Abstract
ObjectiveColorectal cancer (CRC) is the fourth most common site for cancer death in the Republic of Korea. The aim of this study was to describe the trends of colorectal cancer mortality by region.MethodsCRC mortality trends in Republic of Korea were described by region using a Joinpoint regression model in both sexes. The annual percent changes (APCs) were calculated for each segment. Visualization of the changes in mortality rate of colorectal cancer death rates by 16 geographic areas in both sexes between 2000–2004 and 2009–2013 were also conducted.ResultsCRC mortality rates of men showed decreasing trend after increase in Daegu, Gyeongsangnam-do, and Chungcheongbuk-do between 2000 and 2013 based on the joinpoint model, while Gwangju, Jeollabuk-do, Jeollanam-do, and Gyeongsangbuk-do showed increase in CRC mortality during the same period. For women, CRC mortality of Seoul, Incheon, Daejeon, and Gyeongsangnam-do started to decrease in 2005, 2003, 2007, and 2006, respectively. The mortality rate for CRC in the eastern regions, which had relatively low rates of CRC among men in 2000 through 2004, reached a level similar to that in the northwestern regions of 2009 through 2013, while the highest CRC mortality rates in women was observed in Chungcheongbuk-do.ConclusionsReduction in CRC mortality varied across 16 metropolitan cities and provinces in men, and the visualization pattern showed that the east side of South Korea had the least progress in mortality reduction.
Highlights
IntroductionColorectal cancer (CRC) is the third leading cause of cancer death in both sexes in worldwide and the fourth most common cause of cancer death in the Republic of Korea, with crude rates of 18.5=100,000 for men and 13.8=100,000 for women in 2012.4 Mortality rates of CRC have been decreasing in countries in Europe, Oceania, and Asia for the past several decades. This decrease may be affected by increased uptake of CRC screening or differences in socioeconomic status.10–12In previous studies, it has been projected that CRC mortality could be reduced with appropriate interventions, and deliberate public health action is being implemented in selected regions to accomplish the goal. Besides, disparities by geographical regions contribute to variation of CRC mortality. The geospatial approach describing the trends of CRC mortality would be highly useful to better understand the factors that contribute to differences in the overall CRC outcomes by region.5,20In the Republic of Korea, decrease in CRC mortality was observed among women since 2004, whereas mortality of men was stabilized since 2002.2 the extent to which these decreases varies by sex and its influence on the regional characteristics of Korean CRC death rates are not documented in previous studies
It has been projected that Colorectal cancer (CRC) mortality could be reduced with appropriate interventions,13,14 and deliberate public health action is being implemented in selected regions to accomplish the goal
In the Republic of Korea, decrease in CRC mortality was observed among women since 2004, whereas mortality of men was stabilized since 2002.2 the extent to which these decreases varies by sex and its influence on the regional characteristics of Korean CRC death rates are not documented in previous studies
Summary
Colorectal cancer (CRC) is the third leading cause of cancer death in both sexes in worldwide and the fourth most common cause of cancer death in the Republic of Korea, with crude rates of 18.5=100,000 for men and 13.8=100,000 for women in 2012.4 Mortality rates of CRC have been decreasing in countries in Europe, Oceania, and Asia for the past several decades. This decrease may be affected by increased uptake of CRC screening or differences in socioeconomic status.10–12In previous studies, it has been projected that CRC mortality could be reduced with appropriate interventions, and deliberate public health action is being implemented in selected regions to accomplish the goal. Besides, disparities by geographical regions contribute to variation of CRC mortality. The geospatial approach describing the trends of CRC mortality would be highly useful to better understand the factors that contribute to differences in the overall CRC outcomes by region.5,20In the Republic of Korea, decrease in CRC mortality was observed among women since 2004, whereas mortality of men was stabilized since 2002.2 the extent to which these decreases varies by sex and its influence on the regional characteristics of Korean CRC death rates are not documented in previous studies. Colorectal cancer (CRC) is the third leading cause of cancer death in both sexes in worldwide and the fourth most common cause of cancer death in the Republic of Korea, with crude rates of 18.5=100,000 for men and 13.8=100,000 for women in 2012.4 Mortality rates of CRC have been decreasing in countries in Europe, Oceania, and Asia for the past several decades.. Colorectal cancer (CRC) is the third leading cause of cancer death in both sexes in worldwide and the fourth most common cause of cancer death in the Republic of Korea, with crude rates of 18.5=100,000 for men and 13.8=100,000 for women in 2012.4 Mortality rates of CRC have been decreasing in countries in Europe, Oceania, and Asia for the past several decades.5–7 This decrease may be affected by increased uptake of CRC screening or differences in socioeconomic status.. The wide geographical variation in the mortality of CRC is evident, there was lack of evidence assessing regional differences with consideration of age and sex
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