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Gender differences in the trend of colorectal cancer incidence in Singapore, 1968–2002

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background and aims

Over the past decades, incidence trends of colorectal cancer are sharply increased in Singapore. In this population-based study we describe changes in colorectal cancer incidence in Singapore and explore the reasons behind these changes through age-period cohort (APC) modeling.

Methods

We included all 22,609 colorectal cancer cases reported to the Singapore Cancer Registry between 1968 and 2002. Poisson regression, using age-period (AP) and age-cohort (AC) models was used to determine the effects of age at diagnosis, calendar period, and birth cohort.

Results

Male colorectal cancer rates between 1968 and 2002 from 20 to 40 per 100,000 person years. The increase was sharpest among older men, for whom there was a significant AC effect. Female colorectal cancer rates increased until 1992 (from 16 to 29 per 100,000 person years) and stabilized afterward. For women under 65 years, we observed a significant AP effect, corresponding to a sudden rise in colorectal cancer incidence around 1978.

Conclusions

This study demonstrates important gender differences in colorectal cancer incidence in Singapore, with increasing rates among men, and stabilized rates in women. The increase in men is mainly attributable to an incidence increase in the oldest age groups, probably due to increased exposure to dietary and lifestyle risk factors earlier in life. The stabilization in female colorectal cancer risk could be due to lower exposure to lifestyle risk factors and prophylactic removal of precancerous lesions.

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Authors and Affiliations

  1. Centre for Molecular Epidemiology, Faculty of Medicine, National University of Singapore, Singapore, Singapore, 119077

    Inge M. C. M. de Kok, Chia Siong Wong, Kee Seng Chia, Xueling Sim, Chuen Seng Tan & Helena M. Verkooijen

  2. Department of Public Health, Erasmus Medical Centre Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands

    Inge M. C. M. de Kok

  3. Department of Epidemiology and Biostatistics, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

    Lambertus A. Kiemeney

  4. Department of Community, Occupational and Family Medicine, Faculty of Medicine, National University of Singapore, Singapore, Singapore

    Kee Seng Chia & Helena M. Verkooijen

Authors
  1. Inge M. C. M. de Kok
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  2. Chia Siong Wong
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  3. Kee Seng Chia
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  4. Xueling Sim
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  5. Chuen Seng Tan
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  6. Lambertus A. Kiemeney
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  7. Helena M. Verkooijen
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Correspondence to Inge M. C. M. de Kok.

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de Kok, I.M.C.M., Wong, C.S., Chia, K.S. et al. Gender differences in the trend of colorectal cancer incidence in Singapore, 1968–2002. Int J Colorectal Dis 23, 461–467 (2008). https://doi.org/10.1007/s00384-007-0421-9

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  • DOI: https://doi.org/10.1007/s00384-007-0421-9

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