title: The changing distribution and survival of colorectal carcinoma: an epidemiological study in an area of northern Italy.
abstract: OBJECTIVE
  This study analyses the inter-relations of anatomical tumour location, gender, age and incidence rates for colorectal cancer from 1978 to 1999 in an area of northern Italy: the Parma district.
  
  
  METHODS
  Data were obtained from the Parma Cancer Registry. Age-adjusted incidence rates were analysed by gender, age and colorectal cancer subsites. In addition, 5 year observed survival rates were determined.
  
  
  RESULTS
  In the Parma area, the incidence of colorectal cancer is rising. We have observed a true increase in the rate of the age standardized incidence of right colon cancer, linked to an increased incidence of left colon cancer, while the incidence of rectal cancer has remained constant. The frequency of right-sided colon cancer was higher in aged patients, and in women. Age-standardized relative survival of patients after diagnosis of colorectal cancer between 1992 and 1996 was found to be significantly higher than age-standardized relative survival after diagnosis between 1978 and 1982.
  
  
  CONCLUSIONS
  In the Parma area there has been an increased incidence of right colon cancer, linked to an increased incidence of left colon cancer, while the incidence of rectal cancer has remained constant. We feel that this shift, whatever the reason for it, has important implications for the choice of screening techniques.
authors.affiliation: Department of Surgical Sciences, Section of General Surgical Clinics and Surgical Therapy, Parma University Medical School, Italy. leosarli@unipr.it
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Sarli
authors.forename: Maria
authors.initials: M
authors.lastname: Michiara
authors.forename: Paolo
authors.initials: P
authors.lastname: Sgargi
authors.forename: Domenico
authors.initials: D
authors.lastname: Iusco
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Lisi
authors.forename: Francesco
authors.initials: F
authors.lastname: Leonardi
authors.forename: Maria A
authors.initials: MA
authors.lastname: Bella
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sgobba
authors.forename: Luigi
authors.initials: L
authors.lastname: Roncoroni
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D003110:Colonic Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology; D012042:Registries; D017678:Sex Distribution; D015996:Survival Rate