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Irish Journal of Medical Science (1971 -)

, Volume 186, Issue 1, pp 113–121 | Cite as

Colorectal cancer incidence and survival by sub-site and stage of diagnosis: a population-based study at the advent of national screening

  • J. McDevittEmail author
  • H. Comber
  • P. M. Walsh
Original Article

Abstract

Background

The location and staging of a colorectal cancer (CRC) determine prognosis and choice of treatment. We examined the sub-site, sex, and stage distribution for CRC in Ireland for patients diagnosed in the period immediately prior to the implementation of a national screening programme.

Methods

Incident cases of CRC were abstracted from the National Cancer Registry for the period 1994–2012 (n = 38,912). Incidence proportions and 3-year cancer-related survival were calculated.

Results

The incidence of CRC during 2010–2012 averaged 1021 females and 1424 males per year. While the overall incidence rate of CRC was static during 1994–2012, this masked a significant increase in the rate of proximal colon tumours (+1.3 % per year), a decreases in the rate of tumours of overlapping/colon NOS (−2.2 % per year), and no change in the rates of cancers of the distal colon and rectosigmoid junction (RSJ)/rectum. Proximal tumours occurred more frequently in females (F vs. M, 38 vs. 29 %), in older persons and increased over time. Compared to distal colon tumours, proximal colon [RR risk ratio 1.08, 95 % CI (1.05, 1.10)] and RSJ/rectum tumours [RR 1.08 (1.05, 1.11)] were more likely to be diagnosed at late stage. The proportion of late-stage tumours increased steadily over five diagnosis periods [e.g., 1994–1997 (51 %) vs. 2010–2012 (57 %), RR 1.12 (1.08, 1.16)]. Cancer survival improved over four diagnosis periods.

Conclusions

There was a distal-to-proximal shift and a trend towards diagnosis at late stage during 1994–2012. Some reversal of this trend is expected following the implementation of a national screening programme.

Keywords

Colorectal cancer Colon Rectum Stage 

Notes

Compliance with ethical standards

Research involving human participants

For this type of study, formal consent is not required. The National Cancer Registry Board was established by the Minister for Health in 1991 by Statutory Instrument and is wholly funded by the Department of Health. It was set up to record information on all cancer cases occurring in Ireland and has been collecting such data since 1994.

Research involving animals

Not applicable.

