Registro Nacional de Cáncer Uruguay, Montevideo CP 11200, Uruguay.
Departamento de Métodos Cuantitativos, Facultad de Medicina, Universidad de la República, Montevideo CP 1180, Uruguay.
Int J Environ Res Public Health. 2021 Aug 3;18(15):8232. doi: 10.3390/ijerph18158232.
Uruguay has the highest colorectal cancer incidence rates in Latin America. Previous studies reported a stable incidence and a slight increase in mortality among males. We aimed to assess colorectal cancer incidence (2002-2017) and mortality trends (1990-2017) by age groups and sex, using data from the National Cancer Registry. Annual percent changes (APCs) were estimated using joinpoint regression models. We included 27,561 colorectal cancer cases and 25,403 deaths. We found an increasing incidence among both males and females aged 40-49, with annual increases of 3.1% (95%CI: 1.21-5.03) and 2.1% (95%CI: 0.49-3.66), respectively, and an increasein the rate in older males (70+) of 0.60% (95%CI: 0.02-1.20) per year between 2002 and 2017. Mortality remained stable among those younger than 50, whereas it decreased for older females aged 50-69 and 70+ (APC: -0.61% (-1.07-0.14) and -0.68% (-1.02-0.34), respectively), and increased for the oldest males (70+; APC: 0.74 (0.47-1.01)). In conclusion, we found rising colorectal cancer incidence accompanied by stable mortality in young adults. Sex disparities were also found among the older adults, with a more favorable pattern for females. Exposures to dietary and lifestyle risk factors, and inequalities in access to and awareness of screening programs, are probably among the main underlying causes and deserve further investigation.
乌拉圭的结直肠癌发病率在拉丁美洲位居首位。既往研究报告称，男性结直肠癌的发病率保持稳定，死亡率略有上升。本研究旨在利用国家癌症登记处的数据，评估按年龄组和性别划分的结直肠癌发病率（2002-2017 年）和死亡率趋势（1990-2017 年）。采用 Joinpoint 回归模型估计年度百分比变化（APC）。共纳入 27561 例结直肠癌病例和 25403 例死亡病例。我们发现，40-49 岁男性和女性的结直肠癌发病率均呈上升趋势，每年分别增长 3.1%（95%CI：1.21-5.03）和 2.1%（95%CI：0.49-3.66），70 岁以上男性的发病率也呈上升趋势，每年增加 0.60%（95%CI：0.02-1.20）。50 岁以下人群的死亡率保持稳定，而 50-69 岁和 70 岁以上女性的死亡率则呈下降趋势（APC：-0.61%（-1.07-0.14）和-0.68%（-1.02-0.34）），70 岁以上男性的死亡率则呈上升趋势（APC：0.74（0.47-1.01））。综上所述，我们发现年轻人结直肠癌发病率上升，同时死亡率保持稳定。老年人群中也存在性别差异，女性的情况更为有利。饮食和生活方式风险因素的暴露以及筛查项目的可及性和知晓率的不平等可能是主要的潜在原因，值得进一步研究。
