Evaluation of the appropriate age range of colorectal cancer screening based on the changing epidemiology in the past 20 years in taiwan

Abstract

Introduction. According to the recommendation of the United States Preventative Services Task Force, most countries provide average-risk screening for colorectal cancers (CRCs) between the ages of 50 and 75 years. However, the age range of screening should be modified because of an increasing life span. Methods. Totally 124,314 CRC cases were registered in Taiwan Cancer Registry from 1988 to 2007. The 20-year study period was divided into four 5-year increments. We divided the patients into four age groups (under age 50, age 50-74, age 74-84, and over age 85) in each increment to determine whether there were changes in the age distribution. Results. In the subgroup of patients under age 50, the number of CRC cases increased, but they accounted for a decreasing proportion of the total CRCs. In the 50-74 age group, the proportion of CRC cases also dropped. In contrast, the proportion increased in the 75-84 age group. Therefore, 43.63% of CRC patients would not be delegated to screen in the period of 2003-2007 if the CRC screening were restricted in the 50-74 age group. Conclusions. CRC screening for healthy individuals aged over 75 years is necessary.

Figure 1

Number of CRC cases from 1988 to 2007.

Figure 2

The age-specific incidence of CRC in Taiwan.