Effect of colorectal cancer screening on long‐term survival of colorectal cancer patients: Results of the Korea National Cancer Screening Program

Luu, Xuan Quy; Lee, Kyeongmin; Jun, Jae Kwan; Jung, Kyu‐Won; Choi, Kui Son

doi:10.1002/ijc.33953

Cited by 15 publications

(14 citation statements)

References 37 publications

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“…The findings from our study suggest that county‐level rurality plays an important role in CRC survival, particularly for high CRC screening areas. In order to address disparities in CRC mortality in areas with lower CRC screening rates and rural areas, interventions are needed to improve the accessibility, timeliness, and quality of CRC treatment, and follow‐up care 32 as well as the availability of CRC screening 33 . For example, patient navigation is likely to be useful in helping to ensure that patients newly diagnosed with CRC receive timely and appropriate treatment 34 .…”

Section: Discussionmentioning

confidence: 99%

“…In order to address disparities in CRC mortality in areas with lower CRC screening rates and rural areas, interventions are needed to improve the accessibility, timeliness, and quality of CRC treatment, and follow-up care 32 as well as the availability of CRC screening. 33 For example, patient navigation is likely to be useful in helping to ensure that patients newly diagnosed with CRC receive timely and appropriate treatment. 34 Other interventions, such as assisting with patient transportation, may also be helpful in rural areas.…”

Section: County-level Crc Screening Rates Rurality and Crc Survivalmentioning

confidence: 99%

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County‐level colorectal cancer screening rates on colorectal cancer survival in the state of Georgia: Does county‐level rurality matter?

Tsai,

Coughlin,

Cortes

2024

Cancer Medicine

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PurposeInvestigating CRC screening rates and rurality at the county‐level may explain disparities in CRC survival in Georgia. Although a few studies examined the relationship of CRC screening rates, rurality, and/or CRC outcomes, they either used an ecological study design or focused on the larger population.MethodsWe conducted a retrospective analysis utilizing data from the 2004–2010 Surveillance, Epidemiology, and End Results Program. The 2013 United States Department of Agriculture rural–urban continuum codes and 2004–2010 National Cancer Institute small‐area estimates for screening behaviors were used to identify county‐level rurality and CRC screening rates. Kaplan–Meier method and Cox proportional hazard regression were performed.ResultsAmong 22,160 CRC patients, 5‐year CRC survival rates were lower among CRC patients living in low screening areas in comparison with intermediate/high areas (69.1% vs. 71.6% /71.3%; p‐value = 0.030). Patients living in rural high‐screening areas also had lower survival rates compared to non‐rural areas (68.2% vs. 71.8%; p‐value = 0.009). Our multivariable analysis demonstrated that patients living in intermediate (HR, 0.91; 95% CI, 0.85–0.98) and high‐screening (HR, 0.92; 95% CI, 0.85–0.99) areas were at 8%–9% reduced risk of CRC death. Further, non‐rural CRC patients living in intermediate and high CRC screening areas were 9% (HR, 0.91; 95% CI, 0.83–0.99) and 10% (HR, 0.90; 95% CI, 0.82–0.99) less likely to die from CRC.ConclusionsLower 5‐year survival rates were observed in low screening and rural high‐screening areas. Living in intermediate/high CRC screening areas was negatively associated with the risk of CRC death. Particularly, non‐rural patients living in intermediate/high‐screening areas were 8%–9% less likely to die from CRC. Targeted CRC screening resources should be prioritized for low screening and rural communities.

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Section: Discussionmentioning

confidence: 99%

Section: County-level Crc Screening Rates Rurality and Crc Survivalmentioning

confidence: 99%

County‐level colorectal cancer screening rates on colorectal cancer survival in the state of Georgia: Does county‐level rurality matter?

Tsai,

Coughlin,

Cortes

2024

Cancer Medicine

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“…Despite high SDI values, South Korea has a clear upward trend in incidence with unfavorable age-periodcohort risk. In addition to dietary habits and lifestyle reasons, the lack of early attention to CRC screening policy is also one of the main reasons [32,33].…”

Section: Discussionmentioning

confidence: 99%

Distinct time trends in colorectal cancer incidence in countries with SDI levels from 1990 to 2019: An age–period–cohort analysis for the Global Burden of Disease 2019 study

