title: Deteriorating stage profile of gastrointestinal cancer in Finland.
abstract: BACKGROUND
  The prognosis of patients with gastrointestinal (GI) cancer is mainly due to the stage of the tumor at the diagnosis. Regardless of several innovations in diagnostic and therapeutic gastroenterology, there is no longitudinal data of the trends of stage profile of patients with gastrointestinal cancer in Finland.
  
  
  OBJECTIVE
  To study the incidence by stage of GI cancer in Finland in the past 15 yr in the entire country as well as in two subpopulations with different population profile: in a population with a small number of residents over 65 yr of age (Jorvi district) and in a population with a large number of residents over 65 yr of age (Kanta-Häme district).
  
  
  METHODS
  The hospital discharge records of patients with upper or lower GI cancer between 1986 and 2000 were evaluated in Finland as well as in Jorvi and Kanta-Häme hospital districts. The data were obtained from the National Research and Development Centre for Welfare and Health, from the Centre of Statistics and from the Finnish Cancer Registry.
  
  
  RESULTS
  The relative incidence of a localized esophagogastric cancer against more severe stages decreased from 37.9% to 29.3% in the entire country, from 40.8% to 19.1% in Kanta-Häme, and from 44.2% to 33.3% in Jorvi area. Respectively, the relative incidence of localized colorectal cancer decreased from 53.6% to 48.0% in the entire country, from 49.7% to 42.5% in Kanta-Häme, and from 54.5% to 48.4% in Jorvi area.
  
  
  CONCLUSIONS
  During the past 15 yr the incidence by stage of both upper and lower GI cancer is deteriorating in the entire country as well as in areas with low and high percentage of residents over 65 yr of age indicating the increase of the more severe cases. The deterioration has become more pronounced in the 1990s, which requires a careful scrutiny of the function of primary diagnostic services.
authors.affiliation: Department of Surgery, Narvik Hospital, Norway. hannu.paimela@pp.inet.ti
authors.forename: Hannu
authors.initials: H
authors.lastname: Paimela
authors.forename: Oksala
authors.initials: O
authors.lastname: Niku
authors.forename: Mustonen
authors.initials: M
authors.lastname: Harri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005387:Finland / Q000453:epidemiology; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D005843:Geography; D006801:Humans; D015994:Incidence; D008297:Male; D008499:Medical Records; D009367:Neoplasm Staging; D011379:Prognosis; D014057:Tomography, X-Ray Computed