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Colorectal Cancer Incidence Trends in Golestan, Iran: An Age-Period-Cohort Analysis 2004–2018 Publisher Pubmed



Ghasemikebria F1 ; Jafaridelouie N1 ; Semnani S1 ; Fazel A2 ; Etemadi A3 ; Norouzi A1 ; Khandoozi R2 ; Besharat S1 ; Shokouhifar N1 ; Mirkarimi H1 ; Sedaghat S4 ; Mansoury M5 ; Mehrjerdian M6 ; Weiderpass E7 Show All Authors
Authors
  1. Ghasemikebria F1
  2. Jafaridelouie N1
  3. Semnani S1
  4. Fazel A2
  5. Etemadi A3
  6. Norouzi A1
  7. Khandoozi R2
  8. Besharat S1
  9. Shokouhifar N1
  10. Mirkarimi H1
  11. Sedaghat S4
  12. Mansoury M5
  13. Mehrjerdian M6
  14. Weiderpass E7
  15. Roshandel G1
  16. Bray F8
  17. Malekzadeh R9
Show Affiliations
Authors Affiliations
  1. 1. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
  2. 2. Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
  3. 3. Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
  4. 4. Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
  5. 5. Office of the Statistics and Information Technology, Golestan University of Medical Sciences, Gorgan, Iran
  6. 6. Department of Pathology, Golestan University of Medical Sciences, Gorgan, Iran
  7. 7. Office of the Director, International Agency for Research on Cancer (IARC), Lyon, France
  8. 8. Cancer Surveillance Branch, International Agency for Research on Cancer (IARC), World Health Organization (WHO), Lyon, France
  9. 9. Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran

Source: Cancer Epidemiology Published:2023


Abstract

Background: We investigated the effects of factors including age, birth year (cohort) and diagnosis year (period) on colorectal cancer (CRC) incidence trends in Golestan, Northeast of Iran, 2004–2018. Methods: We obtained data on incidence cases of CRC from the Golestan Population-based Cancer Registry by sex and area of residence (urban/rural). Age-standardized incidence rates (ASRs) were calculated using the World standard population and presented per 100,000 person-years. We calculated the estimated annual percentage change (EAPC) with 95 % confidence intervals (95 % CI) fitted age-period-cohort (APC) models to assess non-linear period and cohort effects as incidence rate ratios (IRRs). Results: Overall, 2839 new cases of CRC (ASR = 13.7) were registered in the GPCR over 2004–2018. Our findings suggested significantly increasing trends in CRC incidence rates from 2004 to 2018 (EAPC = 3.7; 95%CI: 0.4, 7.1), with the greatest changes occurring in rural women (EAPC= 4.7; 95%CI: 0.4, 9.2). We observed a strong cohort effect with a consistent increase in the IRR across successive birth cohorts, starting with the oldest birth cohort (1924) (IRR= 0.1 versus the reference birth cohort of 1955) through to the most recent cohort born in 1983 (IRR= 1.9). The largest cohort effects were found among rural females (IRR = 0.0, and IRR = 2.5 for the oldest and the youngest birth cohorts vs. the reference birth cohort, respectively). Conclusion: The increasing trends in CRC rates in Golestan are largely driven by generational changes in exposure to underlying risk factors. Further investigations are warranted to deliver effective prevention strategies for the control of CRC in Golestan. © 2023 Elsevier Ltd
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