US. Due to large differences in demographics among the different states, we aim to determine trends in the CRC epidemiology and across different states, age groups, and genders. CRC rates, age-adjusted to the standard US population, were obtained from the GBD 2019 database. Time trends were estimated as annual percentage change (APC). A pairwise comparison was conducted between age- and gender-specific trends using the tests of parallelism and coincidence. Age-specific trends were also assessed in two age subgroups: younger adults aged 15-49 years and older adults aged 50-74 years. We also analyzed the prevalence, incidence, mortality, and DALYs in the US between 1990 and 2019. A total of 5.53 million patients were diagnosed with CRC in the US between 1990 and 2019. Overall, CRC incidence rates have significantly increased in younger adults (11.1 per 100,000 persons) and decreased in older adults (136.8 per 100,000 persons) (AAPC = 1.2 vs. -0.6; AAPC difference = 1.8, < 0.001). Age-specific trends were neither identical ( < 0.001) nor parallel ( < 0.001), suggesting that CRC incidence rates are different and increasing at a greater rate in younger adults compared to older adults. However, for both men and women (49.4 and 35.2 per 100,000 persons), incidence rates have decreased over the past three decades at the same rate (AAPC = -0.5 vs. -0.5; AAPC difference = 0, = 0.1). Geographically, the southern states had the highest mortality rates with Mississippi having the highest rate of 20.1 cases per 100,000 population in 2019. Massachusetts, New York, and the District of Colombia had the greatest decreases in mortality over the study period (-42.1%, -41.4%, and -40.9%). Decreased mortality was found in all states except Mississippi, where the mortality of CRC increased over the study period (+1.5%). This research provides crucial insights for policymakers to tailor resource allocation, emphasizing the dynamic nature of CRC burden across states and age groups, ultimately informing targeted strategies for prevention and intervention.
结直肠癌（CRC）约占美国所有癌症病例和死亡人数的十分之一。由于不同州的人口统计学差异很大，我们旨在确定CRC流行病学在不同州、年龄组和性别的趋势。根据2019年全球疾病负担（GBD）数据库获得了按美国标准人口年龄调整后的CRC发病率。时间趋势以年度百分比变化（APC）进行估计。使用平行性检验和一致性检验对年龄和性别特异性趋势进行两两比较。还在两个年龄亚组中评估了年龄特异性趋势：15至49岁的年轻成年人和50至74岁的年长成年人。我们还分析了1990年至2019年美国的患病率、发病率、死亡率和伤残调整生命年（DALYs）。1990年至2019年期间，美国共有553万患者被诊断患有CRC。总体而言，年轻成年人的CRC发病率显著上升（每10万人中有11.1例），而年长成年人的发病率下降（每10万人中有136.8例）（年度百分比变化率[AAPC]=1.2对-0.6；AAPC差异=1.8，P<0.001）。年龄特异性趋势既不相同（P<0.001）也不平行（P<0.001），这表明CRC发病率不同，且年轻成年人的发病率增长速度高于年长成年人。然而，过去三十年中，男性和女性的发病率均以相同速度下降（每10万人中有49.4例和35.2例）（AAPC=-0.5对-0.5；AAPC差异=0，P=0.1）。在地理上，南部各州的死亡率最高，2019年密西西比州的死亡率最高，为每10万人口中有20.1例。在研究期间，马萨诸塞州、纽约州和哥伦比亚特区的死亡率下降幅度最大（分别为-42.1%、-41.4%和-40.9%）。除密西西比州外，所有州的死亡率均有所下降，在研究期间，密西西比州的CRC死亡率有所上升（+1.5%）。这项研究为政策制定者调整资源分配提供了关键见解，强调了CRC负担在各州和年龄组中的动态性质，最终为预防和干预的针对性策略提供了依据。
Zotero 插件
