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Trends of colorectal cancer incidence and mortality rates from 2003 to 2014 in Italy

Manuel Zorzi, Luigino Dal Maso, Silvia Francisci, Carlotta Buzzoni, Massimo Rugge, Stefano Guzzinati
Tumori 2019 March 27, : 300891619838336
30917756

OBJECTIVE: To evaluate the trends of colorectal cancer (CRC) incidence and mortality rates from 2003 to 2014 in Italy by age groups and regions.

METHODS: We used the data of 48 cancer registries from 17 Italian regions to estimate standardized incidence and mortality rates overall and by sex, age groups (<50, 50-69, 70+ years), and geographic area (northwest, northeast, center, south, and islands). Time trends were expressed as annual percent change in rates (APC) with 95% confidence intervals (95% CI).

RESULTS: Incidence rates decreased from 104.3 (2003) to 89.9 × 100,000 (2014) in men and from 64.3 to 58.4 × 100,000 in women. Among men, incidence decreased during 2007-2010 (APC -4.0, 95% CI -6.0 to -1.9) and 2010-2014 (APC -0.7, 95% CI -1.4 to 0.0), while in women it linearly decreased during the whole period (APC -1.1, 95% CI -1.4 to -0.8). Mortality rates showed a linear reduction both in men (APC -0.7, 95% CI -1.0 to -0.3) and women (APC -0.9, 95% CI -1.2 to -0.6) and decreased respectively from 41.1 to 39.2 × 100,000 and from 24.6 to 23.1 × 100,000. In the 50- to 69-year-old range (screening target age), incidence showed a prescreening increase, followed by a peak after screening started, and a decline thereafter. Incidence and mortality rates significantly decreased in all areas but in the south and islands, where incidence increased and mortality remained stable.

CONCLUSIONS: A renewed commitment by all regional health systems to invest in primary (i.e., lifestyle) and secondary (i.e., screening programs) prevention is of utmost importance.

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