Mortality of colorectal cancer in Taiwan, 1971–2010: temporal changes and age–period–cohort analysis
- First Online:
Colorectal cancer (CRC) is the second most common cause of cancer death in developed countries among men (after lung cancer) and the third most common among women. This study thus examines the long-term trends of CRC mortality in Taiwan.
CRC cases were collective between patients aged 30 years or older and younger than 85 years from the Taiwan death registries during 1971–2010. Standard descriptive techniques such as age-standardized mortality rates (ASMR), aural percent change, and age–period–cohort analyses were used.
The increase of percentage change by each age group in men was higher than in women. The ASMR of CRC increased 2-fold for men and almost 1.5-fold for women during the periods 1971–1975 and 2006–2010. For age–period–cohort analysis, the estimated mortality rate increased steadily with age in both sexes, and plateaued at 175.29 per 100,000 people for men and 128.14 per 100,000 for women in the 80- to 84-year-old group. Period effects were weak in both sexes. Cohort effects were strong. Between 30 and 59 years of age, the sex ratio showed that the female CRC mortality rate was higher than that of their male counterparts. Conversely, the mortality risk of CRC in men was higher than that in women when they were between 60 and 84 years old.
The current findings showed a consistent increase in mortality from CRC over the years. Changes in the patient sex ratio indicated an important etiological role of sex hormones, especially in women aged 60 years or younger.
KeywordsAge–period–cohort analysis Colorectal cancer Sex ratio Taiwan
- 6.Ferrari P, Jenab M, Norat T, Moskal A, Slimani N, Olsen A, Tjonneland A, Overvad K, Jensen MK, Boutron-Ruault MC, Clavel-Chapelon F, Morois S, Rohrmann S, Linseisen J, Boeing H, Bergmann M, Kontopoulou D, Trichopoulou A, Kassapa C, Masala G, Krogh V, Vineis P, Panico S, Tumino R, van Gils CH, Peeters P, Bueno-de-Mesquita HB, Ocke MC, Skeie G, Lund E, Agudo A, Ardanaz E, Lopez DC, Sanchez MJ, Quiros JR, Amiano P, Berglund G, Manjer J, Palmqvist R, Van Guelpen B, Allen N, Key T, Bingham S, Mazuir M, Boffetta P, Kaaks R, Riboli E (2007) Lifetime and baseline alcohol intake and risk of colon and rectal cancers in the European prospective investigation into cancer and nutrition (EPIC). Int J Cancer J Int Cancer 121(9):2065–2072. doi:10.1002/ijc.22966 Google Scholar
- 7.Edwards BK, Ward E, Kohler BA, Eheman C, Zauber AG, Anderson RN, Jemal A, Schymura MJ, Lansdorp-Vogelaar I, Seeff LC, van Ballegooijen M, Goede SL, Ries LA (2010) Annual report to the nation on the status of cancer, 1975–2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer 116(3):544–573. doi:10.1002/cncr.24760 PubMedCrossRefGoogle Scholar
- 11.Sung JJ, Lau JY, Young GP, Sano Y, Chiu HM, Byeon JS, Yeoh KG, Goh KL, Sollano J, Rerknimitr R, Matsuda T, Wu KC, Ng S, Leung SY, Makharia G, Chong VH, Ho KY, Brooks D, Lieberman DA, Chan FK (2008) Asia Pacific consensus recommendations for colorectal cancer screening. Gut 57(8):1166–1176. doi:10.1136/gut.2007.146316 PubMedCrossRefGoogle Scholar
- 12.Cause of death statistics in Taiwan. (2010)Google Scholar
- 17.Hu NC, Chen JD, Lin YM, Chang JY, Chen YH (2011) Stepwise relationship between components of metabolic syndrome and risk of colorectal adenoma in a Taiwanese population receiving screening colonoscopy. Journal of the Formosan Medical Association =. Taiwan yi zhi 110(2):100–108. doi:10.1016/S0929-6646(11)60016-8 PubMedCrossRefGoogle Scholar
- 18.Wang CCTTC, Hsiehb T, Hsua CS, Wanga PC, Lina HH, Kao JH (2012) Severity of fatty liver on ultrasound correlates with metabolic and cardiovascular risk. Kaohsiung J Med Sci:1-10Google Scholar