References

  1. 1.
    Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J et al (2013) Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer Oxf Engl 1990 49:1374–1403. doi: 10.1016/j.ejca.2012.12.027 Google Scholar
  2. 2.
    World Cancer Report. http://www.iarc.fr/en/publications/books/wcr/wcr-order.php. Accessed 6 Apr 2016
  3. 3.
    National cancer registry (2014) Cancer in Ireland 1994–2012: annual report of National Cancer Registry. NCR, CorkGoogle Scholar
  4. 4.
    Wu X, Chen VW, Martin J et al (2004) Subsite-specific colorectal cancer incidence rates and stage distributions among Asians and Pacific Islanders in the United States, 1995 to 1999. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 13:1215–1222CrossRefGoogle Scholar
  5. 5.
    Meza R, Jeon J, Renehan AG, Luebeck EG (2010) Colorectal cancer incidence trends in the United States and United Kingdom: evidence of right- to left-sided biological gradients with implications for screening. Cancer Res 70:5419–5429. doi: 10.1158/0008-5472.CAN-09-4417 CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Papagiorgis PC, Oikonomakis I, Delaportas D et al (2014) Proximal shift of colorectal cancer. A persistent phenomenon with multiple causes, patterns and clinical implications. J BUON Off J Balk Union Oncol 19:605–617Google Scholar
  7. 7.
    (2014) BowelScreen—The National Bowel Screening Programme is now available to men and women aged 60-69. http://www.cancer.ie/content/bowelscreen-national-bowel-screening-programme-now-available-men-and-women-aged-60-69#sthash.w8rHdscg.dpbs. Accessed 6 April 2016
  8. 8.
    O’Brien K, Comber H, Sharp L (2013) Completeness of case ascertainment at the Irish National Cancer Registry. Ir J Med Sci. doi: 10.1007/s11845-013-0993-z Google Scholar
  9. 9.
    Fritz AG (2000) International classification of diseases for oncology: ICD-O. World Health Organization, GenevaGoogle Scholar
  10. 10.
    Sobin LH, Fleming ID (1997) TNM classification of malignant tumors, fifth edition. Cancer 80:1803–1804. doi: 10.1002/(SICI)1097-0142(19971101)80:9<1803:AID-CNCR16>3.0.CO;2-9 CrossRefPubMedGoogle Scholar
  11. 11.
    Zou G (2004) A modified Poisson regression approach to prospective studies with binary data. Am J Epidemiol 159:702–706. doi: 10.1093/aje/kwh090 CrossRefPubMedGoogle Scholar
  12. 12.
    White IR, Royston P, Wood AM (2011) Multiple imputation using chained equations: issues and guidance for practice. Stat Med 30:377–399. doi: 10.1002/sim.4067 CrossRefPubMedGoogle Scholar
  13. 13.
    Jensen OM, International Agency for Research on Cancer, World Health Organization, International Association of Cancer Registries (1991) Cancer registration: principles and methods. International Agency for Research on Cancer; Distributed in the USA by Oxford University Press, Lyon, New YorkGoogle Scholar
  14. 14.
    Kim HJ, Fay MP, Feuer EJ, Midthune DN (2000) Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 19:335–351CrossRefPubMedGoogle Scholar
  15. 15.
    Howlader N, Ries LAG, Mariotto AB et al (2010) Improved estimates of cancer-specific survival rates from population-based data. J Natl Cancer Inst 102:1584–1598. doi: 10.1093/jnci/djq366 CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Rim SH, Seeff L, Ahmed F et al (2009) Colorectal cancer incidence in the United States, 1999–2004. Cancer 115:1967–1976. doi: 10.1002/cncr.24216 CrossRefPubMedGoogle Scholar
  17. 17.
    Cress RD, Morris C, Ellison GL, Goodman MT (2006) Secular changes in colorectal cancer incidence by subsite, stage at diagnosis, and race/ethnicity, 1992–2001. Cancer 107:1142–1152. doi: 10.1002/cncr.22011 CrossRefPubMedGoogle Scholar
  18. 18.
    Namm J, Ng M, Roy-Chowdhury S et al (2008) Quantitating the impact of stage migration on staging accuracy in colorectal cancer. J Am Coll Surg 207:882–887. doi: 10.1016/j.jamcollsurg.2008.08.019 CrossRefPubMedGoogle Scholar
  19. 19.
    Derwinger K, Carlsson G, Gustavsson B (2007) Stage migration in colorectal cancer related to improved lymph node assessment. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol 33:849–853. doi: 10.1016/j.ejso.2007.02.003 Google Scholar
  20. 20.
    McDonald JR, Renehan AG, O’Dwyer ST, Haboubi NY (2012) Lymph node harvest in colon and rectal cancer: current considerations. World J Gastrointest Surg 4:9–19. doi: 10.4240/wjgs.v4.i1.9 CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Steele SR, Park GE, Johnson EK et al (2014) The impact of age on colorectal cancer incidence, treatment, and outcomes in an equal-access health care system. Dis Colon Rectum 57:303–310. doi: 10.1097/DCR.0b013e3182a586e7 CrossRefPubMedGoogle Scholar
  22. 22.
    HTA_population_based_colorectal_cancer_screening_programme.pdf. https://www.hiqa.ie/system/files/HTA_population_based_colorectal_cancer_screening_programme.pdf. Accessed 6 April 2016

Copyright information

© European Union  2016

Authors and Affiliations

  1. 1.National Cancer RegistryCorkIreland

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