Registre Bourguignon des Cancers Digestifs, Inserm U866, Université de Bourgogne, CHU Dijon, F-21079 BP 87900 21079 Dijon Cedex, France.
BMC Cancer. 2011 Jun 30;11:282. doi: 10.1186/1471-2407-11-282.
France stands among high-risk areas for colorectal cancer. Different trends in CRC incidence are reported around the world. The aim of this study was to provide temporal trends in CRC incidence over a 30-year period in a French well-defined population.
Between 1976 and 2005, 17,028 new cases were registered by the Burgundy digestive cancer registry. The mean variations in age-standardized incidence rates were estimated using a Poisson regression adjusted for age for each gender and location. The cumulative risk by birth cohort of developing a cancer over the age range 0-74 years was estimated using an age-cohort model.
Incidence rates for right and left colon cancers increased more rapidly in males (respectively +11.7% and +10.3% on average by 5-year period) than in females (respectively +5.9% and +6.1%). It remained stable for sigmoid cancers in males (-0.1%) and decreased in females (-5.2%). It also decreased for rectal cancers both in males (-2.7%) and in females (-2.0%). The cumulative risk increased from 3.9% for males born around 1900 to 4.9% for those born around 1930 and then slightly decreased (4.5% among those born around 1950). It remained at the same level for females born around 1900 (2.7%) as for those born around 1930 (2.7%) and then slightly increased (2.9%) for those born around 1950. For right colon cancers, the cumulative risk increased strikingly in successive birth cohorts from 0.53% to 1.2% in males and 0.55% to 0.77% in females. The corresponding cumulative risks for the left colon were 0.24% and 0.42% in males and 0.14% and 0.29% in females. For sigmoid cancer, they decreased from 1.59% to 1.08% in males, and 0.88% to 0.80% in females.
Temporal variations in incidence rates of colorectal cancers differed according to subsite, suggesting different aetiological factors and implications for diagnosis and screening strategies. Total colonoscopy must be the preferred strategy in high-risk groups or after a positive faecal occult blood test.
法国是结直肠癌的高危地区之一。世界各地报道了结直肠癌发病率的不同趋势。本研究的目的是提供法国一个明确界定人群中 30 年来结直肠癌发病率的时间趋势。
在 1976 年至 2005 年间，勃艮第消化癌症登记处登记了 17028 例新病例。使用泊松回归调整了每个性别和位置的年龄标准化发病率的平均变化。使用年龄队列模型估计了在 0-74 岁年龄段中因出生队列而患癌症的累积风险。
男性右结肠和左结肠癌的发病率增长更快（每 5 年分别增加 11.7%和 10.3%），而女性的发病率增长更慢（分别为 5.9%和 6.1%）。男性乙状结肠癌的发病率保持稳定（-0.1%），女性的发病率则下降（-5.2%）。男性直肠癌的发病率也下降（-2.7%），女性的发病率也下降（-2.0%）。男性的累积风险从 1900 年左右出生的 3.9%增加到 1930 年左右出生的 4.9%，然后略有下降（1950 年左右出生的 4.5%）。1900 年左右出生的女性的累积风险（2.7%）与 1930 年左右出生的女性（2.7%）相同，然后略有增加（1950 年左右出生的 2.9%）。对于右结肠癌，男性的累积风险从连续的出生队列中的 0.53%显著增加到 1.2%，女性的累积风险从 0.55%增加到 0.77%。对于左结肠癌，男性的累积风险分别为 0.24%和 0.42%，女性的累积风险分别为 0.14%和 0.29%。对于乙状结肠癌，男性的累积风险从 1.59%下降到 1.08%，女性的累积风险从 0.88%下降到 0.8%。
结直肠癌发病率的时间变化因部位不同而不同，提示不同的病因和诊断及筛查策略的意义。在高危人群或粪便潜血试验阳性后，全结肠镜检查必须是首选策略。
