早发性癌症是一种新兴的全球流行病吗？现有的证据和对未来的影响

SCI

7 Octember 2022

Is early-onset cancer an emerging global epidemic? Current evidence and future implications

（Nat Rev Clin Oncol；IF:65.011）

• Ugai T, Sasamoto N, Lee HY, et al. Is early-onset cancer an emerging global epidemic? Current evidence and future implications. Nat Rev Clin Oncol. 2022

• CORRESPONDENCE TO : tugai@bwh.harbard.edu; sogino@bwh.Advard.edu

Abstract |

Over the past several decades, the incidence of early-onset cancers, often defined as cancers diagnosed in adults <50 years of age, in the breast, colorectum, endometrium, oesophagus, extrahepatic bile duct, gallbladder, head and neck, kidney, liver, bone marrow, pancreas, prostate, stomach and thyroid has increased in multiple countries. Increased use of screening programmes has contributed to this phenomenon to a certain extent, although a genuine increase in the incidence of early-onset forms of several cancer types also seems to have emerged. Evidence suggests an aetiological role of risk factor exposures in early life and young adulthood. Since the mid-20th century, substantial multigenerational changes in the exposome have occurred (including changes in diet, lifestyle, obesity, environment and the microbiome, all of which might interact with genomic and/or genetic susceptibilities). However, the effects of individual exposures remain largely unknown. To study early-life exposures and their implications for multiple cancer types will require prospective cohort studies with dedicated biobanking and data collection technologies. Raising awareness among both the public and health-care professionals will also be critical. In this Review, we describe changes in the incidence of early-onset cancers globally and suggest measures that are likely to reduce the burden of cancers and other chronic non-communicable diseases.

在过去几十年中，乳腺癌、结直肠癌、子宫内膜癌、食道癌、肝外胆管癌、胆囊癌、头颈部癌、肾癌、肝癌、骨髓癌、胰腺癌、前列腺癌、胃癌和甲状腺癌的发病率在许多国家都有所上升。尽管这些癌症的早发性发病率似乎也在确实地增加，更多的筛查也在一定程度上促成了这一现象。有证据表明，在青年和成年初期，风险因素暴露在病因学上起到了作用。自20世纪中叶以来，暴露组发生了重大的多代变化(包括饮食、生活方式、肥胖、环境和微生物组的变化，所有这些都可能与基因组和/或遗传易感性相互作用)。然而，个人接触的影响在很大程度上仍不清楚。要研究早期暴露及其对多种癌症类型的影响，将需要使用专门的生物库和数据收集技术进行前瞻性队列研究。提高公众和卫生保健专业人员的认识也是至关重要的。在这篇综述中，我们描述了全球早发性癌症发病率的变化，并提出了可能减轻癌症和其他慢性非传染性疾病负担的措施。