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Zhang YJ, Li XY, Guo ZL. Temporal trends of migraine and tension-type headache burden across the BRICS: implications from the Global Burden of Disease study 2019. Front Neurol 2023; 14:1307413. [PMID: 38187142 PMCID: PMC10771321 DOI: 10.3389/fneur.2023.1307413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/06/2023] [Indexed: 01/09/2024] Open
Abstract
Background Headache disorders have become a significant global public health issue, with a notably high prevalence observed in developing countries. However, few studies have assessed headache disorders trends in Brazil, Russia, India, China and South Africa (BRICS). This study aimed to assess the prevalence of headache disorders in individuals across the BRICS, spanning the years 1990 to 2019. Methods We obtained headache disorders data from the Global Burden of Disease 2019 study (GBD2019). This evaluation examined incidence rates, prevalence, and disability-adjusted life-years (DALYs) for migraine and tension-type headache (TTH) across demographic factors like age, gender, year, and country. Migraine and TTH were diagnosed based on the International Classification of Headache Disorders (ICHD-3) criteria. We used disease codes from the International Classification of Diseases, 10th revision to identify migraine and TTH cases. Statistical analyzes included calculating age-standardized rates and estimated annual percentage changes. Future disease burden was projected using a log-linear age-period-cohort model. Results In 2019, India had the highest prevalence of migraine (213890207.93 cases) and TTH (374,453,700 cases). Brazil had the highest migraine age-standardized prevalence rate (18,331 per 100,000) and incidence rate (1,489 per 100,000). For TTH, India had the highest prevalence (26,160 per 100,000) while Russia had the highest incidence (11,512 per 100,000). From 1990 to 2019, China showed the greatest increase in migraine and TTH prevalence. India had the highest migraine (7,687,692) and TTH (741,392) DALYs in 2019. Conclusion Migraine and TTH remain highly prevalent in BRICS nations, inflicting considerable disability burden. While India and China face mounting disease prevalence, Brazil contends with high incidence rates. Tailored interventions based on country-specific epidemiological profiles are warranted to mitigate the public health impact.
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Affiliation(s)
- Yuan-jie Zhang
- Department of Neurosurgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xin-yu Li
- Department of Neurosurgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhi-lin Guo
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Waldmann A, Borchers P, Katalinic A. Temporal trends in age- and stage-specific incidence of colorectal adenocarcinomas in Germany. BMC Cancer 2023; 23:1180. [PMID: 38041106 PMCID: PMC10693075 DOI: 10.1186/s12885-023-11660-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 11/21/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND A national colorectal cancer (CRC) screening programme was launched in 2002 in Germany. A comprehensive evaluation of the programme effectiveness using real-world data is still lacking. In addition, there are regional reports on increasing colorectal cancer incidence in younger populations. Therefore, we aimed to describe and compare the overall, age- and stage-specific incidence trends for colorectal, colon and rectal cancer. METHODS We used data from seven population-based cancer registries in Germany. We report absolute and relative changes in incidence rates between the early screening phase (2003-2005) and the most recent time period available (2015-2017), as well as annual percent changes. We analysed incidences according to tumour site (colorectum, colon, and rectum) and to six age groups (young adults: 15-34, 35-39, 40-49, screening-entitled/older adults: 50-54, 55-69 and 70 + years old). RESULTS In our sample of 271,011 colorectal adenocarcinomas, about two-thirds were located in the colon and 95% of them occurred in the age group 50+ (50-54: 5%, 55-69: 32.8%, 70+: 57.2%). For the time period 2003-2005 the age-specific incidence rates of individuals in the age group 55-69 were about 76/100,00 for colon and 54/100,000 for rectal cancer (age group 70 + colon: 179/100,000; rectum: 84/100,000). The incidence rates in young adults were less than 13% of that of individuals in the age group 55-69 (< 5% of individuals aged 70+; <33% of individuals aged 50-54). Over time, incidence decreased in individuals at the age of 55+, for all subsites considered as well as for early and late stage cancers (with few exceptions), while incidence of young adult CRC (both early and late stage) increased steepest in the youngest age groups. For late stage rectal cancer, a shift was observed in all age groups from UICC stage IV to stage III being the most frequent stage. CONCLUSIONS Six years after the introduction of the national colonoscopy screening program, late stage CRC incidence began to decline substantially in the screening-eligible age groups (55-69, 70+). It is likely that this decline and the increase in early stage CRC observed in younger age groups can be attributed to the program. Long lasting public awareness campaigns for CRC screening might have led to opportunistic screening in younger adults. Whether these benefits outweigh the possible harm of screening in younger age groups remains unclear.
