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. 2023 Feb 1;118(2):338-344.
doi: 10.14309/ajg.0000000000002058. Epub 2022 Oct 11.

Time Trends in Colorectal Cancer Incidence From 1992 to 2016 and Colorectal Cancer Mortality From 1980 to 2018 by Age Group and Geography in Canada

Kathleen M Decker  1   2   3 , Pascal Lambert  2   3 , Jen Bravo  3 , Alain Demers  4 , Harminder Singh  1   2   5
Affiliations

Time Trends in Colorectal Cancer Incidence From 1992 to 2016 and Colorectal Cancer Mortality From 1980 to 2018 by Age Group and Geography in Canada

Kathleen M Decker et al. Am J Gastroenterol. .

Abstract

Introduction: Several reports have highlighted increasing colorectal cancer (CRC) incidence among younger individuals. However, little is known about variations in CRC incidence or mortality across age subgroups in different geographical locations. We aimed to examine time trends in CRC incidence and mortality in Canada by age group and geography in this population-based, retrospective cohort study.

Methods: Individuals diagnosed with CRC from 1992 to 2016 or who died of CRC from 1980 to 2018 in Canada were studied. Geography was determined using an individual's postal code at diagnosis from the Canadian Cancer Registry or province or territory of death from the Canadian Vital Statistics Death Database. Geography was categorized into Atlantic, Central, Prairies, West, and Territories. Canadian Cancer Registry data were used to determine CRC incidence from 1992 to 2016. Canadian Vital Statistics Death data were used to determine CRC mortality from 1980 to 2018.

Results: Among all age groups, CRC incidence was highest in Atlantic Canada, was lowest in Western Canada, and increased with age. CRC incidence increased over time for individuals aged 20-44 years and was stable or decreased for other age groups in all regions. CRC mortality was highest in Atlantic Canada and lowest in the Prairies and Western Canada. CRC mortality decreased for individuals in all age groups and regions except among individuals aged 20-49 years in the Territories.

Discussion: Most of Canada has not yet seen an increase in CRC burden in the age group of 45-49 years, which is a reason to not lower the start age for CRC screening in Canada. Targeted CRC screening should be considered for individuals younger than 50 years who live in the Territories.

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Conflict of interest statement

Guarantor of the article: Kathleen M. Decker, PhD.

Specific author contributions: K.M.D.: conceptualization, funding acquisition, methodology, project administration, supervision, writing original draft and review and editing. P.L.: conceptualization, formal analysis, methodology, supervision, writing—review and editing. J.B.: formal analysis, methodology, writing—review and editing. A.D.: conceptualization, funding acquisition, methodology, writing—review and editing. H.S.: conceptualization, funding acquisition, methodology, writing original draft and review and editing. All authors have read and agreed to the published version of the manuscript.

Financial support: This study was supported by the CancerCare Manitoba Foundation. The CancerCare Manitoba Foundation had no role in the design, collection, analysis, and interpretation of the data. The analysis took place at Statistics Canada's Manitoba Research Data Centre (RDC). The RDC is supported by funds to the Canadian Research Data Centre Network (CRDCN) from the Social Sciences and Humanities Research Council (SSHRC), the Canadian Institute for Health Research (CIHR), the Canadian Foundation for Innovation (CFI), and Statistics Canada. Although the research and analysis are based on data from Statistics Canada, the opinions expressed do not represent the views of Statistics Canada. Statistics Canada vetted the data for confidentiality but had no role in the design, collection, analysis, and interpretation of the data.

Potential competing interests: None to report.

Institutional review board statement: This study was conducted according to the guidelines of the Declaration of Helsinki and approved by the University of Manitoba's Health Research Ethics Board (HS21853, H2018:217), Manitoba Health's Health Information Privacy Committee, Statistics Canada, and CancerCare Manitoba's Research and Resource Impact Committee. Because data were deidentified, informed consent was not required.

Figures

Figure 1.
Figure 1.
Time trends in CRC incidence rate per 100,000 individuals by age group for Atlantic, Central, Prairies, and Western Canada, 1992–2016. CRC, colorectal cancer.
Figure 2.
Figure 2.
Time trends in CRC incidence rate per 100,000 individuals by age group in the Territories, Canada, 1992–2016. CRC, colorectal cancer.
Figure 3.
Figure 3.
Time trends in CRC mortality rate per 100,000 individuals by age group in Atlantic, Central, Prairies, and Western Canada, 1980–2018. CRC, colorectal cancer.
Figure 4.
Figure 4.
Time trends in CRC mortality rate per 100,000 individuals by age group in the Territories, Canada, 1980–2018. CRC, colorectal cancer.
See this image and copyright information in PMC

References

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