背景:早发性结直肠癌(EOCRC)的发病率,在过去的几十年里,许多国家都在增加。本研究旨在评估Aotearoa新西兰的这一趋势,并评估其对毛利人的影响。
方法:分析了2000-2020年Aotearoa新西兰国家癌症登记处所有新病例的结直肠癌(CRC)的粗发病率和年龄标准化发病率。趋势是按性别估计的,种族,年龄组和癌症的位置以及到2040年的预测。
结果:在2000年至2020年之间,新西兰奥特罗阿共诊断出56,761例CRC,其中3,702个是EOCRC,年龄标准化发病率显着降低(P=8.2×10-80),从61.0例/100,000例下降到47.3例。EOCRC发病率在所有部位(近端结肠,远端结肠和直肠),而50-79岁人群的发病率平均每十年下降18%(IRR0.82,p=<0.0005),再次在所有网站上。在80岁以上的人群中,CRC发病率没有显著的平均变化。在毛利人中,年龄标准化发病率无显著变化.然而,由于EOCRC(IRR1.36,p=<0.0005)的显着增加,粗发病率(IRR1.28,p=<0.0005)显着增加。到2040年,我们预测EOCRC的发病率将从8.00上升到14.9/100,000(毛利人的6.33到10.00/100,000)。然而,由于人口老龄化,估计所有CRC病例的43.0%将在80岁以上的人群中诊断(毛利人在70岁以上为45.9%).
结论:从2000年到2020年,Aotearoa新西兰的CRC年龄标准化发病率下降,但不是毛利人。同期EOCRC的发生率持续上升,在毛利人中速度更快。然而,随着新西兰奥特罗阿的人口老龄化,而对于毛利人来说,老年人的儿童权利委员会将继续主导病例数。
BACKGROUND: The incidence of early-onset colorectal cancer (EOCRC), diagnosed before age 50, has been rising in many countries in the past few decades. This study aims to evaluate this trend in Aotearoa New Zealand and assess its impact on Māori.
METHODS: Crude incidence and age-standardized incidence of colorectal cancer (CRC) was analyzed from all new cases from the Aotearoa New Zealand national cancer registry for the period 2000-2020. Trends were estimated by sex, ethnicity, age group and location of cancer and projections made to 2040.
RESULTS: Between 2000 and 2020, there were a total of 56,761 cases of CRC diagnosed in Aotearoa New Zealand, 3,702 of these being EOCRC, with age-standardized incidence decreasing significantly (P = 8.2 × 10- 80) from 61.0 to 47.3 cases per 100,000. EOCRC incidence increased on average by 26% per decade (incidence rate ratio (IRR) 1.26, p = < 0.0001) at all sites (proximal colon, distal colon and rectum), while the incidence in those aged 50-79 years decreased on average by 18% per decade (IRR 0.82, p = < 0.0005), again across all sites. There was no significant average change in CRC incidence in those over 80 years. In Māori, there was no significant change in age-standardized incidence. There was however a significant increase in crude incidence rates (IRR 1.28, p = < 0.0005) driven by significant increases in EOCRC (IRR1.36, p = < 0.0005). By 2040, we predict the incidence of EOCRC will have risen from 8.00 to 14.9 per 100,000 (6.33 to 10.00 per 100,000 in Māori). However, due to the aging population an estimated 43.0% of all CRC cases will be diagnosed in those over 80 years of age (45.9% over 70 years of age in Māori).
CONCLUSIONS: The age-standardized incidence of CRC from 2000 to 2020 decreased in Aotearoa New Zealand, but not for Māori. The incidence of EOCRC over the same period continues to rise, and at a faster rate in Māori. However, with the ageing of the population in Aotearoa New Zealand, and for Māori, CRC in the elderly will continue to dominate case numbers.