Spatial variation in stage distribution in colorectal cancer in the Netherlands

2012 ◽  
Vol 48 (8) ◽  
pp. 1119-1125 ◽  
Author(s):  
M.A.G. Elferink ◽  
E. Pukkala ◽  
J.M. Klaase ◽  
S. Siesling
2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3531-3531
Author(s):  
Myrtle F Krul ◽  
Marloes AG Elferink ◽  
Niels FM Kok ◽  
Evelien Dekker ◽  
Iris Lansdorp-Vogelaar ◽  
...  

3531 Background: Population-based screening for colorectal cancer (CRC) aims to decrease incidence and mortality due to precancerous polyp removal, early detection and early treatment of CRC. In the Netherlands, phased introduction of a biennial fecal immunochemical hemoglobin test started in 2014 for individuals aged 55-75. This evaluation of the national data focuses on the initial effect of CRC screening on incidence and stage distribution and the impact on stage IV disease. Methods: All CRC patients diagnosed in the Netherlands between 2009 and 2018 were selected from the Netherlands Cancer Registry (NCR). Patients were linked to the Dutch national pathology registry (PALGA) to identify screen-detected tumors. Results: The NCR identified 137,717 CRC patients between 2009 and 2018. The incidence within screening age (55-75 yr) of all CRC stages showed an initial peak after introduction of screening in 2014, followed by a continuous decrease for all stages. CRC incidence outside the screening age did not show these explicit changes between 2009 and 2018. In 2018, the incidence of stage IV CRC within screening age was lower than the level at the start of the screening program. Stage distribution within screening age shifted towards earlier stages in the screening period (2014-2018) compared to the period before screening (2009-2012) (stage I: 31% vs. 18%, stage II: 22% vs. 26%, stage III: 29% vs. 31%, Stage IV: 18% vs. 25%, respectively). In the period 2014-2018 and within screening age, the ratio of screen-detected and symptom-detected tumors was highest in stage I (47%:53%) and lowest in stage IV (9%:91%). Screen-detected compared to symptom-detected stage IV patients diagnosed in the period 2014-2018 and within screening age had more frequently single organ metastases (74.5% vs 57.4%, p < 0.001), higher resection rate of the primary tumor (57.5% vs. 41.3%; p < 0.001) and higher local treatment rate of metastases (40.0% vs. 23.4% p < 0.001). The median overall survival of screen-detected stage IV patients was significantly longer than that of symptom-detected stage IV patients (31.0 months (95% CI: 27.7 – 34.3) vs. 15.0 months (95% CI: 14.5 – 15.5), p < 0.001). Conclusions: The initial results of the introduction of CRC screening in the Netherlands showed a favorable trend on CRC incidence and stage distribution. Screen-detected patients with stage IV disease had less extensive disease, resulting in better treatment options and improved survival.


2009 ◽  
Vol 125 (12) ◽  
pp. 2945-2952 ◽  
Author(s):  
Colinda C.J.M. Simons ◽  
Laura A.E. Hughes ◽  
Ilja C.W. Arts ◽  
R. Alexandra Goldbohm ◽  
Piet A. van den Brandt ◽  
...  

2015 ◽  
Vol 41 (8) ◽  
pp. 1059-1067 ◽  
Author(s):  
J.A. Govaert ◽  
M. Fiocco ◽  
W.A. van Dijk ◽  
A.C. Scheffer ◽  
E.J.R. de Graaf ◽  
...  

2016 ◽  
Vol 95 (3) ◽  
pp. 253-268 ◽  
Author(s):  
Hanneke Verweij ◽  
Geert-Jan Vis ◽  
Elke Imberechts

AbstractThe spatial distribution of porosity and permeability of the Rupel Clay Member is of key importance to evaluate the spatial variation of its sealing capacity and groundwater flow condition. There are only a limited number of measured porosity and permeability data of the Rupel Clay Member in the onshore Netherlands and these data are restricted to shallow depths in the order of tens of metres below surface. Grain sizes measured by laser diffraction and SediGraph® in samples of the Rupel Clay Member taken from boreholes spread across the country were used to generate new porosity and permeability data for the Rupel Clay Member located at greater burial depth. Effective stress and clay content are important parameters in the applied grain-size based calculations of porosity and permeability.The calculation method was first tested on measured data of the Belgian Boom Clay. The test results showed good agreement between calculated permeability and measured hydraulic conductivity for depths exceeding 200m.The spatial variation in lithology, heterogeneity and also burial depth of the Rupel Clay Member in the Netherlands are apparent in the variation of the calculated permeability. The samples from the north of the country consist almost entirely of muds and as a consequence show little lithology-related variation in permeability. The vertical variation in permeability in the more heterogeneous Rupel Clay Member in the southern and east-southeastern part of the country can reach several orders of magnitude due to increased permeability of the coarser-grained layers.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6501-6501
Author(s):  
Jade Zhou ◽  
Shelly Kane ◽  
Celia Ramsey ◽  
Melody Ann Akhondzadeh ◽  
Ananya Banerjee ◽  
...  

6501 Background: Effective cancer screening leads to a substantial increase in the detection of earlier stages of cancer, while decreasing the incidence of later stage cancer diagnoses. Timely screening programs are critical in reducing cancer-related mortality in both breast and colorectal cancer by detecting tumors at an early, curable stage. The COVID-19 pandemic resulted in the postponement or cancellation of many screening procedures, due to both patient fears of exposures within the healthcare system as well as the cancellation of some elective procedures. We sought to identify how the COVID-19 pandemic has impacted the incidence of early and late stage breast and colorectal cancer diagnoses at our institution. Methods: We examined staging for all patients presenting to UCSD at first presentation for a new diagnosis of malignancy or second opinion in 2019 and 2020. Treating clinicians determined the stage at presentation for all patients using an AJCC staging module (8th edition) in the electronic medical record (Epic). We compared stage distribution at presentation in 2019 vs 2020, both for cancers overall and for colorectal and breast cancer, because these cancers are frequently detected by screening. Results: Total numbers of new patient visits for malignancy were similar in 2019 and 2020 (1894 vs 1915 pts), and stage distribution for all cancer patients was similar (stage I 32% in 2019 vs 29% in 2020; stage IV 26% in both 2019 and 2020). For patients with breast cancer, we saw a lower number of patients presenting with stage I disease (64% in 2019 vs 51% in 2020) and a higher number presenting with stage IV (2% vs 6%). Similar findings were seen in colorectal cancer (stage I: 22% vs 16%; stage IV: 6% vs 18%). Conclusions: Since the COVID-19 pandemic, there has been an increase in incidence of late stage presentation of colorectal and breast cancer, corresponding with a decrease in early stage presentation of these cancers at our institution. Cancer screening is integral to cancer prevention and control, specifically in colorectal and breast cancers which are often detected by screening, and the disruption of screening services has had a significant impact on our patients. We plan to continue following these numbers closely, and will present data from the first half of 2021 as it becomes available.


2018 ◽  
Vol 8 (1) ◽  
Author(s):  
C. C. J. M. Simons ◽  
L. J. Schouten ◽  
R. W. Godschalk ◽  
F. J. van Schooten ◽  
P. A. van den Brandt ◽  
...  

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