流行病学分类变化和早期结肠直肠癌发病率
Valérie Jooste1,2,3,4,5, Jean-Baptiste Nousbaum5,6, Arnaud Alves5,7,8
1Digestive Cancer Registry of Burgundy, Dijon, France.
JAMA network open
|November 5, 2025
概括
2013年神经内分泌瘤 (NEN) 分类变化显著影响了早期结直肠癌 (EOCRC) 发病率,导致年轻患者的人为增加. 这强调了在分析癌症趋势时需要考虑分类变化.
科学领域:
- 在瘤学瘤学.
- 癌症流行病学 癌症流行病学
- 胃肠病学 胃肠病学
背景情况:
- 以前的研究表明,早期结直肠癌 (EOCRC) 发病率的上升与癌症登记指南的变化相吻合.
- 这些研究并没有同时根据年龄和阶段对结直肠腺癌 (ADC) 和神经内分泌瘤 (NEN) 的模式进行比较.
研究的目的:
- 分析结直肠癌发病率模式,按病原体类型和诊断时的瘤阶段进行分析.
- 为了比较50岁以下的个体与老年患者的这些模式.
主要方法:
- 一项队列研究利用了2004年至2021年法国癌症登记处网络 (FRANCIM) 的数据.
- 包括7个法国行政区新诊断患有侵袭性结肠直肠癌的个人.
- 用Poisson和Joinpoint回归计算和建模了ADC和NEN的特定年龄发病率.
主要成果:
- 在15-39岁的人群中,EOCRC发病率增加 (女性:每年2.9%,男性:每年2.6%).
- ADC的比率保持稳定,而NEN的比率增加,特别是在2004年至2013年期间,然后消失.
- 在15-39岁的年龄组中,NEN的增加最为明显 (29.7%的EOCRC案件).
- 结肠直肠腺癌与远程转移 (ADC M1) 的发病率在所有年龄段都上升.
结论:
- 2013年NEN分类变化在观察到的EOCRC发病率模式中发挥了重要作用,创造了人工的增加.
- 公共卫生官员在解释EOCRC趋势时应该考虑这种分类工件.
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