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Affiliation(s)
- Annika Waldmann
- Institute for Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23562, Luebeck, Germany.
| | - Pia Borchers
- Institute for Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23562, Luebeck, Germany
| | - Alexander Katalinic
- Institute for Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23562, Luebeck, Germany
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3
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Medici B, Riccò B, Caffari E, Zaniboni S, Salati M, Spallanzani A, Garajovà I, Benatti S, Chiavelli C, Dominici M, Gelsomino F. Early Onset Metastatic Colorectal Cancer: Current Insights and Clinical Management of a Rising Condition. Cancers (Basel) 2023; 15:3509. [PMID: 37444619 DOI: 10.3390/cancers15133509] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/19/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Despite a recent overall decrease in colorectal cancer (CRC) incidence and mortality, there has been a significant rise in CRC diagnoses in young adults. Early onset colorectal cancer (EOCRC) is defined as CRC diagnosed before the age of 50. Possible predisposing conditions include not only genetic syndromes but also other risk factors, such as microbiome alteration, antibiotic exposure, obesity, diabetes mellitus, and inflammatory bowel disease. EOCRC tends to be diagnosed later than in the older counterpart because of a lack of awareness and the fact that screening for CRC usually starts at the age of 50. Furthermore, CRC in young adults seems to be related to unique molecular features and more aggressive clinical behavior. This paper aims to provide an in-depth review of this poorly understood subject, with a comprehensive review of the state of the art and considerations for future perspectives.
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Affiliation(s)
- Bianca Medici
- Department of Oncology and Hematology, Division of Oncology, University Hospital of Modena, 41124 Modena, Italy
| | - Beatrice Riccò
- Department of Oncology and Hematology, Division of Oncology, University Hospital of Modena, 41124 Modena, Italy
| | - Eugenia Caffari
- Department of Oncology and Hematology, Division of Oncology, University Hospital of Modena, 41124 Modena, Italy
| | - Silvia Zaniboni
- Department of Oncology and Hematology, Division of Oncology, University Hospital of Modena, 41124 Modena, Italy
| | - Massimiliano Salati
- Department of Oncology and Hematology, Division of Oncology, University Hospital of Modena, 41124 Modena, Italy
| | - Andrea Spallanzani
- Department of Oncology and Hematology, Division of Oncology, University Hospital of Modena, 41124 Modena, Italy
| | - Ingrid Garajovà
- Medical Oncology Unit, University Hospital of Parma, 43100 Parma, Italy
| | - Stefania Benatti
- Department of Oncology and Hematology, Division of Oncology, University Hospital of Modena, 41124 Modena, Italy
| | - Chiara Chiavelli
- Laboratory of Cellular Therapy, Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Massimo Dominici
- Department of Oncology and Hematology, Division of Oncology, University Hospital of Modena, 41124 Modena, Italy
| | - Fabio Gelsomino
- Department of Oncology and Hematology, Division of Oncology, University Hospital of Modena, 41124 Modena, Italy
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4
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Yang B, Lv Y, Shi O, Yan M, Li X, Kang W, Yang Y, Wang W, Wang Q. The global burden of colorectal cancer attributable to high plasma glucose in 204 countries and territories, 1990-2019: an analysis of the Global Burden of Disease Study. Public Health 2023; 217:46-53. [PMID: 36854250 DOI: 10.1016/j.puhe.2023.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/30/2022] [Accepted: 01/23/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVES This study aimed to estimate the burden of colorectal cancer (CRC) attributable to high plasma glucose from 1990 to 2019. STUDY DESIGN AND METHODS Data on the disease burden were retrieved from the Global Burden of Disease online database. Estimated average percentage change (EAPC) was used to quantify the age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years (DALYs) rate (ASDR) of high plasma glucose-related CRC trends by sex and location between 1990 and 2019. RESULTS Globally, the death number and DALYs of CRC attributable to high plasma glucose remained a steady increase at global level from 1990 to 2019, and similar trends have been reported in age-standardized rate. The country with the largest number of death cases and DALYs of high plasma glucose-related CRC in 2019 was China, followed by the United States of America and India. Nearly three-quarters of total countries experienced an increase in the ASMR and ASDR, and the greatest increase of ASMR and ASDR was found in Uzbekistan (EAPC = 5.32) and Equatorial Guinea (EAPC = 4.65), respectively. A negative correlation was found between sociodemographic indices and the EAPC of ASMR and ASDR (rASMR = -0.259, p < 0.001; rASDR = -0.282, p < 0.001). CONCLUSIONS A significant increase in mortality and DALYs of CRC attributable to high plasma glucose was observed in global and most countries, especially in the developing countries. Public health policies and targeted programs are needed to reduce the burden of disease.
