title: Trends in colorectal cancer incidence: a period and birth-cohort analysis in a well-defined French population.
abstract: BACKGROUND
  France stands among high-risk areas for colorectal cancer. Different trends in CRC incidence are reported around the world. The aim of this study was to provide temporal trends in CRC incidence over a 30-year period in a French well-defined population.
  
  
  METHODS
  Between 1976 and 2005, 17,028 new cases were registered by the Burgundy digestive cancer registry. The mean variations in age-standardized incidence rates were estimated using a Poisson regression adjusted for age for each gender and location. The cumulative risk by birth cohort of developing a cancer over the age range 0-74 years was estimated using an age-cohort model.
  
  
  RESULTS
  Incidence rates for right and left colon cancers increased more rapidly in males (respectively +11.7% and +10.3% on average by 5-year period) than in females (respectively +5.9% and +6.1%). It remained stable for sigmoid cancers in males (-0.1%) and decreased in females (-5.2%). It also decreased for rectal cancers both in males (-2.7%) and in females (-2.0%). The cumulative risk increased from 3.9% for males born around 1900 to 4.9% for those born around 1930 and then slightly decreased (4.5% among those born around 1950). It remained at the same level for females born around 1900 (2.7%) as for those born around 1930 (2.7%) and then slightly increased (2.9%) for those born around 1950. For right colon cancers, the cumulative risk increased strikingly in successive birth cohorts from 0.53% to 1.2% in males and 0.55% to 0.77% in females. The corresponding cumulative risks for the left colon were 0.24% and 0.42% in males and 0.14% and 0.29% in females. For sigmoid cancer, they decreased from 1.59% to 1.08% in males, and 0.88% to 0.80% in females.
  
  
  CONCLUSIONS
  Temporal variations in incidence rates of colorectal cancers differed according to subsite, suggesting different aetiological factors and implications for diagnosis and screening strategies. Total colonoscopy must be the preferred strategy in high-risk groups or after a positive faecal occult blood test.
authors: Registre Bourguignon des Cancers Digestifs, Inserm U866, Université de Bourgogne, CHU Dijon, F-21079 BP 87900 21079 Dijon Cedex, France.
authors: Marion
authors: M
authors: Chauvenet
authors: Vanessa
authors: V
authors: Cottet
authors: Côme
authors: C
authors: Lepage
authors: Valérie
authors: V
authors: Jooste
authors: Jean
authors: J
authors: Faivre
authors: Anne-Marie
authors: AM
authors: Bouvier
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D012004:Rectal Neoplasms / Q000453:epidemiology; D012042:Registries; D017678:Sex Distribution; D012811:Sigmoid Neoplasms / Q000453:epidemiology; D055815:Young Adult