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. 2019 Nov 18;191(46):E1262-E1273.
doi: 10.1503/cmaj.190355.

Age-standardized cancer-incidence trends in Canada, 1971-2015

Darren R Brenner  1 , Yibing Ruan  2 , Eileen Shaw  2 , Dylan O'Sullivan  2 , Abbey E Poirier  2 , Emily Heer  2 , Paul J Villeneuve  2 , Stephen D Walter  2 , Christine M Friedenreich  2 , Leah Smith  2 , Prithwish De  2
Affiliations

Age-standardized cancer-incidence trends in Canada, 1971-2015

Darren R Brenner et al. CMAJ. .

Abstract

Background: Although cancer incidence over time is well documented in Canada, trends by birth cohort and age group are less well known. We analyzed age- and sex-standardized incidence trends in Canada for 16 major cancer sites and all cancers combined.

Methods: We obtained nationally representative population-based cancer incidence data in Canada between 1971 and 2015 from the National Cancer Incidence Reporting System (1969-1992) and the Canadian Cancer Registry (1992-2015). We analyzed cancer-incidence trends, reported as annual percent change (APC) for each 10-year group from age 20 to 89 years. We also estimated age-adjusted incidence rate ratios from fitted birth cohort models.

Results: Across most age categories, the most recent trends show significant decreases in the incidence of cervical (APC -8.8% to -0.33%), lung (men: -7.42% to -0.36%; women: -6.27% to 1.07%), bladder (women: -4.12% to -0.07%; men: -5.13% to -0.38%) and prostate cancer (-11.11% to -1.11%). Significant increasing trends were observed for kidney, thyroid and uterine cancers. Overall incidence has increased among both sexes younger than 50 years of age, with recent increases in pancreatic cancer among men, breast cancer among women and colorectal cancer among both sexes. From the birth cohort analysis, we observed increasing trends in colorectal, liver and prostate cancers among men; kidney cancer and melanoma among women; and thyroid cancer among both sexes. We observed decreasing trends in cervical and ovarian cancers, and in bladder and lung cancers among men.

Interpretation: Cancer incidence is decreasing at many sites targeted by primary-prevention efforts, such as smoking cessation and screening programs. Substantial increases in incidence among younger populations are driven by cancers possibly associated with obesity.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1:
Figure 1:
Age-standardized incidence rates of all cancers in men in Canada (1971–2015). Note: APC = annual percent change, CI = confidence interval.
Figure 2:
Figure 2:
Age-standardized incidence rates of all cancers in women in Canada (1971–2015). Note: APC = annual percent change, CI = confidence interval.
Figure 3:
Figure 3:
Age-standardized incidence rates of colorectal cancer in men in Canada (1971–2015). Note: APC = annual percent change, CI = confidence interval.
Figure 4:
Figure 4:
Age-standardized incidence rates of breast cancer in women in Canada (1971–2015). Note: APC = annual percent change, CI = confidence interval.
Figure 5:
Figure 5:
Age-standardized incidence rates of colorectal cancer in women in Canada (1971–2015). Note: APC = annual percent change, CI = confidence interval.
See this image and copyright information in PMC

References

    1. Canadian Cancer Society’s Advisory Committee on Cancer Statistics. Canadian Cancer Statistics 2017. Toronto: Canadian Cancer Society; 2017.
    1. Brenner DR, Ruan Y, Shaw E, et al. Increasing colorectal cancer incidence trends among younger adults in Canada. Prev Med 2017;105:345–9. - PubMed
    1. National Cancer Incidence Reporting System (1969–1992) [database]. Ottawa: Statistics Canada; 1993.
    1. Canadian Cancer Registry (1992–2012) [database]. Ottawa: Statistics Canada; 2013.
    1. Canadian Cancer Registry (CCR) system guide — 2010 edition. Ottawa: Statistics Canada; modified 2014 Apr. 4.

MeSH terms