Changing trends in the incidence, stage, survival, and screen-detection of colorectal cancer: A population-based study

Amit K. Gupta, L. Joseph Melton, Gloria M Petersen, Lawrence J. Timmons, Santhi Swaroop Vege, William S. Harmsen, Nancy N. Diehl, Alan R. Zinsmeister, David A. Ahlquist

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

Background & Aims: Colorectal cancer (CRC) screening has been advocated increasingly during the past 2 decades, but there is little direct evidence that it has affected cancer incidence or presentation at the population level. This study assessed concurrent trends in CRC incidence, presentation, survival, mortality, and polypectomies in Olmsted County, Minnesota. Methods: Longitudinal observational study was conducted of all Olmsted County residents with colorectal adenocarcinoma first diagnosed in 1980-1999. Results: Altogether, 889 invasive CRCs were diagnosed among Olmsted County residents from 1980 through 1999. Annual age- and sex-adjusted CRC incidence rates decreased significantly during this period (P =. 02) with a 23% decline from 60 per 100,000 in 1980-1984 to 46 per 100,000 in 1995-1999. This was primarily accounted for by a 40% reduction in left-sided CRC (P <. 001). The incidence of right-sided CRC remained unchanged, but the proportion of right-sided CRC increased from 46% to 58%. Cancer stage shifted downward, and survival improved over time. The overall proportion of screen-detected CRC rose from 8% to 17%. Annual adjusted adenomatous polypectomy rates increased dramatically from 86 to 320 per 100,000 (P <. 001). Conclusions: The incidence of CRC in Olmsted County has declined in recent years. An impact of screening is suggested by the observed upward trend in screen-detected cases, a favorable stage shift, and a concurrent rise in polypectomy rates. However, the incidence of right-sided cancer remains unaltered and might be less affected by historically used screening interventions. Most CRCs still present symptomatically, and more effective population screening is needed.

Original languageEnglish (US)
Pages (from-to)150-158
Number of pages9
JournalClinical Gastroenterology and Hepatology
Volume3
Issue number2
DOIs
StatePublished - Feb 2005

Fingerprint

Colorectal Neoplasms
Incidence
Population
Neoplasms
Early Detection of Cancer
Observational Studies
Longitudinal Studies
Adenocarcinoma
Cohort Studies
Mortality

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Changing trends in the incidence, stage, survival, and screen-detection of colorectal cancer : A population-based study. / Gupta, Amit K.; Melton, L. Joseph; Petersen, Gloria M; Timmons, Lawrence J.; Vege, Santhi Swaroop; Harmsen, William S.; Diehl, Nancy N.; Zinsmeister, Alan R.; Ahlquist, David A.

In: Clinical Gastroenterology and Hepatology, Vol. 3, No. 2, 02.2005, p. 150-158.

Research output: Contribution to journalArticle

Gupta, Amit K. ; Melton, L. Joseph ; Petersen, Gloria M ; Timmons, Lawrence J. ; Vege, Santhi Swaroop ; Harmsen, William S. ; Diehl, Nancy N. ; Zinsmeister, Alan R. ; Ahlquist, David A. / Changing trends in the incidence, stage, survival, and screen-detection of colorectal cancer : A population-based study. In: Clinical Gastroenterology and Hepatology. 2005 ; Vol. 3, No. 2. pp. 150-158.
@article{5d433a3c91034b8f8ee7802741cea244,
title = "Changing trends in the incidence, stage, survival, and screen-detection of colorectal cancer: A population-based study",
abstract = "Background & Aims: Colorectal cancer (CRC) screening has been advocated increasingly during the past 2 decades, but there is little direct evidence that it has affected cancer incidence or presentation at the population level. This study assessed concurrent trends in CRC incidence, presentation, survival, mortality, and polypectomies in Olmsted County, Minnesota. Methods: Longitudinal observational study was conducted of all Olmsted County residents with colorectal adenocarcinoma first diagnosed in 1980-1999. Results: Altogether, 889 invasive CRCs were diagnosed among Olmsted County residents from 1980 through 1999. Annual age- and sex-adjusted CRC incidence rates decreased significantly during this period (P =. 02) with a 23{\%} decline from 60 per 100,000 in 1980-1984 to 46 per 100,000 in 1995-1999. This was primarily accounted for by a 40{\%} reduction in left-sided CRC (P <. 001). The incidence of right-sided CRC remained unchanged, but the proportion of right-sided CRC increased from 46{\%} to 58{\%}. Cancer stage shifted downward, and survival improved over time. The overall proportion of screen-detected CRC rose from 8{\%} to 17{\%}. Annual adjusted adenomatous polypectomy rates increased dramatically from 86 to 320 per 100,000 (P <. 001). Conclusions: The incidence of CRC in Olmsted County has declined in recent years. An impact of screening is suggested by the observed upward trend in screen-detected cases, a favorable stage shift, and a concurrent rise in polypectomy rates. However, the incidence of right-sided cancer remains unaltered and might be less affected by historically used screening interventions. Most CRCs still present symptomatically, and more effective population screening is needed.",
author = "Gupta, {Amit K.} and Melton, {L. Joseph} and Petersen, {Gloria M} and Timmons, {Lawrence J.} and Vege, {Santhi Swaroop} and Harmsen, {William S.} and Diehl, {Nancy N.} and Zinsmeister, {Alan R.} and Ahlquist, {David A.}",
year = "2005",
month = "2",
doi = "10.1016/S1542-3565(04)00664-0",
language = "English (US)",
volume = "3",
pages = "150--158",
journal = "Clinical Gastroenterology and Hepatology",
issn = "1542-3565",
publisher = "W.B. Saunders Ltd",
number = "2",

