Objective:To evaluate population-level temporal relationships between modifiable lifestyle factors and rising breast, colorectal and uterine cancer incidence rates among females under 50 years old.Methods:This retrospective ecological study utilized data from the United States Cancer Statistics (USCS) for cancer incidence, the National Health and Nutrition Examination Survey (NHANES) for health-related behaviors, and the Behavioral Risk Factor Surveillance System (BRFSS) for physical activity. Modifiable lifestyle factors analyzed included obesity (BMI ≥ 30 kg/m2), smoking, alcohol use, fiber and saturated fat intake, caloric intake, and physical activity. Trends were assessed using average annual percent change (AAPC), and population-level correlations between cancer incidence and lifestyle factors were evaluated using Pearson correlation coefficients.Results:Between 2001 and 2018, 914,659 breast, 144,130 colorectal, and 124,399 uterine cancer cases were identified. The largest increases in cancer incidence occurred in age groups under 30 years old. Colorectal cancer increased by 6.9%, followed by uterine cancer at 4.8% and breast cancer at 1.7%, allp< 0.001. When examining this age group by race, colorectal cancer increased by 8.0% (p< 0.001) annually in White women aged 20–24 years, while uterine cancer rose 4.8% (p< 0.001) in Hispanic women in the 20–24 and 25–29 year age groups. Breast cancer also increased by 2.0% (p< 0.001) per year in White women 25–29 years old. Smoking rates decreased, and alcohol consumption and obesity rates increased. No significant correlation was found between cancer incidence and smoking, caloric intake, saturated fat, or physical activity. A moderate positive correlation was identified between alcohol use and cancer risk (r = 0.55–0.67,p< 0.05). Obesity prevalence showed strong population-level temporal correlation with cancer incidence for all three cancers with stratified analysis demonstrating the strongest correlations in patients with class III obesity.Conclusions:From 2001 to 2018, the incidence of breast, colorectal, and uterine cancers increased most sharply among women under 30 years of age. Over the same period, obesity prevalence in this population also increased. These population-level observations are hypothesis-generating and require confirmation in individual-level, prospective studies to determine whether and how obesity and other lifestyle factors influence early-onset cancer risk.
目的：评估50岁以下女性中可改变的生活方式因素与乳腺癌、结直肠癌和子宫癌发病率上升之间的人群层面时间关联。 方法：本回顾性生态学研究利用美国癌症统计数据（USCS）获取癌症发病率，国家健康与营养调查（NHANES）获取健康相关行为数据，行为风险因素监测系统（BRFSS）获取体力活动数据。分析的可改变生活方式因素包括肥胖（BMI ≥ 30 kg/m²）、吸烟、饮酒、膳食纤维与饱和脂肪摄入量、热量摄入及体力活动。采用年均百分比变化（AAPC）评估趋势，并使用皮尔逊相关系数评估癌症发病率与生活方式因素之间的人群层面相关性。 结果：2001年至2018年间，共发现914,659例乳腺癌、144,130例结直肠癌和124,399例子宫癌病例。癌症发病率增幅最大的是30岁以下年龄组。结直肠癌年增长6.9%，子宫癌4.8%，乳腺癌1.7%，均p<0.001。按种族细分该年龄组发现：20-24岁白人女性结直肠癌年增长8.0%（p<0.001）；20-24岁及25-29岁西班牙裔女性子宫癌年增长4.8%（p<0.001）；25-29岁白人女性乳腺癌年增长2.0%（p<0.001）。同期吸烟率下降，饮酒率与肥胖率上升。癌症发病率与吸烟、热量摄入、饱和脂肪或体力活动无显著相关性。饮酒与癌症风险呈中度正相关（r=0.55–0.67，p<0.05）。肥胖患病率与三种癌症发病率在人群层面呈现强时间相关性，分层分析显示Ⅲ级肥胖患者相关性最强。 结论：2001年至2018年间，30岁以下女性的乳腺癌、结直肠癌和子宫癌发病率上升最为显著。同期该人群肥胖患病率同步增长。这些人群层面的观察结果具有假设生成价值，需通过个体层面的前瞻性研究进一步验证，以确定肥胖及其他生活方式因素是否及如何影响早发性癌症风险。
Population-Level Trends in Lifestyle Factors and Early-Onset Breast, Colorectal, and Uterine Cancers
肿瘤(癌症)患者之家