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. 2024 Sep 24;16(19):3245.
doi: 10.3390/cancers16193245.

Incidence and Dynamics of CRC Stage Migration: A Regional vs. a National Analysis

Carol Faris  1 , Araceli Cuaranta  1 , Michael Abdelmasseh  1 , Rob Finley  1 , Barbara Payne  1 , Alexei Gorka  1 , Juan Sanabria  1
Affiliations

Incidence and Dynamics of CRC Stage Migration: A Regional vs. a National Analysis

Carol Faris et al. Cancers (Basel). .

Abstract

Background/objectives: Due to an increased rate of surveillance colonoscopy, we aim to determine the impact of stage migration on the incidence and overall survival (OS) of patients who underwent pathological staging of colorectal cancer (CRC) at our Health Network System.

Methods: Two datasets were included: subjects from the tumor registry at a regional Comprehensive Cancer Center (n = 1385) and subjects from the Surveillance, Epidemiology, and End Results (SEER) national database (n = 202,391).

Results: A significant increase in the diagnosis of CRC Stage 1 and 4 was observed, with a decrease in stage 2, and no change in Stage 3 in the National datasets (p < 0.01). There was an increase in Stage 4 CRC diagnosis, with a concurrent decrease in stage 2, and no changes in stages 1 and 3 in the regional dataset (p < 0.05). OS followed the expected and progressive decrease in OS by stage (from 1 to 4, p < 0.01).

Conclusions: The present findings confirmed CRC stage migration in our Health Network System, along with a national trend conducive to an increased OS for early CRC stages.

Keywords: Will Rogers phenomenon; colorectal cancer stages; overall survival (OS) by stage; stage migration.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Trends in cancer incidence from Stage 0 to Stage 4 over time based on a national and regional database. The y-axis shows the incidence rate as percentage (%) by stage, and the x-axis shows the year of diagnosis. (A) There was a significant increase in the incidence of early (stages 0 and 1) and late stages (Stage 3 and 4), and a significant decrease in Stage 2 diagnosis (p < 0.01). (B) There was an increase incidence of late stage 4, and a significant decrease in the incidence of Stage 2 diagnoses (p < 0.05).
Figure 1
Figure 1
Trends in cancer incidence from Stage 0 to Stage 4 over time based on a national and regional database. The y-axis shows the incidence rate as percentage (%) by stage, and the x-axis shows the year of diagnosis. (A) There was a significant increase in the incidence of early (stages 0 and 1) and late stages (Stage 3 and 4), and a significant decrease in Stage 2 diagnosis (p < 0.01). (B) There was an increase incidence of late stage 4, and a significant decrease in the incidence of Stage 2 diagnoses (p < 0.05).
Figure 2
Figure 2
National overall survival (OS) curves for CRC by stage over time. The curves represent survival probabilities over a 5-year period. Stage of CRC at diagnosis was associated with OS at 5 years (p < 0.01).
Figure 3
Figure 3
CRC incidence by age from 1990 to 2020. The incidence rates have remained.
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