Sex variation in colorectal cancer mortality: trends and implications for screening.
Eur J Public Health
; 33(2): 331-335, 2023 04 01.
Article
in En
| MEDLINE
| ID: mdl-36847663
ABSTRACT
BACKGROUND:
Colorectal cancer (CRC) screening using faecal tests reduces disease-specific mortality. To investigate mortality and its association with sex, rates in women and men, and in different age ranges, were examined, before and after screening began in Scotland.METHODS:
From 1990-99, no structured screening existed. Three pilots ran from 2000 to 2007 and subsequent full roll-out completed in 2009. Crude mortality rates for 1990-2020 were calculated relative to Scottish population estimates, and age-sex standardized rates calculated for all, pre-screening (<50 years), screening (5-74 years) and post-screening (>74 years) age ranges.RESULTS:
CRC mortality declined from 1990 to 2020, but not linearly, and differed between sexes. In women, 1990-99 showed a steady decline [average annual percentage change (AAPC) -2.1%, 95% confidence interval (CI) -2.8% to -1.4%], but a less marked decline after 2000 (AAPC -0.7%, 95% CI -0.9% to -0.4%). In men, no clear decline was seen from 1990 to 1999 (AAPC -0.4%, 95% CI -1.1% to 0.4%), but mortality declined from 2000 to 2020 (AAPC -1.7%, 95% CI -1.9% to -1.5%). This pattern was exaggerated in the screening age ranges. For 2000-20, the overall reduction in mortality was less in women and in the screening age range. In the post-screening age range, reductions were smaller, but an increase was seen in the pre-screening age range, greater in women.CONCLUSIONS:
CRC mortality fell during 1990-2020, but the decline differed markedly between sexes, indicating a larger beneficial effect of screening on CRC mortality in men compared to women use of different thresholds for the sexes might lead to equality.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Colorectal Neoplasms
/
Early Detection of Cancer
Type of study:
Diagnostic_studies
/
Incidence_studies
/
Prognostic_studies
/
Screening_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
Eur J Public Health
Journal subject:
EPIDEMIOLOGIA
/
SAUDE PUBLICA
Year:
2023
Document type:
Article
Affiliation country:
United kingdom