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000169018 1001_ $$0P:(DE-HGF)0$$aCardoso, Rafael$$b0$$eFirst author
000169018 245__ $$aColorectal cancer incidence, mortality, and stage distribution in European countries in the colorectal cancer screening era: an international population-based study.
000169018 260__ $$aLondon$$bThe Lancet Publ. Group$$c2021
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000169018 500__ $$a#EA:C120#LA:C070#/2021 Jul;22(7):1002-1013
000169018 520__ $$aColorectal cancer screening programmes and uptake vary substantially across Europe. We aimed to compare changes over time in colorectal cancer incidence, mortality, and stage distribution in relation to colorectal cancer screening implementation in European countries.Data from nearly 3·1 million patients with colorectal cancer diagnosed from 2000 onwards (up to 2016 for most countries) were obtained from 21 European countries, and were used to analyse changes over time in age-standardised colorectal cancer incidence and stage distribution. The WHO mortality database was used to analyse changes over time in age-standardised colorectal cancer mortality over the same period for the 16 countries with nationwide data. Incidence rates were calculated for all sites of the colon and rectum combined, as well as the subsites proximal colon, distal colon, and rectum. Average annual percentage changes (AAPCs) in incidence and mortality were estimated and relevant patterns were descriptively analysed.In countries with long-standing programmes of screening colonoscopy and faecal tests (ie, Austria, the Czech Republic, and Germany), colorectal cancer incidence decreased substantially over time, with AAPCs ranging from -2·5% (95% CI -2·8 to -2·2) to -1·6% (-2·0 to -1·2) in men and from -2·4% (-2·7 to -2·1) to -1·3% (-1·7 to -0·9) in women. In countries where screening programmes were implemented during the study period, age-standardised colorectal cancer incidence either remained stable or increased up to the year screening was implemented. AAPCs for these countries ranged from -0·2% (95% CI -1·4 to 1·0) to 1·5% (1·1 to 1·8) in men and from -0·5% (-1·7 to 0·6) to 1·2% (0·8 to 1·5) in women. Where high screening coverage and uptake were rapidly achieved (ie, Denmark, the Netherlands, and Slovenia), age-standardised incidence rates initially increased but then subsequently decreased. Conversely, colorectal cancer incidence increased in most countries where no large-scale screening programmes were available (eg, Bulgaria, Estonia, Norway, and Ukraine), with AAPCs ranging from 0·3% (95% CI 0·1 to 0·5) to 1·9% (1·2 to 2·6) in men and from 0·6% (0·4 to 0·8) to 1·1% (0·8 to 1·4) in women. The largest decreases in colorectal cancer mortality were seen in countries with long-standing screening programmes.We observed divergent trends in colorectal cancer incidence, mortality, and stage distribution across European countries, which appear to be largely explained by different levels of colorectal cancer screening implementation.German Cancer Aid (Deutsche Krebshilfe) and the German Federal Ministry of Education and Research.
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000169018 7001_ $$0P:(DE-He78)0311ebf3415e41860b4e2c56fbae6919$$aGuo, Feng$$b1$$udkfz
000169018 7001_ $$0P:(DE-He78)c465139c8b95a919efed7d35ca83ca80$$aHeisser, Thomas$$b2$$udkfz
000169018 7001_ $$aHackl, Monika$$b3
000169018 7001_ $$aIhle, Petra$$b4
000169018 7001_ $$aDe Schutter, Harlinde$$b5
000169018 7001_ $$aVan Damme, Nancy$$b6
000169018 7001_ $$aValerianova, Zdravka$$b7
000169018 7001_ $$aAtanasov, Trajan$$b8
000169018 7001_ $$aMájek, Ondřej$$b9
000169018 7001_ $$aMužík, Jan$$b10
000169018 7001_ $$aNilbert, Mef Christina$$b11
000169018 7001_ $$aTybjerg, Anne Julie$$b12
000169018 7001_ $$aInnos, Kaire$$b13
000169018 7001_ $$aMägi, Margit$$b14
000169018 7001_ $$aMalila, Nea$$b15
000169018 7001_ $$aBouvier, Anne-Marie$$b16
000169018 7001_ $$aBouvier, Véronique$$b17
000169018 7001_ $$aLaunoy, Guy$$b18
000169018 7001_ $$aWoronoff, Anne-Sophie$$b19
000169018 7001_ $$aCariou, Mélanie$$b20
000169018 7001_ $$aRobaszkiewicz, Michel$$b21
000169018 7001_ $$aDelafosse, Patricia$$b22
000169018 7001_ $$aPoncet, Florence$$b23
000169018 7001_ $$aKatalinic, Alexander$$b24
000169018 7001_ $$aWalsh, Paul M$$b25
000169018 7001_ $$aSenore, Carlo$$b26
000169018 7001_ $$aRosso, Stefano$$b27
000169018 7001_ $$aVincerževskienė, Ieva$$b28
000169018 7001_ $$aLemmens, Valery E P P$$b29
000169018 7001_ $$aElferink, Marloes A G$$b30
000169018 7001_ $$aJohannesen, Tom Børge$$b31
000169018 7001_ $$aKørner, Hartwig$$b32
000169018 7001_ $$aPfeffer, Frank$$b33
000169018 7001_ $$aBento, Maria José$$b34
000169018 7001_ $$aRodrigues, Jessica$$b35
000169018 7001_ $$aAlves da Costa, Filipa$$b36
000169018 7001_ $$aMiranda, Ana$$b37
000169018 7001_ $$aZadnik, Vesna$$b38
000169018 7001_ $$aŽagar, Tina$$b39
000169018 7001_ $$aLopez de Munain Marques, Arantza$$b40
000169018 7001_ $$aMarcos-Gragera, Rafael$$b41
000169018 7001_ $$aPuigdemont, Montse$$b42
000169018 7001_ $$aGalceran, Jaume$$b43
000169018 7001_ $$aCarulla, Marià$$b44
000169018 7001_ $$aChirlaque, María-Dolores$$b45
000169018 7001_ $$aBallesta, Monica$$b46
000169018 7001_ $$aSundquist, Kristina$$b47
000169018 7001_ $$aSundquist, Jan$$b48
000169018 7001_ $$aWeber, Marco$$b49
000169018 7001_ $$aJordan, Andrea$$b50
000169018 7001_ $$aHerrmann, Christian$$b51
000169018 7001_ $$aMousavi, Mohsen$$b52
000169018 7001_ $$aRyzhov, Anton$$b53
000169018 7001_ $$0P:(DE-He78)6c5d058b7552d071a7fa4c5e943fff0f$$aHoffmeister, Michael$$b54$$udkfz
000169018 7001_ $$0P:(DE-He78)90d5535ff896e70eed81f4a4f6f22ae2$$aBrenner, Hermann$$b55$$eLast author$$udkfz
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