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Affiliation(s)
- Bin Yang
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China; The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, 450001, China
| | - Youyou Lv
- Department of Anesthesiology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, 519000, China
| | - Oumin Shi
- Health Science Center, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, 518020, China
| | - Mengqing Yan
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China; The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, 450001, China
| | - Xiao Li
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China; The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, 450001, China
| | - Wenjun Kang
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China; The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, 450001, China
| | - Yongli Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Wei Wang
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China; The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, 450001, China.
| | - Qi Wang
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China; China-Canada Medical and Healthcare Science Association, Toronto, ON, L3R 1A3, Canada.
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5
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The global, regional, and national burden of colorectal cancer in 204 countries and territories from 1990 to 2019. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-023-01831-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Abstract
Background
We aimed to estimate the global burden of colorectal cancer (CRC) between 1990 and 2019.
Methods
Data were extracted from the Global Burden of Disease study 2019. Estimated annual percentage changes (EAPCs) were calculated to quantify temporal trends in the age-standardized rates of CRC incidence, deaths, and disability-adjusted life-years (DALYs) by age, sex, region, and country. The correlations of EAPCs in the age-standardized rates with sociodemographic index (SDI) were also analyzed.
Results
From 1990 to 2019, the CRC incidence, deaths, and DALYs increased worldwide by 157%, 110%, and 96%, respectively. The global age-standardized incidence rate increased (EAPC, 0.58; 95% confidence interval [CI], 0.51–0.66), whereas both the age-standardized death rate (EAPC, −0.21; 95% CI, −0.28 to −0.14) and age-standardized DALY rate (EAPC, −0.21; 95% CI, −0.26 to −0.15) presented downward trends. As for regions, the largest increases in the age-standardized incidence rate, age-standardized death rate, and age-standardized DALY rate were observed in East Asia. In terms of countries, the largest increase in CRC incidence was found in Equatorial Guinea (3.98), followed by Vietnam (3.79) and China (3.66). The age-standardized incidence rate was higher in men than in women. Negative correlations were found between the EAPC in the age-standardized incidence rate of CRC and the SDI.
Conclusions
Future CRC preventive strategies should focus on the male population and older adults, especially in East Asia, Qatar, United Arab Emirates, Saudi Arabia, and other high-risk regions.
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The Insulin-like Growth Factor System and Colorectal Cancer. LIFE (BASEL, SWITZERLAND) 2022; 12:life12081274. [PMID: 36013453 PMCID: PMC9410426 DOI: 10.3390/life12081274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 11/29/2022]
Abstract
Insulin-like growth factors (IGFs) are peptides which exert mitogenic, endocrine and cytokine activities. Together with their receptors, binding proteins and associated molecules, they participate in numerous pathophysiological processes, including cancer development. Colorectal cancer (CRC) is a disease with high incidence and mortality rates worldwide, whose etiology usually represents a combination of the environmental and genetic factors. IGFs are most often increased in CRC, enabling excessive autocrine/paracrine stimulation of the cell growth. Overexpression or increased activation/accessibility of IGF receptors is a coinciding step which transmits IGF-related signals. A number of molecules and biochemical mechanisms exert modulatory effects shaping the final outcome of the IGF-stimulated processes, frequently leading to neoplastic transformation in the case of irreparable disbalance. The IGF system and related molecules and pathways which participate in the development of CRC are the focus of this review.
