新加坡早发性结直肠癌趋势:一项多民族人群的流行病学研究。

IF 3.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Hui Lionel Raphael Chen, Qingqing Dawn Chong, Brenda Tay, Siqin Zhou, Evelyn Yi Ting Wong, Isaac Seow-En, Ker Kan Tan, Yi Wang, Adeline Seow, Kwong-Wei Emile Tan, Bee Huat Iain Tan, Sze Huey Tan
{"title":"新加坡早发性结直肠癌趋势:一项多民族人群的流行病学研究。","authors":"Hui Lionel Raphael Chen, Qingqing Dawn Chong, Brenda Tay, Siqin Zhou, Evelyn Yi Ting Wong, Isaac Seow-En, Ker Kan Tan, Yi Wang, Adeline Seow, Kwong-Wei Emile Tan, Bee Huat Iain Tan, Sze Huey Tan","doi":"10.2196/62835","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) incidence and mortality in those aged 50 years and above have decreased over the past 2 decades. However, there is a rising incidence of CRC among individuals under 50 years of age, termed early-onset colorectal cancer (EOCRC). Patients with EOCRC are diagnosed at an advanced stage and may be in more psychosocial, emotional, and financial distress.</p><p><strong>Objective: </strong>Our study examined the epidemiological shifts in CRC in Singapore, a multiethnic country.</p><p><strong>Methods: </strong>CRCs diagnosed at age 20 years and above were identified from the Singapore Cancer Registry (SCR) from 1968 to 2019. Patient characteristics included gender, ethnicity, and age of CRC diagnosis. Population information was obtained from the Department of Statistics Singapore (SingStat). Age-specific incidence rates (ASRs) and age-standardized incidence rates (ASIRs) were calculated. The cohort was divided into 3 age groups: 20-49, 50-64, and ≥65 years. Temporal trends in incidence rates were modeled with joinpoint regression. Birth cohort models were fitted using the National Cancer Institute (NCI) age-period-cohort analysis tool. Cancer-specific survival analysis was performed with the Cox proportional hazards model.</p><p><strong>Results: </strong>In total, 53,044 CRCs were included, and 6183 (11.7%) adults aged 20-49 years were diagnosed with EOCRC. The ASR of EOCRC rose from 5 per 100,000 population in 1968 to 9 per 100,000 population in 1996 at 2.1% annually and rose to 10 per 100,000 population in 2019 at 0.64% annually. The ASR for CRC among adults aged 50-64 years rose at 3% annually from 1968 to 1987 and plateaued from 1987, while the ASR for adults aged 65 years and above rose at 4.1% annually from 1968 to 1989 and 1.3% annually from 1989 to 2003 but decreased from 2003 onwards at 1% annually. The ASR of early-onset rectal cancer increased significantly at 1.5% annually. There was a continued rise in the ASR of EOCRC among males (annual percentage change [APC] 1.5%) compared to females (APC 0.41%). Compared to the 1950-1954 reference birth cohort, the 1970-1984 birth cohort had a significantly higher incidence rate ratio (IRR) of 1.17-1.36 for rectal cancer, while there was no significant change for colon cancer in later cohorts. There were differences in CRC trends across the 3 ethnic groups: Malays had a rapid and persistent rise in the ASR of CRC across all age groups (APC 1.4%-3%), while among young Chinese, only the ASR of rectal cancer was increasing (APC 1.5%). Patients with EOCRC had better survival compared to patients diagnosed at 65 years and above (hazard ratio [HR] 0.73, 95% CI 0.67-0.79, P<.001) after adjusting for covariates.</p><p><strong>Conclusions: </strong>The rise in the incidence of rectal cancer among young adults, especially among Chinese and Malays, in Singapore highlights the need for further research to diagnose CRC earlier and reduce cancer-related morbidity and mortality.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":" ","pages":"e62835"},"PeriodicalIF":3.5000,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Trends in Early-Onset Colorectal Cancer in Singapore: Epidemiological Study of a Multiethnic Population.\",\"authors\":\"Hui Lionel Raphael Chen, Qingqing Dawn Chong, Brenda Tay, Siqin Zhou, Evelyn Yi Ting Wong, Isaac Seow-En, Ker Kan Tan, Yi Wang, Adeline Seow, Kwong-Wei Emile Tan, Bee Huat Iain Tan, Sze Huey Tan\",\"doi\":\"10.2196/62835\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Colorectal cancer (CRC) incidence and mortality in those aged 50 years and above have decreased over the past 2 decades. However, there is a rising incidence of CRC among individuals under 50 years of age, termed early-onset colorectal cancer (EOCRC). Patients with EOCRC are diagnosed at an advanced stage and may be in more psychosocial, emotional, and financial distress.</p><p><strong>Objective: </strong>Our study examined the epidemiological shifts in CRC in Singapore, a multiethnic country.</p><p><strong>Methods: </strong>CRCs diagnosed at age 20 years and above were identified from the Singapore Cancer Registry (SCR) from 1968 to 2019. Patient characteristics included gender, ethnicity, and age of CRC diagnosis. Population information was obtained from the Department of Statistics Singapore (SingStat). Age-specific incidence rates (ASRs) and age-standardized incidence rates (ASIRs) were calculated. The cohort was divided into 3 age groups: 20-49, 50-64, and ≥65 years. Temporal trends in incidence rates were modeled with joinpoint regression. Birth cohort models were fitted using the National Cancer Institute (NCI) age-period-cohort analysis tool. Cancer-specific survival analysis was performed with the Cox proportional hazards model.</p><p><strong>Results: </strong>In total, 53,044 CRCs were included, and 6183 (11.7%) adults aged 20-49 years were diagnosed with EOCRC. The ASR of EOCRC rose from 5 per 100,000 population in 1968 to 9 per 100,000 population in 1996 at 2.1% annually and rose to 10 per 100,000 population in 2019 at 0.64% annually. The ASR for CRC among adults aged 50-64 years rose at 3% annually from 1968 to 1987 and plateaued from 1987, while the ASR for adults aged 65 years and above rose at 4.1% annually from 1968 to 1989 and 1.3% annually from 1989 to 2003 but decreased from 2003 onwards at 1% annually. The ASR of early-onset rectal cancer increased significantly at 1.5% annually. There was a continued rise in the ASR of EOCRC among males (annual percentage change [APC] 1.5%) compared to females (APC 0.41%). Compared to the 1950-1954 reference birth cohort, the 1970-1984 birth cohort had a significantly higher incidence rate ratio (IRR) of 1.17-1.36 for rectal cancer, while there was no significant change for colon cancer in later cohorts. There were differences in CRC trends across the 3 ethnic groups: Malays had a rapid and persistent rise in the ASR of CRC across all age groups (APC 1.4%-3%), while among young Chinese, only the ASR of rectal cancer was increasing (APC 1.5%). Patients with EOCRC had better survival compared to patients diagnosed at 65 years and above (hazard ratio [HR] 0.73, 95% CI 0.67-0.79, P<.001) after adjusting for covariates.</p><p><strong>Conclusions: </strong>The rise in the incidence of rectal cancer among young adults, especially among Chinese and Malays, in Singapore highlights the need for further research to diagnose CRC earlier and reduce cancer-related morbidity and mortality.</p>\",\"PeriodicalId\":14765,\"journal\":{\"name\":\"JMIR Public Health and Surveillance\",\"volume\":\" \",\"pages\":\"e62835\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-02-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JMIR Public Health and Surveillance\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2196/62835\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JMIR Public Health and Surveillance","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2196/62835","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0

