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Trends in incidence, mortality rates, and survival of colorectal cancer in Western Australia from 1990 to 2014: a retrospective whole-population longitudinal study

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Abstract

Purpose

This study aimed to investigate the trends in colorectal cancer (CRC) incidence and mortality rates among the Western Australian (WA) population. This study further compared the trends with the timing of the implementation and rollout of the National Bowel Cancer Screening Program (NBCSP) and examined the survival predictors in CRC cases.

Methods

This study was a whole-population, retrospective longitudinal study and included all individuals with a confirmed histological diagnosis of primary invasive CRC diagnosed in WA from 1990 to 2014 (n = 25,932). The temporal trends were assessed by Joinpoint regression models and Kaplan-Meier survival curves were used to asses 5-year survival. Predictors of survival were examined using multivariable Cox proportional hazard regression models, adjusting for age of diagnosis.

Results

The overall CRC incidence showed an upward trend between 1990 and 2010 (annual percent change (APC) = 1.1%); then, there was a downward trend from 2010 to 2014 (APC = − 5.0%). In younger people (< 50 years), the incidence rate increased steadily (APC = 0.9%) over the study period. The overall CRC mortality trend increased from 1990 to 1999 (APC = 1.6%), decreasing after that (APC = − 2.1%). Younger people had better CRC-related 5-year survival than older people (HR = 0.81, 95%CI 0.75–0.87, p = < 0.001).

Conclusion

This study found that CRC incidence and mortality rates decreased among older people over the last 10 years in Western Australia. However, incidence continues to rise for younger people. Hence, more widespread adoption of the screening program, and potential preventive and early diagnostic strategies should become key priorities for the CRC control in WA.

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Data availability

Under the current ethics approval, the data is not able to be publicly shared.

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Acknowledgments

The research team would like to acknowledge the support of the Western Australian Data Linkage Branch, the Western Australian Department of Health, and the data custodians of the WA Cancer Registry, the WA Death Registry, the Victorian Department of Justice, and the National Coronial Investigation System for their assistance with the study.

Code availability

Code used in this study is not publicly available.

Funding

This study was funded by a Cancer Council Capacity Building and Collaboration Grant 2014.

Author information

Authors and Affiliations

  1. Centre for Health Services Research, School of Population and Global Health, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia

    Suresh Karuppannan, Erin Kelty, Nita Sodhi-Berry & David B. Preen

  2. Department of Gastroenterology, Sir Charles Gairdner Hospital, Nedlands, Australia

    Hooi C. Ee

Authors
  1. Suresh Karuppannan
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  2. Erin Kelty
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  3. Nita Sodhi-Berry
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  4. Hooi C. Ee
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  5. David B. Preen
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Contributions

Conception and design: DP & HE

Administrative support: NSB

Collection and assembly of data: EK

Data analysis and interpretation: SK

Manuscript writing: SK

Final approval of manuscript: All authors

Corresponding author

Correspondence to Erin Kelty.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

Ethical approval for this study was obtained from the Department of Health WA Human Research Ethics Committee (Approval No: HRE 2016/2) and the University of Western Australia Human Research Ethics Committee (Ref No: RA/4/1/8462).

Consent to participate

A waiver of consent was approved for this study by the approving ethics committees, in accordance with the National Statement of the Ethical Conduct in Human Research (2007).

Consent for publication

The manuscript has been reviewed and approved by data custodians, who provided data for the study.

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Karuppannan, S., Kelty, E., Sodhi-Berry, N. et al. Trends in incidence, mortality rates, and survival of colorectal cancer in Western Australia from 1990 to 2014: a retrospective whole-population longitudinal study. Int J Colorectal Dis 35, 1719–1727 (2020). https://doi.org/10.1007/s00384-020-03644-5

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  • DOI: https://doi.org/10.1007/s00384-020-03644-5

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