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Shen D, Wang P, Xie Y, Zhuang Z, Zhu M, Wang X, Huang M, Luo Y, Yu H. Clinical spectrum of rectal cancer identifies hallmarks of early-onset patients and next-generation treatment strategies. Cancer Med 2022; 12:3433-3441. [PMID: 35929660 PMCID: PMC9939204 DOI: 10.1002/cam4.5120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 07/19/2022] [Accepted: 07/28/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The incidence of colorectal cancer is increasing among young adults and more rectal cancers are reported. This study aimed to identify the clinical features specific for early-onset rectal cancer and provide insights on cancer management. METHODS Early-onset (<50 years) and late-onset (≥50 years) rectal cancer patients from a referral tertiary care center (SYSU cohort) and Surveillance Epidemiology and End Results database (SEER cohort) were included to perform a comprehensive comparison on clinical information. RESULTS A total of 552 and 80,341 patients with stages I-III rectal cancer were included in the SYSU and SEER cohorts, respectively. In the SYSU cohort, early-onset diseases had significantly higher prevalence of family history of cancer and history of HBV infection and lower incidence of comorbidities (p < 0.05). In addition, early-onset patients presented more frequently with advanced node stage (N2 stage: 16.9 vs. 9.3%, p = 0.017) and high-risk features, including mucinous or signet cell carcinomas (21.8 vs. 12.9%, p = 0.014), poorly differentiated tumors (28.8 vs. 15.4%, p = 0.002), and perineural invasion (14.5 vs. 7.9%, p = 0.027) compared with late-onset patients. However, early-onset patients received more neoadjuvant (18.5 vs. 11.2%, p = 0.032) and adjuvant treatments (71.0 vs. 45.8%, p < 0.001), and they had better overall survival in both SYSU (HR 0.57, 95% CI: 0.34-0.95; p = 0.029) and SEER (HR 0.38, 95% CI: 0.37-0.40; p < 0.001) cohorts. CONCLUSION Early-onset rectal cancers are distinct from late-onset cases in clinicopathological features, treatment modalities, and outcomes. The clinical trials and studies that are specific for young populations are needed to develop optimal strategies for cancer screening, treatment, and surveillance.
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Affiliation(s)
- Dingcheng Shen
- Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdongChina,Department of Colorectal Surgery, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdongChina
| | - Puning Wang
- Department of Colorectal Surgery, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdongChina
| | - Yumo Xie
- Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdongChina,Department of Colorectal Surgery, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdongChina
| | - Zhuokai Zhuang
- Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdongChina,Department of Colorectal Surgery, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdongChina
| | - Mingxuan Zhu
- Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdongChina,Department of Colorectal Surgery, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdongChina
| | - Xiaolin Wang
- Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdongChina,Department of Colorectal Surgery, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdongChina
| | - Meijin Huang
- Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdongChina,Department of Colorectal Surgery, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdongChina
| | - Yanxin Luo
- Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdongChina,Department of Colorectal Surgery, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdongChina
| | - Huichuan Yu
- Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdongChina,Department of Colorectal Surgery, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdongChina
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Ramírez-Martín R, Pérez-Rodríguez P, Menéndez-Colino R, Martín Maestre I, Gazo Martínez JA, Marijuán Martín JL, Alarcón Alarcón T, Díez Sebastián J, González-Montalvo JI. Prehabilitation and perioperative geriatric care in patients aged over 80 years with colorectal cancer: Results of a cross-speciality geriatrics program. J Geriatr Oncol 2022; 13:813-820. [DOI: 10.1016/j.jgo.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 01/27/2022] [Accepted: 03/07/2022] [Indexed: 12/24/2022]
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Venugopal A, Carethers JM. Epidemiology and biology of early onset colorectal cancer. EXCLI JOURNAL 2022; 21:162-182. [PMID: 35221839 PMCID: PMC8859644 DOI: 10.17179/excli2021-4456] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/13/2021] [Indexed: 12/14/2022]
Abstract
Colorectal cancer (CRC) is the third leading cause of cancer-related mortality in men or women in the United States. Average-risk screening that begins at age 50 years has reduced incidence and mortality of CRC in those over 50 years of age, whereas CRC incidence in those under age 50 years (early onset colorectal cancer (eoCRC)) has recently and dramatically increased. In this review, we summarize the recent literature including risk factors for eoCRC, differences in clinicopathologic presentation and outcomes in eoCRC, and emerging evidence regarding the molecular pathways that are altered in eoCRC compared to later onset CRC (loCRC). Epidemiologic studies of eoCRC show predominance in distal colon and rectum, and association with several modifiable risk factors, including diabetes, obesity, diet, sedentary time, alcohol consumption and smoking. Data regarding potential risk factors of prior antibiotic exposure and microbiome alterations or direct carcinogen exposure are still emerging. Aggressive clinicopathologic features of eoCRC at presentation may be due to delay in diagnosis or more aggressive tumor biology. EoCRC outcomes are similar to loCRC when matched for stage, but overall mortality is greater due to higher frequency of advanced disease at a younger presentation, with more life-years lost. There are only few molecular evaluations of eoCRC to date, with findings of potential increase in TP53 and CTNNB1 somatic mutation and decrease in APC, KRAS and BRAF somatic mutation, compared to loCRC. Other findings include LINE-1 hypomethylation, absence of microsatellite instability (MSI-H), presence of chromosomal instability (CIN) or microsatellite and chromosomal stability (MACS). These studies are only now emerging and have not yet identified a specific molecular signature defining eoCRC. Further research evaluating genetic and molecular differences as well as environmental triggers for eoCRCs should provide a clearer understanding to inform targeted screening for pre-symptomatic at-risk younger individuals.
