影响因子144.8的CA发出警示:年轻人肠癌增加
2017/03/17
美国癌症协会对2000至2014年间发现的大肠癌趋势进行了研究,在影响因子144.8的CA上发表了一篇文章:结肠直肠癌和直肠癌的死亡率在50岁以上的人群中下降;年轻人和中年人的结直肠癌病例和死亡率上升。


近年来,美国癌症协会对2000至2014年间发现的大肠癌趋势进行了研究,发现年轻人和中年人的结直肠癌病例和死亡率上升。本月影响因子144.8的CA: A Cancer Journal for Clinicians上发表了一篇文章:研究人员报道了结肠直肠癌和直肠癌的死亡率在50岁以上的人群中下降。

年轻人结直肠癌比例上升老年人却下降

以前50岁以下的人中很少有人患上结直肠癌,但这一群体的发病率自2000年以来上升了,从每10万人中确诊的5.9例新病例,升至2013年的每10万人中就有7.2例。相比之下,50岁及以上的人的发病率为2013年每10万人中119.3。新病例在65岁以上的人群中仍然最为普遍:2017年135430的新诊断病例中的58%预计都在这一年龄组中。

 

总体而言,大肠癌的发病率和死亡率正在下降。这种下降是由于吸烟和红肉消费的减少,阿司匹林的使用增加(它可以平复刺激肿瘤的生长的炎症),和筛查及治疗的改进。

 

随着年龄在50岁及以上的男性和女性的结肠癌发病率下降,从2000岁到2013岁,年轻人的发病率呈上升趋势(尽管仍较低)。研究人员怀疑:肥胖、不健康饮食和久坐的生活方式的增加导致了50岁以下成年人结直肠癌的病例及死亡人数的上升。

我国结直肠癌患病情况

目前结直肠癌已成为发病率位居世界第三的恶性肿瘤,根据2014年哈尔滨国际结直肠疾病高峰论坛上公布的数据显示,我国结肠癌的发病率十年间翻了近一翻,而30岁以下的青年患者比例占到了15%。

中国直肠癌与西方人比较,有自身的流行病学特点:直肠癌比结肠癌发病率高,低位直肠癌所占比例高,青年人直肠癌比例高。中国人结直肠癌平均发病年龄为48.3岁,而美国白人为69.8岁。研究发现,我国直肠癌患者最集中的年龄段为40至59岁,明显高于40岁以下和60岁以上年龄段。

在我国,南方发病率高于北方,上海、江浙一带为高发区,近年来由于经济发展、生活水平提高以及饮食结构的改变,大肠癌的发病率一直呈上升趋势,为人们所关注。

根据武汉市第一医院胃肠外科邵永胜教授的文章介绍:近年来国内许多资料都向人们发出警报:结直肠癌在疯狂偷袭青年人。就世界范围来说,欧美是大肠癌高发区,小于40岁的年轻人,大肠癌占总大肠癌数的2.2%—4.5%。令人吃惊的是,我国青年人大肠癌所占比例,高出此值4—10倍之多,有报告最年轻一例仅13岁。

要做到大肠癌的早期诊断,年轻人应摒弃侥幸心理,发现问题及时检查,不要拒绝结肠镜检查,须知这是目前早期诊断大肠癌最有效的手段。

参考资料

Colorectal cancer statistics, 2017

Colorectal cancer is on the rise among younger adults

惊!年轻人越来越多得直肠癌

青年人结直肠癌的四种典型特点

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  • Colorectal cancer statistics, 2017

    Colorectal cancer (CRC) is one of the most common malignancies in the United States. Every 3 years, the American Cancer Society provides an update of CRC incidence, survival, and mortality rates and trends. Incidence data through 2013 were provided by the Surveillance, Epidemiology, and End Results program, the National Program of Cancer Registries, and the North American Association of Central Cancer Registries. Mortality data through 2014 were provided by the National Center for Health Statistics. CRC incidence rates are highest in Alaska Natives and blacks and lowest in Asian/Pacific Islanders, and they are 30% to 40% higher in men than in women. Recent temporal patterns are generally similar by race and sex, but differ by age. Between 2000 and 2013, incidence rates in adults aged ≥50 years declined by 32%, with the drop largest for distal tumors in people aged ≥65 years (incidence rate ratio [IRR], 0.50; 95% confidence interval [95% CI], 0.48-0.52) and smallest for rectal tumors in ages 50 to 64 years (male IRR, 0.91; 95% CI, 0.85-0.96; female IRR, 1.00; 95% CI, 0.93-1.08). Overall CRC incidence in individuals ages ≥50 years declined from 2009 to 2013 in every state except Arkansas, with the decrease exceeding 5% annually in 7 states; however, rectal tumor incidence in those ages 50 to 64 years was stable in most states. Among adults aged <50 years, CRC incidence rates increased by 22% from 2000 to 2013, driven solely by tumors in the distal colon (IRR, 1.24; 95% CI, 1.13-1.35) and rectum (IRR, 1.22; 95% CI, 1.13-1.31). Similar to incidence patterns, CRC death rates decreased by 34% among individuals aged ≥50 years during 2000 through 2014, but increased by 13% in those aged <50 years. Progress against CRC can be accelerated by increasing initiation of screening at age 50 years (average risk) or earlier (eg, family history of CRC/advanced adenomas) and eliminating disparities in high-quality treatment. In addition, research is needed to elucidate causes for increasing CRC in young adults. CA Cancer J Clin 2017. © 2017 American Cancer Society.

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