来自GEOCODE（全球早发性结直肠癌数据库）-欧洲联盟的早发性结直肠癌区域模式：回顾性队列研究
Regional patterns of early-onset colorectal cancer from the GEOCODE (Global Early-Onset COlorectal Cancer DatabasE)-European consortium: retrospective cohort study.
作者信息
Daca-Alvarez Maria, Perea José, Corchete Luis, Spinelli Antonino, Foppa Caterina, de Miranda Noel F C C, Nielsen Maartje, Palles Claire, Curley Helen M, Marti-Gallostra Marc, Verdaguer Mireia, Vivas Alfredo, Lorenzo Sofia, Latchford Andrew, Faiz Omar, Monahan Kevin, Pawa Nikhil, Szczepkowski Marek, Ziółkowski Bartosz, Tarnowski Wieslaw, Uryszek Mariusz, Makkai-Popa Silviu-Tiberiu, Azagra Juan S, Llach Joan, Moreria Leticia, Pellise Maria, Holowatyj Andreana N, González-Sarmiento Rogelio, Balaguer Francesc
机构信息
Department of Gastroenterology, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, Barcelona, Spain.
Molecular Medicine Unit-Department of Medicine, Biomedical Research Institute of Salamanca (IBSAL), Institute of Molecular and Cellular Biology of Cancer (IBMCC), University of Salamanca-SACYL-CSIC, Salamanca, Spain.
出版信息
BJS Open. 2025 Mar 4;9(2). doi: 10.1093/bjsopen/zraf024.
BACKGROUND
The incidence of early-onset colorectal cancer is increasing, but in Europe this growth shows a heterogeneous pattern in different countries and regions.
METHODS
Patients from six countries who participated in the Global Early-Onset COlorectal Cancer DatabasE (GEOCODE)-Europe group were included. The inclusion criteria were patients with colorectal adenocarcinoma diagnosed between 18 and 49 years of age, between January 2010 and December 2017, with at least 3 years of follow-up. Patients with inherited colorectal cancer syndromes were excluded.
RESULTS
A total of 851 patients were included with almost equal sex distribution, most were diagnosed at age 39 years or older and 42% of patients were overweight or obese. Diagnoses were predominantly at later stages (62.5% stage III-IV) and tumours were predominantly located in the distal colon (76.9% left colon and rectum). Comparative analysis between countries demonstrated that the UK had a younger age at diagnosis and the Italian cohort had a higher prevalence of being overweight or obese. Patients from Luxembourg had more advanced stage diagnoses and those from The Netherlands had more polyps. Patients from the UK had a greater family history of colorectal cancer. Comparison of Mediterranean versus non-Mediterranean countries showed significant differences in the age at diagnosis and body mass index. The prevalence of early-onset colorectal cancer over the age of 40 years in Mediterranean versus non-Mediterranean countries was 71.4% versus 62.1% (P = 0.002), and early-onset colorectal cancer was diagnosed at a more advanced stage in Mediterranean countries versus non-Mediterranean countries (65.3% versus 54.7%; P = 0.033). Family history of colorectal cancer in a first-degree relative was more common in non-Mediterranean versus Mediterranean countries (19.1% versus 11.4%; P < 0.001).
CONCLUSION
This study highlights significant geographical disparities in the clinical, pathological and familial features of early-onset colorectal cancer across European countries.
背景
早发性结直肠癌的发病率正在上升，但在欧洲，这种增长在不同国家和地区呈现出异质性模式。
方法
纳入了来自六个国家且参与全球早发性结直肠癌数据库（GEOCODE）-欧洲组的患者。纳入标准为2010年1月至2017年12月期间诊断为结直肠腺癌、年龄在18至49岁之间且至少有3年随访期的患者。遗传性结直肠癌综合征患者被排除。
结果
共纳入851例患者，性别分布几乎相等，大多数患者在39岁及以上被诊断，42%的患者超重或肥胖。诊断主要处于晚期（62.5%为III-IV期），肿瘤主要位于结肠远端（76.9%位于左半结肠和直肠）。国家间的比较分析表明，英国的诊断年龄较轻，意大利队列中超重或肥胖的患病率较高。卢森堡的患者诊断分期更晚，荷兰的患者息肉更多。英国的患者有更显著的结直肠癌家族史。地中海国家与非地中海国家的比较显示，诊断年龄和体重指数存在显著差异。40岁以上早发性结直肠癌在地中海国家与非地中海国家的患病率分别为71.4%和62.1%（P = 0.002），且早发性结直肠癌在地中海国家比非地中海国家诊断时分期更晚（65.3%对54.7%；P = 0.033）。非地中海国家与地中海国家相比，一级亲属中有结直肠癌家族史更为常见（19.1%对11.4%；P < 0.001）。
结论
本研究突出了欧洲各国早发性结直肠癌在临床、病理和家族特征方面存在显著的地理差异。
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