新西兰奥塔哥地区早发性结直肠癌的发病率：2000-2020 年。

The incidence of early onset colorectal cancer in Aotearoa New Zealand: 2000-2020.

机构信息

Department of Surgery and Critical Care, University of Otago Christchurch, 36 Cashel St, Christchurch central, Christchurch, New Zealand.

Biostatistics and Computational Biology Unit, University of Otago Christchurch, Christchurch, New Zealand.

出版信息

BMC Cancer. 2024 Apr 12;24(1):456. doi: 10.1186/s12885-024-12122-y.

DOI:10.1186/s12885-024-12122-y

PMID:38609870

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11010297/

Abstract

BACKGROUND

The incidence of early-onset colorectal cancer (EOCRC), diagnosed before age 50, has been rising in many countries in the past few decades. This study aims to evaluate this trend in Aotearoa New Zealand and assess its impact on Māori.

METHODS

Crude incidence and age-standardized incidence of colorectal cancer (CRC) was analyzed from all new cases from the Aotearoa New Zealand national cancer registry for the period 2000-2020. Trends were estimated by sex, ethnicity, age group and location of cancer and projections made to 2040.

RESULTS

Between 2000 and 2020, there were a total of 56,761 cases of CRC diagnosed in Aotearoa New Zealand, 3,702 of these being EOCRC, with age-standardized incidence decreasing significantly (P = 8.2 × 10) from 61.0 to 47.3 cases per 100,000. EOCRC incidence increased on average by 26% per decade (incidence rate ratio (IRR) 1.26, p = < 0.0001) at all sites (proximal colon, distal colon and rectum), while the incidence in those aged 50-79 years decreased on average by 18% per decade (IRR 0.82, p = < 0.0005), again across all sites. There was no significant average change in CRC incidence in those over 80 years. In Māori, there was no significant change in age-standardized incidence. There was however a significant increase in crude incidence rates (IRR 1.28, p = < 0.0005) driven by significant increases in EOCRC (IRR1.36, p = < 0.0005). By 2040, we predict the incidence of EOCRC will have risen from 8.00 to 14.9 per 100,000 (6.33 to 10.00 per 100,000 in Māori). However, due to the aging population an estimated 43.0% of all CRC cases will be diagnosed in those over 80 years of age (45.9% over 70 years of age in Māori).

CONCLUSION

The age-standardized incidence of CRC from 2000 to 2020 decreased in Aotearoa New Zealand, but not for Māori. The incidence of EOCRC over the same period continues to rise, and at a faster rate in Māori. However, with the ageing of the population in Aotearoa New Zealand, and for Māori, CRC in the elderly will continue to dominate case numbers.

摘要

背景

在过去几十年中，许多国家的早发性结直肠癌（EOCRC）发病率有所上升，即在 50 岁之前被诊断出患有结直肠癌。本研究旨在评估新西兰的这一趋势，并评估其对毛利人的影响。

方法

从 2000 年至 2020 年期间，新西兰国家癌症登记处的所有新病例中分析了结直肠癌的粗发病率和年龄标准化发病率。通过性别、族裔、年龄组和癌症部位评估趋势，并对 2040 年进行预测。

结果

2000 年至 2020 年间，新西兰共诊断出 56761 例结直肠癌病例，其中 3702 例为 EOCRC，年龄标准化发病率显著下降（P=8.2×10），从每 100,000 人 61.0 例降至 47.3 例。所有部位（近端结肠、远端结肠和直肠）的 EOCRC 发病率平均每十年增加 26%（发病率比（IRR）为 1.26，p<0.0001），而 50-79 岁人群的发病率平均每十年下降 18%（IRR 为 0.82，p<0.0005）。80 岁以上人群的结直肠癌发病率没有显著的平均变化。毛利人年龄标准化发病率没有显著变化。然而，粗发病率却显著上升（IRR 1.28，p<0.0005），这主要是由于 EOCRC 发病率显著上升（IRR 1.36，p<0.0005）所致。到 2040 年，我们预计 EOCRC 的发病率将从每 100,000 人 8.00 例上升至 14.9 例（毛利人每 100,000 人 6.33 例至 10.00 例）。然而，由于人口老龄化，预计 80 岁以上人群中约 43.0%（毛利人 70 岁以上人群中约 45.9%）的结直肠癌病例将被诊断出来。