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Affiliation(s)
- Anand Venugopal
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - John M Carethers
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Human Genetics and Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
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10
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Incidence trends for twelve cancers in younger adults-a rapid review. Br J Cancer 2022; 126:1374-1386. [PMID: 35132237 PMCID: PMC9090760 DOI: 10.1038/s41416-022-01704-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 12/10/2021] [Accepted: 01/06/2022] [Indexed: 12/19/2022] Open
Abstract
Many cancer referral guidelines use patient’s age as a key criterium to decide who should be referred urgently. A recent rise in the incidence of colorectal cancer in younger adults has been described in high-income countries worldwide. Information on other cancers is more limited. The aim of this rapid review was to determine whether other cancers are also increasing in younger age groups, as this may have important implications for prioritising patients for investigation and referral. We searched MEDLINE, Embase and Web of Science for studies describing age-related incidence trends for colorectal, bladder, lung, oesophagus, pancreas, stomach, breast, ovarian, uterine, kidney and laryngeal cancer and myeloma. ‘Younger’ patients were defined based on NICE guidelines for cancer referral. Ninety-eight studies met the inclusion criteria. Findings show that the incidence of colorectal, breast, kidney, pancreas, uterine cancer is increasing in younger age groups, whilst the incidence of lung, laryngeal and bladder cancer is decreasing. Data for oesophageal, stomach, ovarian cancer and myeloma were inconclusive. Overall, this review provides evidence that some cancers are increasingly being diagnosed in younger age groups, although the mechanisms remain unclear. Cancer investigation and referral guidelines may need updating in light of these trends.
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11
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Schell D, Ullah S, Brooke-Smith ME, Hollington P, Yeow M, Karapetis CS, Watson DI, Pandol SJ, Roberts CT, Barreto SG. Gastrointestinal Adenocarcinoma Incidence and Survival Trends in South Australia, 1990-2017. Cancers (Basel) 2022; 14:cancers14020275. [PMID: 35053439 PMCID: PMC8773524 DOI: 10.3390/cancers14020275] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/27/2021] [Accepted: 01/05/2022] [Indexed: 02/06/2023] Open
Abstract
Simple Summary This study from South Australia using the state’s Cancer Registry data provides compelling evidence for a significant increase in the incidence of young-onset (18–50 years) gastrointestinal (oesophageal, stomach, colon and rectum, and pancreas) adenocarcinomas over the last three decades. The trend observed in the young cohort was not mirrored in older individuals >50 years. This increased incidence, though noted in both sexes, was more pronounced in males compared to females. Survival in the young-onset adenocarcinoma cohort was only seen in patients with colorectal cancers, but not oesophagus, stomach and pancreas. This study calls for a concerted effort aimed at determining the sociodemographic factors underlying this disturbing trend with the aim of developing preventative strategies. Abstract Background & Aims: Globally, there has been a concerning rise in the incidence of young-onset cancers. The aim of this study was to provide trends in the incidence and survival of gastrointestinal adenocarcinomas (oesophagus, stomach, pancreas, and colorectal) in South Australia over a 27-year period. Methods: This is a cross-sectional analysis of a prospective longitudinal database including all cases of gastrointestinal adenocarcinomas