Shiels Meredith S, Haque Anika T, Berrington de González Amy, Camargo M Constanza, Clarke Megan A, Davis Lynn Brittny C, Engels Eric A, Freedman Neal D, Gierach Gretchen L, Hofmann Jonathan N, Jones Rena R, Loftfield Erikka, Sinha Rashmi, Morton Lindsay M, Chanock Stephen J
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
Clinical Cancer Epidemiology Group, The Institute of Cancer Research, London, United Kingdom.
Cancer Discov. 2025 Jul 3;15(7):1363-1376. doi: 10.1158/2159-8290.CD-24-1678.
We estimated age-standardized cancer incidence (2010-2019) and mortality rates (2010-2022) in the United States to investigate whether cancer rates have increased at younger ages. Fourteen cancers had incidence rates that increased in at least one early-onset age group (i.e., 15-29-, 30-39-, and 40-49-year-olds)-9 of these also increased in at least one older-onset age group (i.e., 50-59, 60-69, and 70-79; i.e., female breast, colorectal, kidney, testicular, uterine and pancreatic cancers, and several lymphoid neoplasms). The largest absolute increases in 2019 compared with expected diagnoses based on 2010 rates were female breast (n = 4,834 additional cancers), colorectal (n = 2,099), kidney (n = 1,793), and uterine cancers (n = 1,209). Although there were not concomitant increases in mortality rates for most cancers, colorectal, uterine, and testicular cancer mortality rates increased in early-onset age groups. The drivers of increasing incidence rates are cancer-specific and could include a combination of established and perhaps new etiologic factors, and increased detection.
In the United States, incidence rates of some cancers have increased in early-onset age groups. For many of these cancers, rates have also increased in older-age groups, suggesting that the impact of changes in risk factor prevalence and/or improvements in detection could affect risk across the age range. See related commentary by Cann and Eng, p. 1309.
我们估算了美国2010 - 2019年年龄标准化癌症发病率以及2010 - 2022年死亡率，以调查癌症发病率在较年轻年龄段是否有所上升。14种癌症在至少一个早发年龄组（即15 - 29岁、30 - 39岁和40 - 49岁）的发病率有所上升，其中9种在至少一个晚发年龄组（即50 - 59岁、60 - 69岁和70 - 79岁）也有所上升（即女性乳腺癌、结直肠癌、肾癌、睾丸癌、子宫癌和胰腺癌，以及几种淋巴样肿瘤）。与基于2010年发病率预期诊断数相比，2019年绝对增加数最多的是女性乳腺癌（额外增加4834例癌症）、结直肠癌（2099例）、肾癌（1793例）和子宫癌（1209例）。虽然大多数癌症的死亡率没有随之增加，但结直肠癌、子宫癌和睾丸癌在早发年龄组的死亡率有所上升。发病率上升的驱动因素因癌症而异，可能包括既定的以及或许新出现的病因因素的综合作用，以及检测增加。
在美国，一些癌症在早发年龄组的发病率有所上升。对于其中许多癌症，在老年组发病率也有所上升，这表明风险因素流行率的变化和/或检测改善的影响可能会影响整个年龄范围的风险。见Cann和Eng的相关评论，第1309页。
