title: Temporal trends in mode, site and stage of presentation with the introduction of colorectal cancer screening: a decade of experience from the West of Scotland.
abstract: BACKGROUND
  Population colorectal cancer screening programmes have been introduced to reduce cancer-specific mortality through the detection of early-stage disease. The present study aimed to examine the impact of screening introduction in the West of Scotland.
  
  
  METHODS
  Data on all patients with a diagnosis of colorectal cancer between January 2003 and December 2012 were extracted from a prospectively maintained regional audit database. Changes in mode, site and stage of presentation before, during and after screening introduction were examined.
  
  
  RESULTS
  In a population of 2.4 million, over a 10-year period, 14 487 incident cases of colorectal cancer were noted. Of these, 7827 (54%) were males and 7727 (53%) were socioeconomically deprived. In the postscreening era, 18% were diagnosed via the screening programme. There was a reduction in both emergency presentation (20% prescreening vs 13% postscreening, P⩽0.001) and the proportion of rectal cancers (34% prescreening vs 31% pos-screening, P⩽0.001) over the timeframe. Within non-metastatic disease, an increase in the proportion of stage I tumours at diagnosis was noted (17% prescreening vs 28% postscreening, P⩽0.001).
  
  
  CONCLUSIONS
  Within non-metastatic disease, a shift towards earlier stage at diagnosis has accompanied the introduction of a national screening programme. Such a change should lead to improved outcomes in patients with colorectal cancer.
authors.affiliation: Academic Unit of Colorectal Surgery, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow Royal Infirmary, Room 2.57, New Lister Building, Glasgow Royal Infirmary, 10-16 Alexandra Parade, Glasgow G31 2ER, UK.
authors.forename: D
authors.initials: D
authors.lastname: Mansouri
authors.affiliation: Academic Unit of Colorectal Surgery, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow Royal Infirmary, Room 2.57, New Lister Building, Glasgow Royal Infirmary, 10-16 Alexandra Parade, Glasgow G31 2ER, UK.
authors.forename: D C
authors.initials: DC
authors.lastname: McMillan
authors.affiliation: West of Scotland Cancer Network, Glasgow Royal Infirmary, Glasgow, UK.
authors.forename: C
authors.initials: C
authors.lastname: Crearie
authors.affiliation: West of Scotland Cancer Surveillance Unit, Lillybank Gardens, Glasgow, UK.
authors.forename: D S
authors.initials: DS
authors.lastname: Morrison
authors.affiliation: Department of Public Health Screening Unit, NHS Greater Glasgow & Clyde, West House, Gartnavel Royal Hospital, Glasgow, UK.
authors.forename: E M
authors.initials: EM
authors.lastname: Crighton
authors.affiliation: Academic Unit of Colorectal Surgery, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow Royal Infirmary, Room 2.57, New Lister Building, Glasgow Royal Infirmary, 10-16 Alexandra Parade, Glasgow G31 2ER, UK.
authors.forename: P G
authors.initials: PG
authors.lastname: Horgan
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data* / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011610:Psychosocial Deprivation; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology; D012959:Socioeconomic Factors