Decreased colorectal cancer incidence and mortality in a diverse urban population with increased colonoscopy screening

Abstract Background Although colorectal cancer screening has contributed to decreased incidence and mortality, disparities are present by race/ethnicity. The Citywide Colon Cancer Control Coalition (C5) and NYC Department of Health and Mental Hygiene (DOHMH) promoted screening colonoscopy from 2003 on, and hypothesized future reductions in CRC incidence, mortality and racial/ethnic disparities. Methods We assessed annual percent change (APC) in NYC CRC incidence, stage and mortality rates through 2016 in a longitudinal cross-sectional study of NY State Cancer Registry, NYC Vital Statistics, and NYC Community Health Survey (CHS) data. Linear regression tested associations between CRC mortality rates and risk factors. Results Overall CRC incidence rates from 2000 decreased 2.8% yearly from 54.1 to 37.3/100,000 population in 2016, and mortality rates from 2003 decreased 2.9% yearly from 21.0 to 13.9 in 2016 at similar rates for all racial/ethnic groups. Local stage disease decreased overall with a transient increase from 2002 to 2007. In 2016, CRC incidence was higher among Blacks (42.5 per 100,000) than Whites (38.0), Latinos (31.7) and Asians (30.0). In 2016, Blacks had higher mortality rates (17.9), than Whites (15.2), Latinos (10.4) and Asians (8.8). In 2016, colonoscopy rates among Blacks were 72.2%, Latinos 71.1%, Whites 67.2%, and Asians, 60.9%. CRC mortality rates varied by neighborhood and were independently associated with Black race, CRC risk factors and access to care. Conclusions In a diverse urban population, a citywide campaign to increase screening colonoscopy was associated with decreased incidence and mortality among all ethnic/racial groups. Higher CRC burden among the Black population demonstrate more interventions are needed to improve equity.

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Colorectal Cancer Incidence and Mortality Disparities in New Mexico

Journal of Cancer Epidemiology ◽

10.1155/2014/239619 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Richard M. Hoffman ◽

David K. Espey ◽

Robert L. Rhyne ◽

Melissa Gonzales ◽

Ashwani Rajput ◽

...

Keyword(s):

Colorectal Cancer ◽

New Mexico ◽

American Indians ◽

Ethnic Disparities ◽

Tumor Stage ◽

Mortality Rates ◽

Incidence Rates ◽

Incidence And Mortality ◽

Adjusted Incidence ◽

Racial Ethnic

Background.Previous analyses indicated that New Mexican Hispanics and American Indians (AI) did not experience the declining colorectal cancer (CRC) incidence and mortality rates observed among non-Hispanic whites (NHW). We evaluated more recent data to determine whether racial/ethnic differences persisted.Methods.We used New Mexico Surveillance Epidemiology and End Results data from 1995 to 2009 to calculate age-specific incidence rates and age-adjusted incidence rates overall and by tumor stage. We calculated mortality rates using National Center for Health Statistics’ data. We used joinpoint regression to determine annual percentage change (APC) in age-adjusted incidence rates. Analyses were stratified by race/ethnicity and gender.Results.Incidence rates continued declining in NHW (APC −1.45% men, −1.06% women), while nonsignificantly increasing for AI (1.67% men, 1.26% women) and Hispanic women (0.24%). The APC initially increased in Hispanic men through 2001 (3.33%,P=0.06), before declining (−3.10%,P=0.003). Incidence rates declined in NHW and Hispanics aged 75 and older. Incidence rates for distant-stage cancer remained stable for all groups. Mortality rates declined significantly in NHW and Hispanics.Conclusions.Racial/ethnic disparities in CRC persist in New Mexico. Incidence differences could be related to risk factors or access to screening; mortality differences could be due to patterns of care for screening or treatment.

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Colorectal Cancer Incidence and Mortality Rates Among New York City Adults Ages 20–54 years during 1976–2015

JNCI Cancer Spectrum ◽

10.1093/jncics/pky048 ◽

2018 ◽

Vol 2 (4) ◽

Author(s):

Kellie C Van Beck ◽

John Jasek ◽

Kristi Roods ◽

Jennifer J Brown ◽

Shannon M Farley ◽

...

