Kaire Innos1, Heigo Reima2, Aleksei Baburin3, Keiu Paapsi4, Tiiu Aareleid5, Jaan Soplepmann6. 1. Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619 Tallinn, Estonia. Electronic address: kaire.innos@tai.ee. 2. Department of Surgical Oncology, Haematology and Oncology Clinic, Tartu University Hospital, Puusepa 8, 51014 Tartu, Estonia; Institute of Clinical Medicine, University of Tartu, Puusepa 8, 51014 Tartu, Estonia. Electronic address: heigo.reima@kliinikum.ee. 3. Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619 Tallinn, Estonia. Electronic address: alex.baburin@tai.ee. 4. Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619 Tallinn, Estonia. Electronic address: keiu.paapsi@tai.ee. 5. Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619 Tallinn, Estonia. Electronic address: tiiu.aareleid@tai.ee. 6. Department of Surgical Oncology, Haematology and Oncology Clinic, Tartu University Hospital, Puusepa 8, 51014 Tartu, Estonia; Institute of Clinical Medicine, University of Tartu, Puusepa 8, 51014 Tartu, Estonia. Electronic address: jaan.soplepmann@kliinikum.ee.
Abstract
BACKGROUND: The 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. METHODS: We 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. RESULTS: Age-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%). CONCLUSION: In 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.
BACKGROUND: The 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. METHODS: We 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. RESULTS: Age-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%). CONCLUSION: In 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.
Authors: Norah Alsadhan; Alaa Almaiman; Mar Pujades-Rodriguez; Cathy Brennan; Farag Shuweihdi; Sultana A Alhurishi; Robert M West Journal: BMC Med Res Methodol Date: 2022-05-19 Impact factor: 4.612
Authors: Luigi Ricciardiello; Clarissa Ferrari; Michela Cameletti; Federica Gaianill; Francesco Buttitta; Franco Bazzoli; Gian Luigi de'Angelis; Alberto Malesci; Luigi Laghi Journal: Clin Gastroenterol Hepatol Date: 2020-09-06 Impact factor: 11.382