}

TY - JOUR

T1 - Changing trends in the incidence, stage, survival, and screen-detection of colorectal cancer

T2 - A population-based study

AU - Gupta, Amit K.

AU - Melton, L. Joseph

AU - Petersen, Gloria M

AU - Timmons, Lawrence J.

AU - Vege, Santhi Swaroop

AU - Harmsen, William S.

AU - Diehl, Nancy N.

AU - Zinsmeister, Alan R.

AU - Ahlquist, David A.

PY - 2005/2

Y1 - 2005/2

N2 - Background & Aims: Colorectal cancer (CRC) screening has been advocated increasingly during the past 2 decades, but there is little direct evidence that it has affected cancer incidence or presentation at the population level. This study assessed concurrent trends in CRC incidence, presentation, survival, mortality, and polypectomies in Olmsted County, Minnesota. Methods: Longitudinal observational study was conducted of all Olmsted County residents with colorectal adenocarcinoma first diagnosed in 1980-1999. Results: Altogether, 889 invasive CRCs were diagnosed among Olmsted County residents from 1980 through 1999. Annual age- and sex-adjusted CRC incidence rates decreased significantly during this period (P =. 02) with a 23% decline from 60 per 100,000 in 1980-1984 to 46 per 100,000 in 1995-1999. This was primarily accounted for by a 40% reduction in left-sided CRC (P <. 001). The incidence of right-sided CRC remained unchanged, but the proportion of right-sided CRC increased from 46% to 58%. Cancer stage shifted downward, and survival improved over time. The overall proportion of screen-detected CRC rose from 8% to 17%. Annual adjusted adenomatous polypectomy rates increased dramatically from 86 to 320 per 100,000 (P <. 001). Conclusions: The incidence of CRC in Olmsted County has declined in recent years. An impact of screening is suggested by the observed upward trend in screen-detected cases, a favorable stage shift, and a concurrent rise in polypectomy rates. However, the incidence of right-sided cancer remains unaltered and might be less affected by historically used screening interventions. Most CRCs still present symptomatically, and more effective population screening is needed.

AB - Background & Aims: Colorectal cancer (CRC) screening has been advocated increasingly during the past 2 decades, but there is little direct evidence that it has affected cancer incidence or presentation at the population level. This study assessed concurrent trends in CRC incidence, presentation, survival, mortality, and polypectomies in Olmsted County, Minnesota. Methods: Longitudinal observational study was conducted of all Olmsted County residents with colorectal adenocarcinoma first diagnosed in 1980-1999. Results: Altogether, 889 invasive CRCs were diagnosed among Olmsted County residents from 1980 through 1999. Annual age- and sex-adjusted CRC incidence rates decreased significantly during this period (P =. 02) with a 23% decline from 60 per 100,000 in 1980-1984 to 46 per 100,000 in 1995-1999. This was primarily accounted for by a 40% reduction in left-sided CRC (P <. 001). The incidence of right-sided CRC remained unchanged, but the proportion of right-sided CRC increased from 46% to 58%. Cancer stage shifted downward, and survival improved over time. The overall proportion of screen-detected CRC rose from 8% to 17%. Annual adjusted adenomatous polypectomy rates increased dramatically from 86 to 320 per 100,000 (P <. 001). Conclusions: The incidence of CRC in Olmsted County has declined in recent years. An impact of screening is suggested by the observed upward trend in screen-detected cases, a favorable stage shift, and a concurrent rise in polypectomy rates. However, the incidence of right-sided cancer remains unaltered and might be less affected by historically used screening interventions. Most CRCs still present symptomatically, and more effective population screening is needed.

UR - http://www.scopus.com/inward/record.url?scp=13544268722&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=13544268722&partnerID=8YFLogxK

U2 - 10.1016/S1542-3565(04)00664-0

DO - 10.1016/S1542-3565(04)00664-0

M3 - Article

C2 - 15704049

AN - SCOPUS:13544268722

VL - 3

SP - 150

EP - 158

JO - Clinical Gastroenterology and Hepatology

JF - Clinical Gastroenterology and Hepatology

SN - 1542-3565

IS - 2

ER -