Abstract
Prior to the 1960s, large-bowel cancer received little attention from epidemiologists. The turning point in the epidemiology of large-bowel cancer came with the systematic compilation of incidence data from cancer registries throughout the world. While these efforts were antedated by Segi’s compilations of cancer mortality statistics beginning with 1950, which described sizable gradients in large-bowel cancer death rates, the mortality data had been discounted on the grounds that the contrasts were inflated by intercountry differences in diagnostic and treatment facilities and death certification practices. This attitude began to change when the data in the first edition of ‘Cancer incidence in five continents’ (1) proved to be consistent with the mortality findings. Within a short time span, the concept of substantial intercountry variation in large-bowel cancer risk gained wide acceptance as a prime epidemiologic characteristic of this disease. This feature was stressed at the meeting of the International Working Party of the World Organization of Gastroenterology in 1963, which also noted differences in the presentation of tumors by anatomical segment in high- and low-risk populations (2). The international comparisons pointing to environmental factors as important risk determinants have been reinforced by observations that showed migrants coming to the United States from low-risk European countries and Japan to acquire within their lifetime the high risks characteristic of the host population of US whites (3, 4).
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Haenszel, W., Correa, P. (1982). Epidemiology of Large Bowel Cancer. In: Correa, P., Haenszel, W. (eds) Epidemiology of Cancer of the Digestive Tract. Developments in Oncology, vol 6. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-7502-6_4
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