Zhang

Ding

et al. 2022

Preprint

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Introduction: The burden of colorectal cancer (CRC) plays a pivotal role in the global cancer epidemic. Our study reported the incidence trends in CRC and the associated effects of age, period, and birth cohort in 204 countries and territories over the past 30 years. Methods:The incidence data of CRC wereextracted from the Global Burden of Disease Study (GBD) 2019. We performed the age–period–cohort (APC) model to estimate the overall annual percentage change (net drift) in the incidence rate, the annual percentage change by age group (local drift), and the relative risk (period and cohort effects) of the period and cohort in CRC during 1990–2019. This approach allows examining and distinguishing age, period, and cohort effects in incidence and potentially distinguishing colorectal cancer gaps in prevention and screening. Results: In 2019, the incidence of CRC was 2.17 (95% UI 2.00–2.34) million, of which China, the United States of America, and Japan had the highest incidence population, accounting for 45.9% of the global population. The age–standardized incidence rate (ASIR) was 26.7 (95% UI 28.9–24.6) per 100,000 people, of which 30 countries had an incidence rate greater than 40.0 per 100,000 people. From 1990 to 2019, the middle SDI region had the largest increase in incidence rate, with a net drift of 2.33% (95% CI 2.2%–2.46%, P< 0.001). Globally, the incidence population was concentrated in the age group of 50–69 years, and the age group of 30–34 years had the largest increase in incidence rate (local drift 1.19% (95% CI 1.01%–1.37%)). At the same time, the sex and age distributions of CRC incidence had significant heterogeneity across regions and countries. In the past 30 years, the incidence rate in 31 countries has been well controlled (net drift <0), and most of them were concentrated in high–and high–middle–SDI regions, such as Australia, Czechia, and Belgium, and the relative risk of incidence generally improved over time and consecutive young birth cohorts. CRC incidence showed an unfavorable trend (net drift ≥1%) in 89 countries, of which 27 countries were more significant (net drift >2%), mostly concentrated in the middle SDI region, such as China, Mexico, and Brazil, and the risk of period and birth cohort was unfavorable. Conclusion: Globally, the incidence of CRC has shown an overall upward trend over the past 30 years, with the exception of some countries with higher SDI values. Significant age–period–cohort differences were observed in the risk of incidence in CRC worldwide. Effective prevention and control policies need to take into account the age–period–cohort effect characteristics of different regions.

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“…In the case of opportunistic screening, colonoscopy is widely accessible across the country at a cost that is more affordable than in other developed countries [ 14 , 15 ]. Recently, there have been reports of improvements in CRC screening rates, and the effectiveness of CRC screening has gained widespread acceptance in Korea [ 11 , 13 , 16 , 17 ]. However, there seems to be insufficient consideration as to whether CRC screening is being evenly distributed among all individuals.…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic inequality in organized and opportunistic screening for colorectal cancer: results from the Korean National Cancer Screening Survey, 2009-2021

Luu,

Lee,

Jun

et al. 2023

Epidemiol Health

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OBJECTIVES: This study aimed to investigate socioeconomic status (SES)-based inequality in colorectal cancer (CRC) screening in Korea. We assessed whether the rates of opportunistic and organized CRC screening differed according to income and education levels.METHODS: We analyzed data from the Korean National Cancer Screening Survey of 27,654 cancer-free individuals, aged 50-74 years, from 2009 to 2021. The weighted cancer screening rates with trends were estimated with the average annual percentage change using joinpoint regression. Inequality was calculated in both relative and absolute terms, based on a Poisson regression model.RESULTS: The organized screening rate increased significantly from 22.1% in 2009 to 53.1% in 2020 and 50.6% in 2021, with an average annual change of 8.6% (95% confidence interval [CI], 4.9 to 12.5). In contrast, no significant trend was observed for opportunistic screening. The SES inequality in opportunistic screening uptake was indicated by a slope index of inequality (SII) of 9.74% (95% CI, 6.36 to 13.12), relative index of inequality (RII) of 2.18 (95% CI, 1.75 to 2.70) in terms of education level; and an SII of 7.03% (95% CI, 4.09 to 9.98), RII of 1.81 (95% CI, 1.41 to 2.31) in terms of measured income. Although there was an increasing trend in income inequality, no significant SES inequalities were observed in the overall estimates for organized screening.CONCLUSIONS: Organized CRC screening is effective in improving the participation rate, regardless of SES. However, significant inequalities were found in opportunistic screening, suggesting room for improvement in the overall equity of CRC screening.

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Effect of colorectal cancer screening on long‐term survival of colorectal cancer patients: Results of the Korea National Cancer Screening Program

Cited by 15 publications

References 37 publications

County‐level colorectal cancer screening rates on colorectal cancer survival in the state of Georgia: Does county‐level rurality matter?

County‐level colorectal cancer screening rates on colorectal cancer survival in the state of Georgia: Does county‐level rurality matter?

Distinct time trends in colorectal cancer incidence in countries with SDI levels from 1990 to 2019: An age–period–cohort analysis for the Global Burden of Disease 2019 study

Socioeconomic inequality in organized and opportunistic screening for colorectal cancer: results from the Korean National Cancer Screening Survey, 2009-2021

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