prospectively reported to the South Australian (State) Cancer Registry from 1990 to 2017. Results: A total of 28,566 patients diagnosed with oesophageal, stomach, pancreatic, or colorectal adenocarcinoma between 1990 and 2017 were included in the study. While the overall incidence for gastrointestinal adenocarcinomas in individuals >50 years has decreased since 2000 (IRR of 0.97 (95% CI 0.94–1.00; p = 0.06)) compared to 1990–1999, the rate amongst individuals aged 18–50 has significantly increased (IRR 1.41 (95% CI 1.27–1.57; p < 0.001)) during the same reference time period. Although noted in both sexes, the rate of increase in incidence was significantly greater in males (11.5 to 19.7/100,000; p < 0.001). The overall survival from adenocarcinomas across all subsites improved in the >50-year cohort in the last decade (HR 0.89 (95% CI 0.86–0.93; p < 0.001)) compared to 1990–1999. In individuals aged 18–50 years, there has only been a significant improvement in survival for colorectal cancer (HR 0.82 (95% CI 0.68–0.99; p < 0.04)), but not the other subsites. A lower overall survival was noted for males in both age cohorts (18–50 years—HR 1.24 (95% CI 1.09–1.13; p < 0.01) and >50 years—HR 1.13 (95% CI 1.10–1.16; p < 0.001), respectively) compared to females. Conclusions: This study from South Australia demonstrates a significant increase in young-onset gastrointestinal adenocarcinomas over the last 28 years, with a greater increase in the male sex. The only significant improvement in survival in this cohort has been noted in colorectal cancer patients.
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Affiliation(s)
- Dominique Schell
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia; (D.S.); (S.U.); (P.H.); (C.S.K.); (D.I.W.)
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia; (D.S.); (S.U.); (P.H.); (C.S.K.); (D.I.W.)
| | - Mark E. Brooke-Smith
- Flinders Medical Center, Division of Surgery and Perioperative Medicine, Flinders University, Adelaide, SA 5042, Australia; (M.E.B.-S.); (M.Y.)
| | - Paul Hollington
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia; (D.S.); (S.U.); (P.H.); (C.S.K.); (D.I.W.)
- Flinders Medical Center, Division of Surgery and Perioperative Medicine, Flinders University, Adelaide, SA 5042, Australia; (M.E.B.-S.); (M.Y.)
| | - Marina Yeow
- Flinders Medical Center, Division of Surgery and Perioperative Medicine, Flinders University, Adelaide, SA 5042, Australia; (M.E.B.-S.); (M.Y.)
| | - Christos S. Karapetis
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia; (D.S.); (S.U.); (P.H.); (C.S.K.); (D.I.W.)
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA 5042, Australia
- Department of Medical Oncology, Flinders Medical Centre, Flinders University, Adelaide, SA 5042, Australia
| | - David I. Watson
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia; (D.S.); (S.U.); (P.H.); (C.S.K.); (D.I.W.)
- Flinders Medical Center, Division of Surgery and Perioperative Medicine, Flinders University, Adelaide, SA 5042, Australia; (M.E.B.-S.); (M.Y.)
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA 5042, Australia
| | - Stephen J. Pandol
- Cedars-Sinai Medical Center, Division of Digestive and Liver Diseases, Los Angeles, CA 90048, USA;
| | - Claire T. Roberts
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia; (D.S.); (S.U.); (P.H.); (C.S.K.); (D.I.W.)
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA 5042, Australia
- Correspondence: (C.T.R.); (S.G.B.)
| | - Savio G. Barreto
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia; (D.S.); (S.U.); (P.H.); (C.S.K.); (D.I.W.)
- Flinders Medical Center, Division of Surgery and Perioperative Medicine, Flinders University, Adelaide, SA 5042, Australia; (M.E.B.-S.); (M.Y.)
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA 5042, Australia
- Correspondence: (C.T.R.); (S.G.B.)
