Department of Surgery, Colorectal Unit, Skåne University Hospital, S-205 02, Malmö, Sweden.
Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden.
Int J Colorectal Dis. 2019 Jul;34(7):1221-1226. doi: 10.1007/s00384-019-03312-3. Epub 2019 May 17.
Data on the incidence of colorectal cancer (CRC) is conflicting, and it is unknown if the incidence is constant, declining, or increasing. Proximal colon cancer is considered to be more common among older individuals, but recent data have shown that rectal cancer and distal colon cancer have been increasing in the younger population. The aim of this study was to determine the trends regarding CRC incidence and tumour location in Sweden.
CRC statistics from the National Board of Health and Welfare 1995-2015 were used. CRC incidence rates by age group (< 50 years, 50-79 years, ≥ 80 years), sex, and tumour localisation (proximal colon, distal colon, or rectum) were calculated and analysed using Poisson regression.
The age-standardised incidence of CRC increased in Sweden during the study period. This increase was significant (P < 0.0001) for colon cancer during the study period for all age groups regardless of tumour localisation. The greatest increase (27-52% per decade) in the colon cancer incidence rate was seen among men and women < 50 years of age. The incidence rate for rectal cancer increased for men < 50 years (P < 0.0001), decreased for both men and women aged ≥ 80 years (P < 0.005), and did not change for the remaining groups.
The CRC incidence in Sweden, in particular colon cancer, is increasing regardless of tumour localisation for individuals < 50 years of age. This paper supports the implementation of population-based colorectal cancer screening. A diagnostic workup should be performed in symptomatic individuals < 50 years of age.
结直肠癌（CRC）的发病率数据存在争议，目前尚不清楚其发病率是保持不变、下降还是上升。近端结肠癌被认为在老年人中更为常见，但最近的数据表明，直肠癌和远端结肠癌在年轻人群中的发病率一直在上升。本研究旨在确定瑞典 CRC 发病率和肿瘤部位的趋势。
使用国家卫生福利委员会 1995-2015 年的 CRC 统计数据。根据年龄组（<50 岁、50-79 岁、≥80 岁）、性别和肿瘤定位（近端结肠、远端结肠或直肠）计算并分析 CRC 发病率，并使用泊松回归进行分析。
在研究期间，瑞典的 CRC 年龄标准化发病率增加。这一增长在所有年龄组中均具有统计学意义（P<0.0001），无论肿瘤定位如何，结肠癌在研究期间都有所增加。在<50 岁的男性和女性中，结肠癌发病率的最大增幅（每十年增加 27-52%）。<50 岁男性的直肠癌发病率增加（P<0.0001），≥80 岁的男性和女性的发病率降低（P<0.005），其余组别的发病率没有变化。
无论肿瘤定位如何，瑞典的 CRC 发病率，特别是<50 岁人群的结肠癌发病率都在上升。本文支持实施基于人群的结直肠癌筛查。对于<50 岁有症状的个体，应进行诊断性检查。
