Long-term trends in colorectal cancer: incidence, localization, and presentation

Abstract

Background The purpose of this study was to assess trends in incidence and presentation of colorectal cancer (CRC) over a period of 37 years in a stable population in Mid-Norway. Secondarily, we wanted to predict the future burden of CRC in the same catchment area. Methods All 2268 patients diagnosed with CRC at Levanger Hospital between 1980 and 2016 were included in this study. We used Poisson regression to calculate the incidence rate ratio (IRR) and analyse factors associated with incidence. Results The incidence of CRC increased from 43/100,000 person-years during 1980–1984 to 84/100,000 person-years during 2012–2016. Unadjusted IRR increased by 1.8% per year, corresponding to an overall increase in incidence of 94.5%. Changes in population (ageing and sex distribution) contributed to 28% of this increase, whereas 72% must be attributed to primary preventable factors associated with lifestyle. Compared with the last observational period, we predict a further 40% increase by 2030, and a 70% increase by 2040. Acute colorectal obstruction was associated with tumours in the left flexure and descending colon. Spontaneous colorectal perforation was associated with tumours in the descending colon, caecum, and sigmoid colon. The incidence of obstruction remained stable, while the incidence of perforation decreased throughout the observational period. The proportion of earlier stages at diagnosis increased significantly in recent decades. Conclusion CRC incidence increased substantially from 1980 to 2016, mainly due to primary preventable factors. The incidence will continue to increase during the next two decades, mainly due to further ageing of the population.

Octogenarian patients with colon cancer – postoperative morbidity and mortality are the major challenges

“…During this period, the average age of the population also increased. In particular, the number of octogenarian inhabitants increased by 73%, from 2184 individuals in 1980, to 3800 individuals in 2016 [ 4 ].…”

“…In Nordic countries, increases have been observed in the population, life expectancy, and incidence of colon cancer over the last few decades. These trends are likely to continue; thus, the number of older patients with colon cancer will continue to increase [ 1 , 2 ], and a significant proportion of these patients will be octogenarians (i.e., aged 80–89 years) [ 3 , 4 ].…”

Management of obstructive colon cancer: Current status, obstacles, and future directions

“…Obstructive colon cancer is usually classified as right-sided or left-sided according to proximal or distal to the splenic flexure. Previous studies indicate that more than half of acute obstructive colon cancer occurs on the left side, most commonly in the sigmoid colon[ 1 , 6 , 8 ]. The anatomic characteristic of a narrow luminal diameter in the left-sided colon explains the higher incidence of obstructive colon cancer compared to the right-sided colon.…”

“…Unfortunately, despite active screening efforts, the incidence of obstructive colon cancer remains stable[ 3 , 6 ]. The management of obstructive colon cancer is complex and challenging due to multiple factors, including the patient’s index presentation of a poor general condition, limited information regarding the cancer stage, and the need for immediate intervention in an emergency setting.…”

Nano-Delivery of a Novel Inhibitor of Polynucleotide Kinase/Phosphatase (PNKP) for Targeted Sensitization of Colorectal Cancer to Radiation-Induced DNA Damage

“…Colorectal cancer (CRC) is the second most common cause of cancer death globally ( 1 ) and its incidence is expected to increase by 33% by 2028 ( 2 ). Clinical outcomes from the conventional treatment options in CRC appear to depend on the location as well as molecular features of individual tumors ( 3 ).…”