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