摘要

背景:在过去的20年里,50岁及以上人群的结直肠癌发病率和死亡率有所下降。然而,在50岁以下的人群中,CRC的发病率正在上升,被称为早发性结直肠癌(EOCRC)。EOCRC患者在诊断时处于更晚期,可能遭受更多的心理、情感和经济困扰。目的:探讨新加坡这个多民族国家结直肠癌的流行病学变化。方法:从新加坡癌症登记处确定1968年至2019年20岁及以上诊断的crc。患者特征包括性别、种族和CRC诊断年龄。人口资料来自新加坡统计局。计算年龄特异性发病率(ASR)和年龄标准化发病率(ASIR)。该队列分为3个年龄组:20 - 49岁、50 - 64岁和≥65岁。发病率的时间趋势用连接点回归建模。出生队列模型使用国家癌症研究所(NCI)年龄-时期-队列分析工具进行拟合。采用Cox比例风险模型进行肿瘤特异性生存分析。结果:纳入53044例crc, 6183例(11.7%)年龄在20 - 49岁的成年人被诊断为EOCRC。EOCRC的ASR从1968年的5 / 10万上升到1996年的9 / 10万,年均2.1%,2019年上升到10 / 10万,年均0.64%。从1968年到1987年,50岁到64岁的成年人CRC的ASR以每年3%的速度上升,从1987年开始趋于平稳,而65岁及以上的成年人的ASR从1968年到1989年以每年4.1%的速度上升,从1989年到2003年以每年1.3%的速度上升,但从2003年开始以每年1%的速度下降。与女性(APC: 0.41%)相比,男性EOCRC的ASR (APC: 1.5%)持续上升,早发性直肠癌的APC以每年1.5%的速度显著增加。与1950 - 1954年出生参考队列相比,1970 - 1984年出生队列的直肠癌发病率比(IRR)为1.17 - 1.36,显著高于1950 - 1954年出生队列,而在之后的队列中,结肠癌的发病率没有显著变化。3个民族的CRC趋势存在差异。马来人在所有年龄组中CRC的ASR都有快速和持续的上升(APC: 2- 3%),而在年轻的华人中,只有直肠癌的ASR在增加(APC: 1.5%)。与65岁及以上确诊的患者相比,EOCRC患者的生存率更高(HR 0.73, 95% CI 0.67 - 0.79, P)。结论:年轻人,尤其是新加坡华人和马来人直肠癌发病率的上升,凸显了进一步研究早期诊断CRC和降低癌症相关发病率和死亡率的必要性。临床试验:
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Trends in Early-Onset Colorectal Cancer in Singapore: Epidemiological Study of a Multiethnic Population.