Keyword(s):

Colorectal Cancer ◽

New York ◽

New York City ◽

York City ◽

New York State ◽

Mortality Rates ◽

Registry Data ◽

Mortality Trends ◽

Annual Percent Change ◽

Incidence And Mortality

Abstract Colorectal cancer (CRC) incidence rates are rising in younger Americans and mortality rates are increasing among younger white Americans. We used New York State Cancer Registry data to examine New York City CRC incidence and mortality trends among adults ages 20–54 years by race from 1976 to 2015. Annual percent change (APC) was considered statistically significant at P less than .05 using a two-sided test. CRC incidence increased among those ages 20–49 years, yet blacks had the largest APC of 2.2% (1993–2015; 95% confidence interval [CI] = 1.4% to 3.1%) compared with 0.5% in whites (1976–2015; 95% CI = 0.2% to 0.7%). Among those aged 50–54 years, incidence increased among blacks by 0.8% annually (1976–2015; 95% CI = 0.4% to 1.1%), but not among whites. CRC mortality decreased among both age and race groups. These findings emphasize the value of local registry data to understand trends locally, the importance of timely screening, and the need for clinicians to consider CRC among all patients with compatible signs and symptoms.

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What factors are related to non-participation in colorectal cancer screening?

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1345 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

I Portillo Villares ◽

M Solis Ibinagagoitia ◽

S Unanue-Arza ◽

L Martinez-Indart ◽

A Lebeña Maluf ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Primary Care ◽

Screening Programme ◽

Participation Rate ◽

First Trimester ◽

Cross Sectional ◽

Crc Screening ◽

Incidence And Mortality ◽

High Participation

Abstract Background The Basque Health Service (Spain) approved the Colorectal Cancer (CRC) screening programme in 2008; targeted at residents (50 to 69 years old) by biennial faecal immunochemical test and colonoscopy in positive cases. Total coverage was reached in 2014. Despite our high participation rate (72.3%), some people have never been screened, probably due to several factors (socio-economic factors, lifestyles, comorbidities, health preventive actions, etc.). The identification of these factors could be crucial in order to improve the results and impact of the programme. Methods Cross sectional descriptive study. All invited population in a complete round between 2015 and the first trimester of 2017 were included. Data base was linked to registered health risk factors, preventive activities managed by Primary Care and socioeconomic deprivation index. Univariate and multivariate analyses were performed by SPSS 23.0. Results 515,388 people were invited and 71.9% participated. Non-participation is significantly (p ≤ 0.001) related to: being men (OR = 1.10); younger than 60 (OR = 1.18); smoker (OR = 1.20); hypertensive (OR = 1.14) and diabetic (OR = 1.40), as well as to having a severe comorbidity (OR = 2.09) and very high deprivation (OR = 1.15). Low use of Primary Care services (OR = 2.39) and inappropriate control of risk factors also increase the likelihood of not participating. Conclusions Several factors addressed in Primary Care influence the participation in the CRC Screening Programme. Its results and impact (decreasing incidence and mortality) could be improved if individual and socioeconomic factors are taken into account to increase participation. Primary care and social networks are key in further planned interventions. Key messages Decreasing inequalities in the screening participation is one of the most important objectives in this Public Health strategy. Primary Care plays a key role in all the screening programmes’ implementations.

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Development of a tablet app designed to improve African Americans’ screening colonoscopy rates

Translational Behavioral Medicine ◽

10.1093/tbm/ibz014 ◽

2019 ◽

Vol 10 (2) ◽

pp. 375-383

Author(s):

Sarah J Miller ◽

Jamilia R Sly ◽

Kemi B Gaffney ◽

Zhiye Jiang ◽

Brittney Henry ◽

...

