Abstract

This study aimed to assess time trends in colorectal cancer incidence from 1983 to 2012 in Latin America. This was an ecological time-series study whose population consisted of individuals aged 20 years or older diagnosed with colorectal cancer. Data from population-based cancer registries in Cali (Colombia), Costa Rica, Goiânia (Brazil), and Quito (Ecuador), were used for rates estimation, while time trends estimations were proceeded by the Joinpoint Regression Program. The study showed an increase in colorectal cancer incidence in men and women in Cali (2.8% and 3.2%, respectively), Costa Rica (3.1% and 2.1%, respectively), and Quito (2.6% and 1.2%, respectively), whereas in Goiânia, only women showed an increase in colorectal cancer rates (3.3%). For colon cancer, we observed an increasing trend in incidence rates in men and women in Cali (3.1% and 2.9%, respectively), Costa Rica (3.9% and 2.8%, respectively), and Quito (2.9% and 1.8%). For rectal cancer, we observed an increasing trend in incidence in men and women in Cali (2.5% and 2.6%, respectively), Costa Rica (2.2% and 1%, respectively), and Goiânia (5.5% and 4.6%, respectively), while in Quito only men showed an upward trend (2.8%). The study found increases in colorectal cancer, colon cancer, and rectal cancer in four Latin America regions. This findings reflect lifestyle, such as dietary changes, following the economic opening, and the prevalence variations of colorectal cancer risk factors by sex and between the four studied regions. Finally, the different strategies adopted by regions for colorectal cancer diagnosis and screening seem to influence the observed variation between anatomical sites.

Highlights

  • Along with the third-highest cancer incidence, colorectal cancer is considered a public health problem worldwide, especially in Latin America, ranking as the most common digestive system neoplasm in 2020 1

  • Goiânia showed the highest rates of colorectal cancer (32.2/100,000 men, and 28.6/100,000 women), colon cancer (19.3/100,000 men, and 17.5/100,000 women), and rectal cancer (13.0/100,000 men, and 12.7/100,000 women), whereas Quito presented the lowest rates for colorectal cancer (13.9/100,000 men and 14.6/100,000 women), colon cancer (8.6/100,000 men and 8.9/100,000 women), and rectal cancer (5.4/100,000 men and 5.7/100,000 women) (Table 1)

  • Rectal cancer showed an increasing trend in incidence in men in Cali (AAPC = 2.5%; 95% confidence intervals (95%CI): 1.43.6), Costa Rica (AAPC = 2.2%; 95%CI: 1.4-3.0), Goiânia (AAPC = 5.5%; 95%CI: 3.8-7.3), and Quito (AAPC = 2.8%; 95%CI: 0.7-5.0), whereas for women we observed a significant increase in Cali (AAPC = 2.6%; 95%CI: 1.7-3.5), Costa Rica (AAPC = 1.0%; 95%CI: 0.0-2.1), and Goiânia (AAPC = 4.6%; 95%CI: 2.7-6.6) (Table 2)

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Summary

Introduction

Along with the third-highest cancer incidence (excluding non-melanoma skin cancer), colorectal cancer is considered a public health problem worldwide, especially in Latin America, ranking as the most common digestive system neoplasm in 2020 1. Several studies have analyzed colorectal cancer incidence worldwide, only a few were carried out in Latin America 4. Arnold et al 2 conducted a complete study to date, using the International Agency for Research on Cancer (IARC) data from 1980 to 2007, and found three distributions of colorectal cancer: increasing incidence and mortality rates in recent decades in countries with rapid economic transition, including Brazil, Costa Rica, and Colombia; increasing incidence and decreasing mortality in high Human Development Index (HDI) countries, including Canada and the United Kingdom; and decreases in both rates in countries with very high HDI as Australia, Japan, and France. We aimed to assess time trends in incidence rates for colorectal cancer in Cali (Colombia), Goiânia (Brazil), Quito (Ecuador), and Costa Rica from 1983 to 2012, according to sex and anatomical site

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