Background: Colorectal cancer (CRC) incidence and mortality in those aged 50 years and above have decreased over the past 2 decades. However, there is a rising incidence of CRC among individuals under 50 years of age, termed early-onset colorectal cancer (EOCRC). Patients with EOCRC are diagnosed at an advanced stage and may be in more psychosocial, emotional, and financial distress.

Objective: Our study examined the epidemiological shifts in CRC in Singapore, a multiethnic country.

Methods: CRCs diagnosed at age 20 years and above were identified from the Singapore Cancer Registry (SCR) from 1968 to 2019. Patient characteristics included gender, ethnicity, and age of CRC diagnosis. Population information was obtained from the Department of Statistics Singapore (SingStat). Age-specific incidence rates (ASRs) and age-standardized incidence rates (ASIRs) were calculated. The cohort was divided into 3 age groups: 20-49, 50-64, and ≥65 years. Temporal trends in incidence rates were modeled with joinpoint regression. Birth cohort models were fitted using the National Cancer Institute (NCI) age-period-cohort analysis tool. Cancer-specific survival analysis was performed with the Cox proportional hazards model.

Results: In total, 53,044 CRCs were included, and 6183 (11.7%) adults aged 20-49 years were diagnosed with EOCRC. The ASR of EOCRC rose from 5 per 100,000 population in 1968 to 9 per 100,000 population in 1996 at 2.1% annually and rose to 10 per 100,000 population in 2019 at 0.64% annually. The ASR for CRC among adults aged 50-64 years rose at 3% annually from 1968 to 1987 and plateaued from 1987, while the ASR for adults aged 65 years and above rose at 4.1% annually from 1968 to 1989 and 1.3% annually from 1989 to 2003 but decreased from 2003 onwards at 1% annually. The ASR of early-onset rectal cancer increased significantly at 1.5% annually. There was a continued rise in the ASR of EOCRC among males (annual percentage change [APC] 1.5%) compared to females (APC 0.41%). Compared to the 1950-1954 reference birth cohort, the 1970-1984 birth cohort had a significantly higher incidence rate ratio (IRR) of 1.17-1.36 for rectal cancer, while there was no significant change for colon cancer in later cohorts. There were differences in CRC trends across the 3 ethnic groups: Malays had a rapid and persistent rise in the ASR of CRC across all age groups (APC 1.4%-3%), while among young Chinese, only the ASR of rectal cancer was increasing (APC 1.5%). Patients with EOCRC had better survival compared to patients diagnosed at 65 years and above (hazard ratio [HR] 0.73, 95% CI 0.67-0.79, P<.001) after adjusting for covariates.

Conclusions: The rise in the incidence of rectal cancer among young adults, especially among Chinese and Malays, in Singapore highlights the need for further research to diagnose CRC earlier and reduce cancer-related morbidity and mortality.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
13.70
自引率
2.40%
发文量
136
审稿时长
12 weeks
期刊介绍: JMIR Public Health & Surveillance (JPHS) is a renowned scholarly journal indexed on PubMed. It follows a rigorous peer-review process and covers a wide range of disciplines. The journal distinguishes itself by its unique focus on the intersection of technology and innovation in the field of public health. JPHS delves into diverse topics such as public health informatics, surveillance systems, rapid reports, participatory epidemiology, infodemiology, infoveillance, digital disease detection, digital epidemiology, electronic public health interventions, mass media and social media campaigns, health communication, and emerging population health analysis systems and tools.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信