Colorectal cancer incidence, mortality, and stage distribution in European countries in the colorectal cancer screening era: an international population-based study

Authors	CARDOSO R. GUO F. HEISSER T. HACKL M. IHLE P. DE SCHUTTER H. VAN DAMME N. VALERIANOVA Z. ATANASOV T. MÁJEK Ondřej MUŽÍK Jan NILBERT M. C. TYBJERG A. J. INNOS K. MAGI M. MALILA N. BOUVIER A. M. BOUVIER V. LAUNOY G. WORONOFF A. S. CARIOU M. ROBASZKIEWICZ M. DELAFOSSE P. PONCET F. KATALINIC A. WALSH P. M. SENORE C. ROSSO S. VINCERZEVSKIENE I. LEMMENS V. E. P. P. ELFERINK M. A. G. JOHANNESEN T. B. KORNER H. PFEFFER F. BENTO M. J. RODRIGUES J. DA COSTA F. A. MIRANDA A. ZADNIK V. ZAGAR T. MARQUES A. L. D. MARCOS-GRAGERA R. PUIGDEMONT M. GALCERAN J. CARULLA M. CHIRLAQUE M. D. BALLESTA M. SUNDQUIST K. SUNDQUIST J. WEBER M. JORDAN A. HERRMANN C. MOUSAVI M. RYZHOV A. HOFFMEISTER M. BRENNER H.
Year of publication	2021
Type	Article in Periodical
Magazine / Source	Lancet Oncology
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00199-6/fulltext
Doi	http://dx.doi.org/10.1016/S1470-2045(21)00199-6
Keywords	colorectal cancer; incidence; mortality; stage distribution; Europe
Description	Findings In countries with long-standing programmes of screening colonoscopy and faecal tests (ie, Austria, the Czech Republic, and Germany), colorectal cancer incidence decreased substantially over time, with AAPCs ranging from -2 center dot 5% (95% CI -2 center dot 8 to -2 center dot 2) to -1 center dot 6% (-2 center dot 0 to -1 center dot 2) in men and from -2 center dot 4% (-2 center dot 7 to -2 center dot 1) to -1 center dot 3% (-1 center dot 7 to -0 center dot 9) in women. In countries where screening programmes were implemented during the study period, age-standardised colorectal cancer incidence either remained stable or increased up to the year screening was implemented. AAPCs for these countries ranged from -0 center dot 2% (95% CI -1 center dot 4 to 1 center dot 0) to 1 center dot 5% (1 center dot 1 to 1 center dot 8) in men and from -0 center dot 5% (-1 center dot 7 to 0 center dot 6) to 1 center dot 2% (0 center dot 8 to 1 center dot 5) in women. Where high screening coverage and uptake were rapidly achieved (ie, Denmark, the Netherlands, and Slovenia), age-standardised incidence rates initially increased but then subsequently decreased. Conversely, colorectal cancer incidence increased in most countries where no large-scale screening programmes were available (eg, Bulgaria, Estonia, Norway, and Ukraine), with AAPCs ranging from 0 center dot 3% (95% CI 0 center dot 1 to 0 center dot 5) to 1 center dot 9% (1 center dot 2 to 2 center dot 6) in men and from 0 center dot 6% (0 center dot 4 to 0 center dot 8) to 1 center dot 1% (0 center dot 8 to 1 center dot 4) in women. The largest decreases in colorectal cancer mortality were seen in countries with long-standing screening programmes.