Abstract
BackgroundFrance stands among high-risk areas for colorectal cancer. Different trends in CRC incidence are reported around the world. The aim of this study was to provide temporal trends in CRC incidence over a 30-year period in a French well-defined population.MethodsBetween 1976 and 2005, 17,028 new cases were registered by the Burgundy digestive cancer registry. The mean variations in age-standardized incidence rates were estimated using a Poisson regression adjusted for age for each gender and location. The cumulative risk by birth cohort of developing a cancer over the age range 0-74 years was estimated using an age-cohort model.ResultsIncidence rates for right and left colon cancers increased more rapidly in males (respectively +11.7% and +10.3% on average by 5-year period) than in females (respectively +5.9% and +6.1%). It remained stable for sigmoid cancers in males (-0.1%) and decreased in females (-5.2%). It also decreased for rectal cancers both in males (-2.7%) and in females (-2.0%). The cumulative risk increased from 3.9% for males born around 1900 to 4.9% for those born around 1930 and then slightly decreased (4.5% among those born around 1950). It remained at the same level for females born around 1900 (2.7%) as for those born around 1930 (2.7%) and then slightly increased (2.9%) for those born around 1950. For right colon cancers, the cumulative risk increased strikingly in successive birth cohorts from 0.53% to 1.2% in males and 0.55% to 0.77% in females. The corresponding cumulative risks for the left colon were 0.24% and 0.42% in males and 0.14% and 0.29% in females. For sigmoid cancer, they decreased from 1.59% to 1.08% in males, and 0.88% to 0.80% in females.ConclusionTemporal variations in incidence rates of colorectal cancers differed according to subsite, suggesting different aetiological factors and implications for diagnosis and screening strategies. Total colonoscopy must be the preferred strategy in high-risk groups or after a positive faecal occult blood test.
Highlights
France stands among high-risk areas for colorectal cancer
The aim of this paper is to provide updated temporal trends in colorectal cancer incidence over a 30-year period in a well-defined French population, and to differentiate the influences of period of diagnosis and birth cohort
Patients The Digestive Cancer Registry records all digestive tract cancers diagnosed in two administrative districts of Burgundy, France (1,052,000 inhabitants according to the 1999 census)
Summary
France stands among high-risk areas for colorectal cancer. Different trends in CRC incidence are reported around the world. The aim of this study was to provide temporal trends in CRC incidence over a 30-year period in a French well-defined population. In France, colorectal cancer is currently the third most common cancer in men and the second in women [1]. In 2005, the number of new cases was estimated to be 37,413 for both genders with age-standardized rates of 37.7/100,000 in males and 24.5/100,000 in females [1]. Incidence in France is comparable to that found in other high-risk areas of Western Europe, North America, Australia/New Zealand, and Japan [2], whereas it remains lower in Africa and Asia. Colorectal cancers differentiate the influences of period of diagnosis and birth cohort
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