He Ke-Jie, Gong Guoyu
The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou city, Zhejiang Province, China.
School of Medicine, Xiamen University, Xiamen, China.
Transl Oncol. 2024 Aug;46:101984. doi: 10.1016/j.tranon.2024.101984. Epub 2024 Jun 1.
Unhealthy diets significantly contribute to stomach, colorectal and esophageal cancer burden globally. Western diets high in processed and red meats promote carcinogenesis in these gastrointestinal cancers. However, adolescent and young adult (AYA) patients' unique needs regarding these cancers have been neglected.
Data from the 2019 Global Burden of Disease study was used to quantify stomach, colorectal and esophageal cancer burden among AYAs from 1990 to 2040 across 204 countries. Correlations between the burden of these cancers and the Socio-demographic Index were examined.
High SDI locations experienced the largest reduction in cancer DALY rate change from 1990 to 2019 (-22% [-12 to -33]), compared to a small increase in low-middle SDI regions. Middle SDI areas saw the largest reduction in DALY rate change from 1990 to 2019 (-62% [-32 to -75]), compared to a small decrease in low-middle SDI locations (-9% [-27 to 10]) in esophageal cancer. From 1990-2019, stomach cancer deaths and DALYs declined across all SDI regions, with the largest reductions in high SDI locations (-61% [-57 to -69]) and smallest in low-middle SDI areas (-25% [-13 to -34]). Colorectal cancer deaths and DALYs rose across all SDI regions except high SDI locations, which showed a slight decrease.
This study demonstrates the evolving global burden of stomach, colorectal and esophageal cancers among AYAs. The highest burden was in high-middle and high SDI regions, underscoring the need to prioritize initiatives targeting these gastrointestinal malignancies in youth.
不健康饮食在全球范围内对胃癌、结直肠癌和食管癌负担有显著影响。富含加工肉类和红肉的西方饮食会促进这些胃肠道癌症的致癌作用。然而,青少年和青年(AYA)患者在这些癌症方面的独特需求一直被忽视。
利用2019年全球疾病负担研究的数据,对204个国家1990年至2040年期间AYA人群中的胃癌、结直肠癌和食管癌负担进行量化。研究了这些癌症负担与社会人口指数之间的相关性。
与中低社会人口指数地区的小幅上升相比,高社会人口指数地区在1990年至2019年期间癌症伤残调整生命年(DALY)率变化下降幅度最大(-22%[-12至-33])。在食管癌方面,中社会人口指数地区在1990年至2019年期间DALY率变化下降幅度最大(-62%[-32至-75]),而中低社会人口指数地区下降幅度较小(-9%[-27至10])。从1990年到2019年,所有社会人口指数地区的胃癌死亡人数和DALYs均有所下降,高社会人口指数地区下降幅度最大(-61%[-57至-69]),中低社会人口指数地区最小(-25%[-13至-34])。除高社会人口指数地区略有下降外,所有社会人口指数地区的结直肠癌死亡人数和DALYs均有所上升。
本研究表明了全球范围内AYA人群中胃癌、结直肠癌和食管癌负担的演变。最高负担出现在高中社会人口指数和高社会人口指数地区,这凸显了优先开展针对青年人群这些胃肠道恶性肿瘤的防治措施的必要性。