《NEJM Evidence》发表的一项研究显示，美国几乎所有年龄段的结直肠癌发病率均出现上升趋势 1。数据显示，经年龄调整的结直肠癌发病率曾从2000年的每10万人55.2例持续下降至2022年的36.7例，但在2023年反弹升至每10万人38.3例 1。这是自20多年前以来，美国总体结直肠癌发病率首次出现增长，且这一趋势已延伸至包括65-69岁在内的所有年龄段 1。
在具体年龄组别中，45-49岁人群的发病率增幅最为显著，2019年至2023年间年均增长率达到12.76% 1。研究人员指出，这一特定年龄段的增长可能与筛查年龄的下调有关，因为现行国家指南建议平均风险成年人应从45岁开始接受定期筛查，直至75岁 1。然而，其他年龄组同样出现的发病率上升暗示可能存在尚未明确的潜在风险因素，目前研究者正在调查环境化学暴露是否为此类未知因素之一 1。
鉴于结直肠癌是美国癌症相关死亡的第二大原因，且在50岁以下成年人中居首位，专家警告称这一发病率逆转的趋势将对医疗系统造成沉重负担 1。研究强调，公众需继续遵循筛查建议并密切关注相关症状 1。
A study published in NEJM Evidence by a team from the University of Chicago reveals that colorectal cancer incidence is increasing across almost every age group in the United States. This marks the first time in more than two decades that overall rates have risen, reversing a long-term downward trend 1. The increase extends to all age groups, including those aged 65 to 69 years 1. Colorectal cancer remains the second leading cause of cancer-related deaths nationally and ranks first among adults under 50 years old 1.
The age-adjusted incidence rate declined from 55.2 cases per 100,000 people in 2000 to 36.7 cases in 2022, but subsequently increased to 38.3 cases in 2023 1. The most significant annual increase was observed in the 45-to-49-year-old demographic, which saw a rise of 12.76% between 2019 and 2023 1. While this specific spike may be linked to national guidelines recommending that average-risk adults begin regular screening at age 45 through age 75, researchers suggest that increases in other age groups point to unknown risk factors 1. Consequently, the study’s authors are investigating environmental chemical exposures as potential contributors to this concerning trend 1.
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