Cassetti Tiziana, Stracci Fabrizio, Canosa Antonio, Minelli Liliana, Scheibel Massimo, Romagnoli Carlo, La Rosa Francesco
Umbrian Population Cancer Registry, Perugia, Italy.
Tumori. 2007 Jan-Feb;93(1):13-8. doi: 10.1177/030089160709300103.
The epidemiology of colorectal cancer in Umbria, Italy, was evaluated, and data were analyzed in the pre-screening period to better understand the etiology of the disease and to develop screening strategies.
Incident data were collected by the Umbrian Population Cancer Registry and mortality data by the Nominative Regional Mortality Registry from 1994 to 2002. The survival rates relative to Italian cancer registries were derived from the Italian Associations of Cancer Registries publications. Time trends were analyzed by joinpoint regression. The follow-up for survival rates referred to December 31, 2005.
The trend of colorectal cancer age-adjusted incidence showed a slight, constant, but non significant increase over time. The mortality trend showed a slight, constant, but non-significant decrease. Age at diagnosis remained constant in males, whereas in females it showed a significant increase of about 1.5 years. In the last period, all incidence rates increased with age, but in males they presented a rapid increase in the 55-74 age group, levelled and declined up to 84 and after again reached, which could be a consequence of opportunistic screening practice, probably undergone by males. Mortality in both sexes increased with age, whereas survival rates fell. Comparison of survival rates in some Italian cancer registries showed that the Umbria region, in the 1994-1996 period, was the zone with the highest relative survival; in the 1996-1999 period, the rate stopped, differently from other Italian zones. In the last period, the highest survival rates were recorded by registries covering zones with active screening programs.
The present reduction of mortality in Umbria, as in other Italian areas, is dependent on the natural behavior of the disease, which is linked to a birth cohort-related effect of stabilization and decrease in exposure to risk factors.
对意大利翁布里亚地区结直肠癌的流行病学情况进行评估，并在筛查前阶段分析数据，以更好地了解该疾病的病因并制定筛查策略。
1994年至2002年期间，翁布里亚地区人口癌症登记处收集发病数据，由记名区域死亡率登记处收集死亡数据。相对于意大利癌症登记处的生存率数据来自意大利癌症登记协会的出版物。采用连接点回归分析时间趋势。生存率的随访截止到2005年12月31日。
结直肠癌年龄调整发病率呈轻微、持续但不显著的上升趋势。死亡率呈轻微、持续但不显著的下降趋势。男性的诊断年龄保持不变，而女性的诊断年龄显著增加约1.5岁。在最后阶段，所有发病率均随年龄增长而上升，但男性在55 - 74岁年龄组迅速上升，随后趋于平稳并下降，直至84岁后再次上升，这可能是男性接受机会性筛查的结果。男女死亡率均随年龄增长而上升，而生存率下降。与意大利一些癌症登记处的生存率比较显示，翁布里亚地区在1994 - 1996年期间是相对生存率最高的地区；在1996 - 1999年期间，该比率与其他意大利地区不同，停止上升。在最后阶段，开展积极筛查项目地区的登记处记录的生存率最高。
与意大利其他地区一样，翁布里亚目前死亡率的下降取决于疾病的自然发展过程，这与出生队列相关的稳定效应以及危险因素暴露减少有关。
