台灣15至29歲青少年與年輕成人的癌症發生率趨勢：1995-2011年

The Trend of Cancer Incidence among Adolescents and Young Adults Aged 15 to 29 Years from 1995 to 2011

曹玉婷(Yu-Ting Tsao) ； 江濬如(Chun-Ju Chiang) ； 簡吟曲(Yin-Chu Chien) ； 楊雅雯(Ya-Wen Yang) ； 羅偉成(Wei-Cheng Lo) ； 陳建仁(Chien-Jen Chen) ； 詹其峰(Chyi-Feng Jan)

《台灣家庭醫學雜誌》 26卷1期 (2016/03) Pp. 22-34

https://doi.org/10.3966/168232812016032601003

摘要

背景：癌症是台灣青少年與年輕成人的第三大死亡原因，本研究的目的即為了解台灣15-29歲族群1995至2011年間的各類癌症發生率及其趨勢。方法：取自台灣癌症登記中心1995至2011年登錄資料，15-29歲族群的各類癌症發生率資料。根據National Cancer Institute的SurveillanceEpidemiology and End Results (SEER) program，將診斷分門別類進行國際比較。以年齡差距每5年為單位，再比較各性別與年齡層的各癌症別發生率、年齡標準化發生率(Age-Standardized Rate, ASRs)、年度百分比變化(Annual Percent Change, APCs)、平均年度百分比變化(AverageAnnual Percent Change, AAPCs)，並以Joinpoint統計軟體分析各癌症別發生率趨勢。結果：於1995至2011年間15-29歲族群共有24,738個癌症新發生病例，其中男性佔46.1%。全癌症的年齡標準化發生率分別為男性235.7/100萬，女性285.8/100萬，男女比為0.8。年輕男性發生率最高的癌症前三名分別為肝及肝內膽管癌（22.5/100萬），非何杰金氏淋巴癌（19.7/100萬），以及性腺生殖細胞瘤（18.8/100萬）。年輕女性發生率最高的癌症前三名則分別為甲狀腺癌（61.5/100萬），乳癌（31.4/100萬），及卵巢癌（15.7/100萬）。青少年癌症發生趨勢，在1995-2011這17年間，總發生率AAPC為1.7%，其中男性1.4%，女性1.7%。何杰金氏淋巴癌發生率在男女性皆有顯著上升(p＜0.05)。急性淋巴性白血病、性腺生殖細胞瘤、甲狀腺癌以及腎臟癌的發生率只在男性有顯著上升(p＜0.05)；而非何杰金氏淋巴癌、惡性骨肉瘤、乳癌及胰臟癌的發生率只在女性有顯著上升(p＜0.05)。結論：1995-2011年這17年間，在台灣青少年與年輕成人族群，無論男性或女性，癌症發生率都顯著上升，其中15-29歲族群的女性癌症發生率高於男性。

關鍵字

青少年 ； 年輕成人 ； 癌症發生率 ； 流行病學 ； 台灣

並列摘要

Background: Cancer is the third leading cause of death for adolescents and young adults (AYAs) aged 15-29 years old in Taiwan. This study aimed to investigate the trend of cancer incidence in the AYAs in Taiwan during the period from 1995 to 2011. Methods: Cancer incidence data from 1995 to 2011 were obtained from the Taiwan Cancer Registry. Individual cancers were categorized into specific diagnostic groups and subgroups based on the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) AYA site records. Five-year age-specific incidence rates, world age-standardized rates (ASRs), annual percent changes (APCs), and average annual percent changes (AAPCs) were calculated for AYAs by gender and age groups. The Joinpoint statistical software was used to analyze cancer incidence trends. Results: A total of 24,738 incidence cancer cases, including 11,400 males (46.1%), were collected for data analysis. The age-standardized incidence rates of all cancers were 235.7 and 285.8 per million respectively for males and females (male-to-female ratio: 0.8). The three most common cancers for AYA males were carcinoma of liver and intrahepatic bile ducts (22.5 per million), non-Hodgkin lymphoma (19.7 per million), and germ cell and trophoblastic neoplasms of gonads (18.8 per million). The three leading cancers for AYA females, on the other hand, were thyroid carcinoma (61.5 per million), breast carcinoma (31.4 per million), and gonads carcinoma (15.7 per million). During the 17-year study period, there was a significant increase in incidence of Hodgkin lymphoma for both males and females. For males, there was an increase in incidence of acute lymphoid leukemia, germ cell and trophoblastic neoplasms of gonads, thyroid carcinoma, and carcinoma of kidney. For females, increased incidence was noted in non-Hodgkin lymphoma, osteosarcoma, breast carcinoma, and pancreas carcinoma. Conclusion: Overall, there was an increased incidence for all cancer sites in both male and female AYAs. This study further identified a higher cancer incidence for female AYAs compared to their male counterparts.

並列關鍵字

adolescents ； cancer incidence ； epidemiology ； Taiwan ； young adult

參考文獻

衛生福利部國民健康署：癌症登記線上互動查詢系統。2015年11月18日，取自https://cris.hpa.gov.tw/.

衛生福利部國民健康署：中華民國101年癌症登記報告。2015年11月18日，取自http://www.hpa.gov.tw/BHPNet/Web/Stat/StatisticsShow.aspx?No=201504290001.

National Institute of Health: AYA Site Recode ICD-O-3/WHO 2008 Definition. 2015年11月18日，取自http://seer.cancer.gov/ayarecode/aya-who2008.html

National Institute of Health: Joinpoint Trend Analysis Software. 2015年11月18日，取自http://surveillance.cancer.gov/joinpoint/.

Chiang, CJ,Chen, YC,Chen, CJ,You, SL,Lai, MS(2010).Cancer trends in Taiwan.Jpn J Clin Oncol.40,897-904.