Abstract：
Having metastatic disease at diagnosis poses the great risk of death among AYAs with cancer from all sociodemographic subgroups. This “landscape” study utilized United States Surveillance, Epidemiology, and End Results Program data from 2000−2016 to identify subgroups of AYAs at highest risk for presenting with metastases across twelve cancer sites having a poor-prognosis (5-year survival <50% with metastases). Adjusted odds ratios for risk of metastatic disease presentation were compared for AYAs in aggregate and by sociodemographic subgroup (race/ethnicity, sex, socioeconomic status [SES]). In general, AYAs who were male, racial/ethnic minorities, or low SES were at consistently greatest risk of metastases. Strikingly, having metastatic melanoma was independently associated with multiple AYA sociodemographic subgroups, including males (aOR 3.11 [95% CI 2.64−3.66]), non-Hispanic Blacks (4.04 [2.32−7.04]), Asian Pacific Islanders (2.99 [1.75−5.12]), Hispanics (2.37 [1.85−3.04]), and low SES (2.30 [1.89−2.80]). Non-Hispanic Blacks were more likely to present with metastatic cancer in all sites, except for bone, rhabdomyosarcoma, and stomach. Low SES AYAs are more likely to present with metastatic melanoma, bone tumors, soft tissue sarcomas, breast, cervical, lung, and stomach carcinomas. Building on these results, future cancer-specific studies should investigate the connection between sociodemographic risk factors and biological drivers of metastases. This line of research has potential to inform targeted public health and screening efforts to facilitate risk reduction and earlier detection of these deadly diseases.
摘要：
在诊断时患有转移性疾病会在所有社会人口统计学亚组的AYAs癌症中造成很大的死亡风险。这项“景观”研究利用了美国的监视，流行病学,和2000-2016年的最终结果计划数据，以确定在12个预后不良的癌症部位出现转移的风险最高的AYAs亚组(5年生存率<50%有转移)。在AYAs的总体和社会人口统计学亚组（种族/种族，性别,社会经济地位[SES])。总的来说,AYAs谁是男性，种族/族裔少数，或低SES始终存在最大的转移风险.引人注目的是，转移性黑色素瘤与多个AYA社会人口统计学亚组独立相关，包括男性（aOR3.11[95%CI2.64-3.66]），非西班牙裔黑人（4.04[2.32-7.04]），亚洲太平洋岛民（2.99[1.75-5.12]），西班牙裔（2.37[1.85-3.04]），和低SES（2.30[1.89-2.80]）。非西班牙裔黑人更有可能在所有部位出现转移性癌症，除了骨头,横纹肌肉瘤,和胃。低SESAYAs更有可能出现在转移性黑色素瘤中，骨肿瘤,软组织肉瘤，乳房,子宫颈,肺，和胃癌。在这些结果的基础上，未来的癌症特异性研究应调查社会人口统计学危险因素与转移的生物学驱动因素之间的联系.这一系列研究有可能为有针对性的公共卫生和筛查工作提供信息，以促进降低风险和及早发现这些致命疾病。
