Tsai Meng-Han, Moore Justin X, Cabral Daramola N, Rogers Charles R, Cortes Jorge
Cancer Prevention, Control and Population Health Program, Georgia Cancer Center, Augusta University Augusta, GA, USA.
Georgia Prevention Institute, Augusta University Augusta, GA, USA.
Am J Cancer Res. 2024 Jan 15;14(1):182-191. doi: 10.62347/KTIW8135. eCollection 2024.
The increase of early-onset colorectal cancer (CRC) among younger adults is a major public health concern. However, little is known about variations in CRC incidence across different age groups within small geographic areas in Georgia. We examined temporal trends of CRC incidence in Clayton, East Central, West Central, Northeast, and Southeast regions, by age groups. Annual incidence rates for CRC in individuals aged 15+ years during 2000-2020 in the five regions of Georgia were included. Temporal trends were examined within the five regions and stratified by age group. Joinpoint regression was employed to calculate the annual percent change and corresponding 95% confidence intervals (CIs). Among 20,215 CRC diagnoses, CRC incidence declined over time for East Central (-2.33%; 95% CI, -3.03, -1.64), Northeast (-1.63%; 95% CI, -2.15, -1.04), Southeast (-1.63%; 95% CI, -2.30, -0.96), and West Central (-1.53%; 95% CI, -2.04, -1.03) Georgia. In the 15-44 age group, a notable increase of CRC incidence was found in Clayton, Northeast, and Southeast regions with a range of 2.2%-3.4%. However, adults aged 60+ years experienced a significant decrease in CRC incidence for most Georgia regions (all -value <0.05), except for the Clayton region. In conclusion, CRC incidence declined during 2000-2020 in most Georgia regions. However, early-onset CRC is a major concern in Georgia as young adults (<45 years) living in Clayton, Northeast, and Southeast Georgia experienced significant annual increases in CRC incidence. Targeted CRC screening and awareness campaigns should be prioritized for adults <45 years and in the most impacted areas in Georgia.
年轻成年人中早发性结直肠癌（CRC）的增加是一个主要的公共卫生问题。然而，关于佐治亚州小地理区域内不同年龄组CRC发病率的差异知之甚少。我们按年龄组研究了克莱顿、中东部、中西部、东北部和东南部地区CRC发病率的时间趋势。纳入了佐治亚州五个地区2000 - 2020年期间15岁及以上个体的CRC年发病率。在五个地区内并按年龄组分层研究时间趋势。采用连接点回归计算年变化百分比和相应的95%置信区间（CIs）。在20215例CRC诊断病例中，中东部（-2.33%；95% CI，-3.03，-1.64）、东北部（-1.63%；95% CI，-2.15，-1.04）、东南部（-1.63%；95% CI，-2.30，-0.96）和中西部（-1.53%；95% CI，-2.04，-1.03）佐治亚州的CRC发病率随时间下降。在15 - 44岁年龄组中，克莱顿、东北部和东南部地区的CRC发病率显著增加，增幅在2.2% - 3.4%之间。然而，除克莱顿地区外，佐治亚州大多数地区60岁及以上成年人的CRC发病率显著下降（所有P值<0.05）。总之，2000 - 2020年期间佐治亚州大多数地区的CRC发病率下降。然而，早发性CRC是佐治亚州的一个主要问题，因为生活在佐治亚州克莱顿、东北部和东南部的年轻成年人（<45岁）的CRC发病率每年显著增加。应优先为45岁以下成年人以及佐治亚州受影响最严重的地区开展有针对性的CRC筛查和提高认识运动。