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12
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Foppa C, Tamburello S, Maroli A, Carvello M, Poliani L, Laghi L, Malesci A, Montorsi M, Perea J, Spinelli A. Early age of onset is an independent predictor for worse disease-free survival in sporadic rectal cancer patients. A comparative analysis of 980 consecutive patients. Eur J Surg Oncol 2021; 48:857-863. [PMID: 34740480 DOI: 10.1016/j.ejso.2021.10.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 09/19/2021] [Accepted: 10/22/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND while interest on early-onset colorectal cancer (age ≤49) is on the rise, studies on early-onset rectal cancer (EORC) are limited. The aim of this study was to compare predictors for disease progression/recurrence between sporadic EORC and late-onset RC patients (LORC). METHODS 163 EORC and 830 LORC operated between January 1st, 2010 and April 30th, 2021 at a tertiary center were included. Demographics, tumor characteristics, microsatellite status, gene mutations (KRAS, BRAF, NRAS, PI3Kca) and oncologic outcomes were compared. A Cox proportional hazards regression analysis was performed to ascertain the effect of variables on recurrence/progression and death. Recurrence/Progression free survival (R/PFS) and cancer specific survival (CSS) were analyzed by the Kaplan-Meier estimator. RESULTS Mean age of EORC was 42.16, (46% aged 45-49). A majority of EORC patients had a family history for CRC (p = 0.01) and underwent total neoadjuvant treatment (p = 0.01). EORC patients showed a higher rate of low-grade tumor differentiation (p < 0.0001), stage III-IV (p = 0.001), microsatellite instability (p = 0.02), locoregional nodal (p = 0.001) and distant metastases (p < 0.0001). Accordingly, more EORC patients underwent adjuvant treatment (p < 0.0001). Mutations were mostly reported among LORC cases (p = 0.04), whereas EORC patients showed a worse R/PFS (p = 0.02), even at stage I (p = 0.04). CSS did not differ (p = 0.11) across groups. Multivariate analysis indicated age of onset (p = 0.04) was an independent predictor for progression/recurrence. CONCLUSIONS Age of onset was shown to be an independent unfavorable predictor. Delayed diagnosis could explain this effect in the more advanced stages, while the worse outcomes in stage I may suggest a more aggressive disease behavior.
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Affiliation(s)
- Caterina Foppa
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Sara Tamburello
- IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Annalisa Maroli
- IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Michele Carvello
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Laura Poliani
- IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Luigi Laghi
- IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy; Department of Medicine and Surgery, University of Parma, 43100, Parma, Italy
| | - Alberto Malesci
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Marco Montorsi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - José Perea
- Department of Surgery, Fundación Jiménez Díaz University Hospital, Madrid, Spain; Fundación Jiménez Díaz University Hospital Health Research Institute, Madrid, Spain
| | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
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13
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Hemminki K, Försti A, Hemminki A. Survival in colon and rectal cancers in Finland and Sweden through 50 years. BMJ Open Gastroenterol 2021; 8:bmjgast-2021-000644. [PMID: 34272211 PMCID: PMC8287611 DOI: 10.1136/bmjgast-2021-000644] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/11/2021] [Indexed: 01/28/2023] Open
Abstract
Objectives Global survival studies have shown favourable development in colon and rectal cancers but few studies have considered extended periods or covered populations for which medical care is essentially free of charge. Design We analysed colon and rectal cancer survival in Finland and Sweden over a 50-year period (1967–2016) using data from the Nordcan database. In addition to the standard 1-year and 5-year survival rates, we calculated the difference between these as a novel measure of how well survival was maintained between years 1 and 5. Results Relative 1-year and 5-year survival rates have developed favourably without major shifts for men and women in both countries. For Finnish men, 1-year survival in colon cancer increased from 50% to 82%, and for rectal cancer from 62% to 85%. The Swedish survival was a few per cent unit better for 1-year survival but for 5-year survival the results were equal. Survival of female patients for both cancers was somewhat better than survival in men through 50 years. Overall the survival gains were higher in the early compared with the late follow-up periods, and were the smallest in the last 10 years. The difference between 1-year and 5-year survival in colon cancer was essentially unchanged over the 50-year period while in rectal cancer there was a large improvement. Conclusions The gradual positive development in survival suggests a contribution by many small improvements rather than single breakthroughs. The improvement in 5-year survival in colon cancer was almost entirely driven by improvement in 1-year survival while in rectal cancer the positive development extended to survival past year 1, probably due to successful curative treatments. The current challenges are to reinvigorate the apparently stalled positive development and to extend them to old patients. For colon cancer, survival gains need to be extended past year 1 of diagnosis.
