International Journal of Colorectal Disease

, Volume 23, Issue 5, pp 461–467

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

Authors

    • Centre for Molecular Epidemiology, Faculty of MedicineNational University of Singapore
    • Department of Public HealthErasmus Medical Centre Rotterdam
  • Chia Siong Wong
    • Centre for Molecular Epidemiology, Faculty of MedicineNational University of Singapore
  • Kee Seng Chia
    • Centre for Molecular Epidemiology, Faculty of MedicineNational University of Singapore
    • Department of Community, Occupational and Family Medicine, Faculty of MedicineNational University of Singapore
  • Xueling Sim
    • Centre for Molecular Epidemiology, Faculty of MedicineNational University of Singapore
  • Chuen Seng Tan
    • Centre for Molecular Epidemiology, Faculty of MedicineNational University of Singapore
  • Lambertus A. Kiemeney
    • Department of Epidemiology and BiostatisticsRadboud University Nijmegen Medical Centre
  • Helena M. Verkooijen
    • Department of Community, Occupational and Family Medicine, Faculty of MedicineNational University of Singapore
    • Centre for Molecular Epidemiology, Faculty of MedicineNational University of Singapore
Original Article

DOI: 10.1007/s00384-007-0421-9

Cite this article as:
de Kok, I.M.C.M., Wong, C.S., Chia, K.S. et al. Int J Colorectal Dis (2008) 23: 461. doi:10.1007/s00384-007-0421-9

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.

Keywords

Age-period cohort effectColorectal cancerGenderIncidencePoisson regression

Copyright information

© Springer-Verlag 2007