Paszat Lawrence F, Sutradhar Rinku, Corn Elyse, Tinmouth Jill, Baxter Nancy N, Rabeneck Linda
Institute for Healthcare Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
J Can Assoc Gastroenterol. 2020 Oct 15;4(3):146-155. doi: 10.1093/jcag/gwaa035. eCollection 2021 Jun.
We aimed to evaluate trends in Ontario, Canada, 2002 to 2016, in uptake of colorectal evaluative procedures, colorectal cancer (CRC) incidence and incidence-based mortality in the colorectal screening-age population.
We defined the screening age-eligible population as persons 51 to 74 years of age with ≥1 year eligibility for the Ontario Health Insurance Plan, excluding those with a diagnosis of CRC in the Ontario Cancer Registry (OCR) prior to age 50 or January 1, 2002. We computed annual up-to-date status with colorectal evaluative procedures from billing claims, and CRC incidence from the OCR. In order to compute incidence-based CRC mortality, we included persons with a first diagnosis of CRC between the ages of 51 and 74, diagnosed between January 1, 1992 and December 31, 2001, still alive and <75 years of age on January 1, 2002, based on cause of death from the OCR. Overall, age-stratified and sex-stratified trends were evaluated by Cochran-Armitage trend tests.
Persons up to date with colorectal evaluative procedures increased from 628,214/2,782,061 (22.6%) in 2002 to 2,584,570/4,179,789 (62.2%) in 2016. CRC incidence fell from 129.3/100,000 in 2002 to 94.54/100,000 in 2016, and incidence-based CRC mortality fell from 40.8/100,000 to 24.1/100,000. Decreasing trends in overall and stratified incidence and mortality were all significant, except among persons 51 to 54 years old.
There was continued increase in persons up-to-date with colorectal evaluative procedures, and significant decrease in CRC incidence and incidence-based CRC mortality from 2002 through 2016.
我们旨在评估2002年至2016年加拿大安大略省结肠直肠评估程序的使用情况、结肠直肠癌（CRC）发病率以及结肠直肠筛查年龄人群中基于发病率的死亡率趋势。
我们将筛查年龄符合条件的人群定义为年龄在51至74岁之间、有资格参加安大略省健康保险计划至少1年的人，不包括在安大略癌症登记处（OCR）中50岁之前或2002年1月1日之前被诊断为CRC的人。我们根据计费索赔计算结肠直肠评估程序的年度最新情况，并根据OCR计算CRC发病率。为了计算基于发病率的CRC死亡率，我们纳入了1992年1月1日至2001年12月31日期间首次诊断为CRC、年龄在51至74岁之间、2002年1月1日仍存活且年龄小于75岁的人，数据基于OCR的死亡原因。总体而言，通过 Cochr an-Armitage趋势检验评估年龄分层和性别分层趋势。
进行了结肠直肠评估程序的人数从2002年的628,214/2,782,061（22.6%）增加到2016年的2,584,570/4,179,789（62.2%）。CRC发病率从2002年的129.3/100,000降至2016年的94.54/100,000，基于发病率的CRC死亡率从40.8/100,000降至24.1/100,000。总体及分层发病率和死亡率的下降趋势均具有显著性，但51至54岁人群除外。
2002年至2016年期间，进行结肠直肠评估程序的人数持续增加，CRC发病率及基于发病率的CRC死亡率显著下降。