Keyword(s):

Colorectal Cancer ◽

African Americans ◽

Field Test ◽

Mortality Rates ◽

Descriptive Statistics ◽

Screening Colonoscopy ◽

Iterative Approach ◽

Test Procedures ◽

Racial Ethnic ◽

Qualitative Analyses

Abstract Compared with other racial/ethnic groups, African Americans have the highest colorectal cancer (CRC) morbidity and mortality rates. It is critical to help improve African Americans’ CRC prevention efforts in order to reduce the burden of CRC in this community. The aim of this study was to develop and field test a tablet app, called e-Motivate, designed to improve African Americans’ screening colonoscopy rates. The e-Motivate app was field tested, using an iterative approach. The first version of the app, e-Motivate 1.0, was field tested on 20 African Americans over the age of 50. Participants engaged in a think aloud exercise and provided feedback regarding the app’s usability and acceptability. The results of the first field test were used to modify the app and develop e-Motivate 2.0. The field test procedures were repeated on a new group of participants (N = 18). The results from the second field test were used to make final modifications to the app. Overall, participants responded positively to the app. Qualitative analyses showed that participants found the app to be easy to use and helpful. Furthermore, descriptive statistics revealed that participants found the app to be highly usable and acceptable, exceeding recommended benchmarks for usability and acceptability. Critiques of the app were used to modify and finalize the intervention. The results from the proposed study suggest that the e-Motivate app is highly feasible and acceptable. The next step in this line of research is to conduct a randomized clinical trial to formally test the efficacy of the e-Motivate app for improving screening colonoscopy rates among African Americans.

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Trends of colorectal cancer incidence and mortality rates from 2003 to 2014 in Italy

Tumori Journal ◽

10.1177/0300891619838336 ◽

2019 ◽

Vol 105 (5) ◽

pp. 417-426 ◽

Cited By ~ 2

Author(s):

Manuel Zorzi ◽

Luigino Dal Maso ◽

Silvia Francisci ◽

Carlotta Buzzoni ◽

Massimo Rugge ◽

...

Keyword(s):

Colorectal Cancer ◽

Age Groups ◽

Geographic Area ◽

Cancer Registries ◽

Mortality Rates ◽

Incidence Rates ◽

Annual Percent Change ◽

Screening Programs ◽

Italian Regions ◽

Incidence And Mortality

Objective: To evaluate the trends of colorectal cancer (CRC) incidence and mortality rates from 2003 to 2014 in Italy by age groups and regions. Methods: We used the data of 48 cancer registries from 17 Italian regions to estimate standardized incidence and mortality rates overall and by sex, age groups (<50, 50–69, 70+ years), and geographic area (northwest, northeast, center, south, and islands). Time trends were expressed as annual percent change in rates (APC) with 95% confidence intervals (95% CI). Results: Incidence rates decreased from 104.3 (2003) to 89.9 × 100,000 (2014) in men and from 64.3 to 58.4 × 100,000 in women. Among men, incidence decreased during 2007–2010 (APC −4.0, 95% CI −6.0 to −1.9) and 2010–2014 (APC −0.7, 95% CI −1.4 to 0.0), while in women it linearly decreased during the whole period (APC −1.1, 95% CI −1.4 to −0.8). Mortality rates showed a linear reduction both in men (APC −0.7, 95% CI −1.0 to −0.3) and women (APC −0.9, 95% CI −1.2 to −0.6) and decreased respectively from 41.1 to 39.2 × 100,000 and from 24.6 to 23.1 × 100,000. In the 50- to 69-year-old range (screening target age), incidence showed a prescreening increase, followed by a peak after screening started, and a decline thereafter. Incidence and mortality rates significantly decreased in all areas but in the south and islands, where incidence increased and mortality remained stable. Conclusions: A renewed commitment by all regional health systems to invest in primary (i.e., lifestyle) and secondary (i.e., screening programs) prevention is of utmost importance.