- 19.Lin YC, Chou SC, Huang PT, Chiou HY (2011) Risk factors and predictors of non-alcoholic fatty liver disease in Taiwan. Ann Hepato Off J Mex Assoc Hepatol 10(2):125–132Google Scholar
- 22.Yeh CC, Hsieh LL, Tang R, Chang-Chieh CR, Sung FC (2003) Risk factors for colorectal cancer in Taiwan: a hospital-based case-control study. J Formos Med Assoc = Taiwan yi zhi 102(5):305–312Google Scholar
- 25.Thong T (2011) To Raise the savage to a higher level: the westernization of Nagas and their culture. Mod Asian Stu:1-26Google Scholar
- 29.Chavez-MacGregor M, Elias SG, Onland-Moret NC, van der Schouw YT, Van Gils CH, Monninkhof E, Grobbee DE, Peeters PH (2005) Postmenopausal breast cancer risk and cumulative number of menstrual cycles. Cancer Epidemiol, Biomark Prev Pub Am Assoc Cancer Res, cosponsored Am Soc Prev Oncol 14(4):799–804. doi:10.1158/1055-9965.EPI-04-0465 Google Scholar
- 30.Dossus L, Allen N, Kaaks R, Bakken K, Lund E, Tjonneland A, Olsen A, Overvad K, Clavel-Chapelon F, Fournier A, Chabbert-Buffet N, Boeing H, Schutze M, Trichopoulou A, Trichopoulos D, Lagiou P, Palli D, Krogh V, Tumino R, Vineis P, Mattiello A, Bueno-de-Mesquita HB, Onland-Moret NC, Peeters PH, Dumeaux V, Redondo ML, Duell E, Sanchez-Cantalejo E, Arriola L, Chirlaque MD, Ardanaz E, Manjer J, Borgquist S, Lukanova A, Lundin E, Khaw KT, Wareham N, Key T, Chajes V, Rinaldi S, Slimani N, Mouw T, Gallo V, Riboli E (2010) Reproductive risk factors and endometrial cancer: the European prospective investigation into cancer and nutrition. Int J Cancer J Int Cancer 127(2):442–451. doi:10.1002/ijc.25050 Google Scholar
- 33.Tsilidis KK, Allen NE, Key TJ, Bakken K, Lund E, Berrino F, Fournier A, Olsen A, Tjonneland A, Overvad K, Boutron-Ruault MC, Clavel-Chapelon F, Byrnes G, Chajes V, Rinaldi S, Chang-Claude J, Kaaks R, Bergmann M, Boeing H, Koumantaki Y, Stasinopoulou G, Trichopoulou A, Palli D, Tagliabue G, Panico S, Tumino R, Vineis P, Bueno-de-Mesquita HB, van Duijnhoven FJ, van Gils CH, Peeters PH, Rodriguez L, Gonzalez CA, Sanchez MJ, Chirlaque MD, Barricarte A, Dorronsoro M, Borgquist S, Manjer J, van Guelpen B, Hallmans G, Rodwell SA, Khaw KT, Norat T, Romaguera D, Riboli E (2010) Oral contraceptives, reproductive history and risk of colorectal cancer in the European prospective investigation into cancer and nutrition. Br J Cancer 103(11):1755–1759. doi:10.1038/sj.bjc.6605965 PubMedCrossRefGoogle Scholar
- 35.Nations U (2004) Press release: Majority of world's couples of reproductive age are using contraception (DEV/2469; POP/902). Department of Public Information, New YorkGoogle Scholar
- 37.Winawer S, Fletcher R, Rex D, Bond J, Burt R, Ferrucci J, Ganiats T, Levin T, Woolf S, Johnson D, Kirk L, Litin S, Simmang C (2003) Colorectal cancer screening and surveillance: clinical guidelines and rationale—update based on new evidence. Gastroenterology 124(2):544–560. doi:10.1053/gast.2003.50044 PubMedCrossRefGoogle Scholar
- 38.Yen SJ, Leu SY, Hsu H (1994) Colonoscopic screening for first degree relatives of patients with colorectal cancer. Zhonghua yi xue za zhi = Chin Med J Free China ed 54(3):166–169Google Scholar
- 42.MacGillivray DC, Swartz SE, Robinson AM, Cruess DF, Smith LE (1991) Adenocarcinoma of the colon and rectum in patients less than 40 years of age. Surg, Gynecol Obstet 172(1):1–7Google Scholar
- 46.Liou TY, Hsu H, Chen SS, Feng YS, Wang HM (1989) Evaluation of rapid colon preparation by oral intake of dulcolax for colorectal surgery. Zhonghua yi xue za zhi = Chin Med J Free China ed 44(2):103–108Google Scholar
- 47.Chen CF, Lin JK, Leu SY, Liang CL (1989) Evaluation of rapid colon preparation with Golytely. Zhonghua yi xue za zhi = Chin Med J Free China ed 44(1):45–56Google Scholar