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Affiliation(s)
- Kari Hemminki
- Biomedical Center, Faculty of Medicine and Biomedical Center in Pilsen, Charles University in Prague, Pilsen, Czech Republic .,Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, Heidelberg, Baden-Württemberg, Germany
| | - Asta Försti
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Akseli Hemminki
- Cancer Gene Therapy Group, Helsingin yliopisto, Helsinki, Uusimaa, Finland.,Comprehensive Cancer Center, Helsingin yliopistollinen Keskussairaala, Helsinki, Uusimaa, Finland
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14
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Mueller M, Schneider MA, Deplazes B, Cabalzar-Wondberg D, Rickenbacher A, Turina M. Colorectal cancer of the young displays distinct features of aggressive tumor biology: A single-center cohort study. World J Gastrointest Surg 2021; 13:164-175. [PMID: 33643536 PMCID: PMC7898186 DOI: 10.4240/wjgs.v13.i2.164] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/02/2021] [Accepted: 01/21/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In recent years, a decrease in incidence and mortality of colorectal cancer (CRC) has been observed in developed nations, presumably through public disease awareness and increased screening efforts. However, a rising incidence of CRC in young patients below the age of 50 years has been reported in several studies.
AIM To study tumor biology in CRC patients below 50 years of age.
METHODS All patients with CRC were prospectively enrolled in our single-center oncologic database from January 2013 to December 2018 and were grouped and analyzed according to age (≥ 50 and < 50 years). Clinical as well as histopathological features were analyzed and compared. The study was approved by the local Ethics Committee. Fisher’s exact test or t-test was used to test for differences between the groups, as appropriate. All statistical analysis was performed with IBM SPSS software Version 25 (SPSS Inc, Armonk, NY, United States) and with R-Studio using R Version 3.4.1 (RStudio, Boston, MA, United States).
RESULTS Seventeen percent of the 411 patients were younger than 50 years. Young patients were more often diagnosed with locally advanced T4-tumors and lymph node metastases (36.6% and 62% vs 17.7% and 42%; P < 0.01). In addition, a higher frequency of poorly differentiated (G3) tumors (40% vs 22.4% P < 0.05) was observed. More than every second patient below 40 years of age (51.8%) had distant metastases at diagnosis with a significant higher rate ring of signet cell differentiation compared to patients ≥ 50 years (14.8%, P < 0.05). Mutational status (KRAS, NRAS, BRAF, MSI) as well as selected behavioral risk factors showed no significant differences.
CONCLUSION Distinct histopathologic features of increased biologic aggressiveness are found in patients with CRC of young-onset. Those patients present more frequently with more advanced tumor stages compared to older patients. Features of aggressive tumor biology underscore the need for earlier uptake of routine screening measures.
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Affiliation(s)
- Matteo Mueller
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich 8091, Switzerland
| | - Marcel André Schneider
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich 8091, Switzerland
| | - Barla Deplazes
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich 8091, Switzerland
| | | | - Andreas Rickenbacher
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich 8091, Switzerland
| | - Matthias Turina
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich 8091, Switzerland
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15
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Villa ALP, Parra RS, Feitosa MR, Camargo HPD, Machado VF, Tirapelli DPDC, Rocha JJRD, Feres O. PPARG expression in colorectal cancer and its association with staging and clinical evolution. Acta Cir Bras 2020; 35:e202000708. [PMID: 32813759 PMCID: PMC7433669 DOI: 10.1590/s0102-865020200070000008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/08/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose To evaluate the gene expression of peroxisome proliferator activated receptors gamma (PPARG) in colorectal tumors and to correlate this data with clinical variables of the patients. Methods We analyzed the gene expression of PPARG in 50 samples of colorectal tumors using real-time reverse transcription polymerase chain reaction, and 20 adjacent normal tissue samples as control. The results of these quantifications were correlated with the respective patients’ medical records’ clinical information. Results PPARG expression was not different in the tumor tissue compared to the control tissue. Patients older than 60 years, histological type with mucinous differentiation, more advanced staging at the time of diagnosis, and patients who evolved with recurrence of the disease or death did not present higher PPARG expression. Conclusion Expression of PPARGD was not associated with worse prognosis.
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