Impact of Tumor Progression on Cancer Incidence Curves

摘要: Cancer arises through a multistage process, but it is not fully clear how this process influences the age-specific incidence curve. Studies of colorectal and pancreatic cancer using clonal expansion (MSCE) model have identified two phases curves. One phase linear, beginning about age 60 years, suggesting that at least rare rate-limiting mutations occur before premalignant cells. A second exponential, seen in early-onset cancers occurring years are associated with expansion. Here, we extend MSCE to include malignant cells, an advance permits study effects tumor growth extinction on colorectal, gastric, pancreatic, esophageal adenocarcinomas digestive tract. After adjusting for birth-cohort calendar-year trends, found initiating cell kinetics can explain primary features However, also data these harbored information clinical detection, including rates probabilities three characteristic time scales progression. In addition, mean sojourn times clones until occurrence either first or persistent (surviving) clone. Finally, diagnosis. conclusion, curves harbor significant hidden processes initiation, expansion, transformation, even some limited detection. Res; 73(3); 1086–96. ©2012 AACR.