Increasing late stage colorectal cancer and rectal cancer mortality demonstrates the need for screening: a population based study in Ireland, 1994-2010

dc.contributor.authorClarke, Nicholas
dc.contributor.authorMcDevitt, Joseph
dc.contributor.authorKearney, Patricia M.
dc.contributor.authorSharp, Linda
dc.contributor.funderIrish Cancer Societyen
dc.date.accessioned2016-01-25T15:21:13Z
dc.date.available2016-01-25T15:21:13Z
dc.date.issued2014-05-13
dc.description.abstractBACKGROUND: This paper describes trends in colorectal cancer incidence, survival and mortality from 1994 to 2010 in Ireland prior to the introduction of population-based screening. METHODS: We examined incidence (National Cancer Registry Ireland (NCRI) and mortality (Central Statistics Office) from 1994 to 2010. Age standardised rates (ASR) for incidence and mortality have been calculated, weighted by the European standard population. Annual percentage change was calculated in addition to testing for linear trends in treatment and case fraction of early and late stage disease. Relative survival was calculated considering deaths from all causes. RESULTS: The colorectal cancer ASR was 63.7 per 100,000 in males and 38.7 per 100,000 in females in 2010. There was little change in the ASR over time in either sex, or when colon and rectal cancers were considered separately; however the number of incident cancers increased significantly during 1994-2010 (1752 to 2298). The case fractions of late stage (III/IV) colon and rectal cancers rose significantly over time. One and 5 year relative survival improved for both sexes between the periods 1994-2008. Colorectal cancer mortality ASRs decreased annually from 1994-2009 by 1.8% (95% CI -2.2, -1.4). Rectal cancer mortality ASRs rose annually by 2.4% (95% CI 1.1, 3.6) and 2.8% (95% CI 1.2, 4.4) in males and females respectively. CONCLUSIONS: Increases in late-stage disease and rectal cancer mortality demonstrate an urgent need for colorectal cancer screening. However, the narrow age range at which screening is initially being rolled-out in Ireland means that the full potential for reductions in late-stage cancers and incidence and mortality are unlikely to be achieved. While it is possible that the observed increase in rectal cancer mortality may be partly an artefact of cause of death misclassification, it could also be explained by variations in treatment and adherence to best practice guidelines; further investigation is warranted.en
dc.description.sponsorshipIrish Cancer Society (Grant: CRS11CLA)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid92
dc.identifier.citationCLARKE, N., MCDEVITT, J., KEARNEY, P. M. & SHARP, L. 2014. Increasing late stage colorectal cancer and rectal cancer mortality demonstrates the need for screening: a population based study in Ireland, 1994-2010. BMC Gastroenterology, 14, 1-10. http://dx.doi.org/10.1186/1471-230X-14-92en
dc.identifier.doi10.1186/1471-230x-14-92
dc.identifier.endpage10en
dc.identifier.issn1471-230X
dc.identifier.journaltitleBMC Gastroenterologyen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/2212
dc.identifier.volume14en
dc.language.isoenen
dc.publisherBiomed Central Ltd.en
dc.rights© 2014 Clarke et al.; licensee BioMed Central Ltd., 2014. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en
dc.rights.urihttp://creativecommons.org/licenses/by/2.0/en
dc.subjectColorectalen
dc.subjectCanceren
dc.subjectIrelanden
dc.subjectIncidenceen
dc.subjectSurvivalen
dc.subjectMortalityen
dc.subjectMass screeningen
dc.subjectColonen
dc.subjectRectalen
dc.subjectOccult blood testsen
dc.subjectEndorectal ultrasonographyen
dc.subjectAccuracyen
dc.subjectEuropeen
dc.subjectRatesen
dc.subjectRegressionen
dc.subjectDiagnosisen
dc.subjectOutcomesen
dc.subjectTherapyen
dc.titleIncreasing late stage colorectal cancer and rectal cancer mortality demonstrates the need for screening: a population based study in Ireland, 1994-2010en
dc.typeArticle (peer-reviewed)en
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