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Global Burden, Risk Factors, and Trends of Esophageal Cancer: An Analysis of Cancer Registries from 48 Countries

Cancers ◽

10.3390/cancers13010141 ◽

2021 ◽

Vol 13 (1) ◽

pp. 141

Author(s):

Junjie Huang ◽

Anastasios Koulaouzidis ◽

Wojciech Marlicz ◽

Veeleah Lok ◽

Cedric Chu ◽

...

Keyword(s):

Risk Factors ◽

Esophageal Cancer ◽

The Netherlands ◽

Cancer Registries ◽

Global Burden ◽

Annual Percent Change ◽

The United Kingdom ◽

Incidence And Mortality ◽

Elevated Cholesterol ◽

Prevalence Of Obesity

This study aimed to examine the global burden, risk factors, and trends of esophageal cancer based on age, sex, and histological subtype. The data were retrieved from cancer registries database from 48 countries in the period 1980–2017. Temporal patterns of incidence and mortality were evaluated by average annual percent change (AAPC) using joinpoint regression. Associations with risk factors were examined by linear regression. The highest incidence of esophageal cancer was observed in Eastern Asia. The highest incidence of adenocarcinoma (AC) was found in the Netherlands, the United Kingdom, and Ireland. A higher AC/squamous cell carcinoma (SCC) incidence ratio was associated with a higher prevalence of obesity and elevated cholesterol. We observed an incidence increase (including AC and SCC) in some countries, with the Czech Republic (female: AAPC 4.66), Spain (female: 3.41), Norway (male: 3.10), Japan (female: 2.18), Thailand (male: 2.17), the Netherlands (male: 2.11; female: 1.88), and Canada (male: 1.51) showing the most significant increase. Countries with increasing mortality included Thailand (male: 5.24), Austria (female: 3.67), Latvia (male: 2.33), and Portugal (male: 1.12). Although the incidence of esophageal cancer showed an overall decreasing trend, an increasing trend was observed in some countries with high AC/SCC incidence ratios. More preventive measures are needed for these countries.

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Risk Factors of Inadequate Bowel Preparation for Screening Colonoscopy

Journal of Clinical Medicine ◽

10.3390/jcm10122740 ◽

2021 ◽

Vol 10 (12) ◽

pp. 2740

Author(s):

Efrat L. Amitay ◽

Tobias Niedermaier ◽

Anton Gies ◽

Michael Hoffmeister ◽

Hermann Brenner

Keyword(s):

Risk Factors ◽

Bowel Preparation ◽

Sociodemographic Factors ◽

Cross Sectional Study ◽

Screening Colonoscopy ◽

Cross Sectional ◽

Factors Associated ◽

Screening Practice ◽

Abdominal Symptoms ◽

Inadequate Bowel Preparation

The success of a colonoscopy in detecting and removing pre-cancerous and cancerous lesions depends heavily on the quality of bowel preparation. Despite efforts, 20–44% of colonoscopy participants have an inadequate bowel preparation. We aimed to assess and compare risk factors for inadequate bowel preparation and for the presence of advanced colorectal neoplasms in routine screening practice. In this cross-sectional study, among 8125 participants of screening colonoscopy in Germany with a comprehensive assessment of sociodemographic factors, lifestyle and medical history, we examined factors associated with inadequate bowel preparation and with findings of advanced neoplasms using adjusted log-binomial regression models. Among the identified risk factors assessed, three factors were identified that were significantly associated with inadequate bowel preparation: age ≥ 70 years (adjusted prevalence ratios, aPR, 1.50 95%CI 1.31–1.71), smoking (aPR 1.29 95%CI 1.11–1.50) and abdominal symptoms (aPR 1.14 95%CI 1.02–1.27). The same risk factors were also associated with the prevalence of advanced neoplasms in our study (aPR 1.72, 1.62 and 1.44, respectively). The risk factors associated with inadequate bowel preparation in this study were also associated with a higher risk for advanced neoplasms. Inadequate bowel preparation for colonoscopy might lead to missed colorectal cancer (CRC) precursors and the late diagnosis of CRC. People at high risk of advanced neoplasms are in particular need of enhanced bowel preparation.

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