Subsite- and stage-specific colorectal cancer trends in Estonia prior to implementation of screening |
| |
| Institution: | 1. Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619 Tallinn, Estonia;2. Department of Surgical Oncology, Haematology and Oncology Clinic, Tartu University Hospital, Puusepa 8, 51014 Tartu, Estonia;3. Institute of Clinical Medicine, University of Tartu, Puusepa 8, 51014 Tartu, Estonia;1. Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, Milan, Italy;2. School of Occupational Medicine, Università degli Studi di Milano, Milan, Italy;3. Abadan School of Medical Sciences, Abadan, Iran;1. Department of Urology, University of Oklahoma HSC, Oklahoma City, OK, United States;2. Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States;1. College of Nursing and Health Professions, University of Southern Indiana, Evansville, IN, United States;2. Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, United States;3. Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Chicago, IL, United States;4. Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, United States;5. Department of Epidemiology and Environmental Health Sciences, Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, United States;1. Centre for Public Health Research, Massey University-Wellington Campus, PO Box 756, Wellington 6140, New Zealand;2. Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3010, Australia;3. National Advisor NCD, Head of National Wellness Centre, Ministry of Health & Medical Services, Fiji;4. John A. Burns School of Medicine, University of Hawaii, University of Hawaii Cancer Center,677 Ilalo Street, Honolulu, HI 96813, United States;1. Departments of Clinical Pharmacy and of Medicine, University of California, 3333 California Street, Suite 420, San Francisco, CA, 94143-0613, USA;2. Department of Clinical Pharmacy, University of California, 3333 California Street, San Francisco, CA, 94143-0613, USA;3. San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 500, San Francisco, CA, 94102-6012, USA;1. Department of Haematology and Central Haematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Switzerland;2. Department for BioMedical Research, Inselspital, Bern University Hospital, University of Bern, Switzerland;3. Foundation National Institute for Cancer Epidemiology and Registration (NICER) c/o University of Zurich, Switzerland;4. Divisions of Hematology, Department of Medicine, University Hospital Basel, Switzerland;5. Haematology, University and University Hospital Zurich, Switzerland;6. Division of Haematology and Central Haematology Laboratory, Cantonal Hospital Lucerne, Switzerland;7. Department of Haemato-Oncology, Cantonal Hospital Fribourg, Switzerland;8. Division of Haematology and Transfusion Medicine, Cantonal Hospital Aarau, Switzerland;9. Clinic for Haematology and Oncology,Cantonal Hospital St. Gallen, Switzerland;10. Service and Central Laboratory of Haematology, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital, Switzerland;11. Department of Oncology, Division of Hematology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Switzerland;12. Clinic of Haematology, Oncology Institute of Southern Switzerland, Switzerland |
| |
| Abstract: | BackgroundThe occurrence of colorectal cancer (CRC) in Estonia has been characterised by increasing incidence, low survival and no screening. The study aimed to examine long-term incidence and survival trends of CRC in Estonia with specific focus on subsite and stage.MethodsWe analysed CRC incidence and relative survival using Estonian Cancer Registry data on all cases of colorectal cancer (ICD-10 C18–21) diagnosed in 1995–2014. TNM classification was used to categorise stage.ResultsAge-standardized incidence of colon cancer increased both in men and women at a rate of approximately 1% per year. Significant increase was seen for right-sided tumours, but not for left-sided tumours. Rectal cancer incidence increased significantly only in men and anal cancer incidence only in women. Age-standardized five-year relative survival for colon cancer increased from 50% in 1995–1999 to 59% in 2010–2014; for rectal cancer, from 38% to 56%. Colon cancer survival improved significantly for left-sided tumours (from 51% to 62%) and stage IV disease (from 6% to 15%). For rectal cancer, significant survival gain was seen for stage II (from 58% to 75%), stage III (from 34% to 70%) and stage IV (from 1% to 12%).ConclusionIn the pre-screening era in Estonia, increase in colon cancer incidence was limited to right-sided tumours. Large stage-specific survival gain, particularly for rectal cancer, was probably due to better staging and advances in multimodality treatment. Nonetheless, more than one quarter of new CRC cases are diagnosed at stage IV, emphasising the need for an efficient screening program. |
| |
| Keywords: | Colorectal cancer Colon cancer Rectal cancer Anal cancer Incidence Survival TNM staging |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
