Cayuela Lucía, Flox-Benítez Gema, Peiró Villalba Clara, Giráldez Gallego Álvaro, Cayuela Domínguez Aurelio
Internal Medicine, Hospital Universitario Severo Ochoa.
Internal Medicine, Hospital Universitario Severo Ochoa, España.
Rev Esp Enferm Dig. 2024 Jun;116(6):312-318. doi: 10.17235/reed.2024.10317/2024.
This study aimed to evaluate how age, period, and cohort (A-P-C) impact colorectal cancer (CRC) incidence in Spain from 1990 to 2019.
Using data from the Global Burden of Disease Study 2019, we used joinpoint analysis to identify long-term trends and A-P-C modelling to quantify net drift, local drift, longitudinal age curves, and rate ratios (RRs) of period and cohort effects.
CRC incidence increased steadily in Spain from 1990 to 2019, with a more significant rise in males than in females. The age standardized rates rose from 84.9 to 129.3 cases per 100,000 in males and from 56.9 to 70.3 cases per 100,000 in females. Joinpoint analysis revealed distinct patterns for men and women: male incidence showed three phases (a surge until 1995, a slowdown until 2012, and a subsequent decrease) while female incidence showed a single increase until 2011 and then stabilized. Local drifts increased in all age groups over 45, with stability in males under 45 and a decrease in females aged 30-39. The risk of CRC increased with age, with males consistently having a higher risk than females. The risk of CRC increased over time for both men and women but at different rates. The risk for cohorts born in the early to mid-20th century peaked in the 1960s and remained stable until the late 1990s.
The increasing incidence of CRC in Spain, with distinct patterns by gender and birth cohort, underlines the importance of preventive strategies adapted to temporal and demographic variations to address this public health challenge.
本研究旨在评估年龄、时期和队列（A-P-C）对1990年至2019年西班牙结直肠癌（CRC）发病率的影响。
利用2019年全球疾病负担研究的数据，我们采用连接点分析来确定长期趋势，并采用A-P-C建模来量化净漂移、局部漂移、纵向年龄曲线以及时期和队列效应的率比（RRs）。
1990年至2019年西班牙CRC发病率稳步上升，男性上升幅度大于女性。年龄标准化发病率男性从每10万人84.9例升至129.3例，女性从每10万人56.9例升至70.3例。连接点分析揭示了男性和女性的不同模式：男性发病率呈现三个阶段（1995年前激增，2012年前放缓，随后下降），而女性发病率在2011年前呈现单一上升趋势，然后趋于稳定。45岁以上所有年龄组的局部漂移均增加，45岁以下男性保持稳定，30-39岁女性有所下降。CRC风险随年龄增加，男性风险始终高于女性。男性和女性的CRC风险均随时间增加，但速率不同。20世纪初至中叶出生队列的风险在20世纪60年代达到峰值，并一直稳定到20世纪90年代末。
西班牙CRC发病率上升，且存在性别和出生队列的不同模式，这凸显了根据时间和人口变化调整预防策略以应对这一公共卫生挑战的重要性。
