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@ARTICLE{Guo:295923,
      author       = {L. Guo and L. Wang and L. Cai and Y. Zhang and X. Feng and
                      C. Zhu and W. Gao and R. Cardoso$^*$ and H. Yang and M. Dai
                      and H. Brenner$^*$ and H. Chen},
      title        = {{G}lobal {D}istribution of {C}olorectal {C}ancer {S}taging
                      at {D}iagnosis: {A}n {E}vidence {S}ynthesis.},
      journal      = {Clinical gastroenterology and hepatology},
      volume       = {nn},
      issn         = {1542-3565},
      address      = {New York, NY},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2024-02736},
      pages        = {nn},
      year         = {2024},
      note         = {epub},
      abstract     = {Stage at diagnosis is a key prognostic factor for
                      colorectal cancer (CRC) survival. We aimed to assess the
                      global distribution of CRC staging at diagnosis using
                      population-based or hospital-based registry data.We
                      systematically searched in MEDLINE and Embase from their
                      inception until 6 December 2023. Grey literature was
                      searched through published cancer reports. Studies from
                      population-based or hospital-based cancer registries
                      reporting the stage distribution of diagnosed CRC were
                      included. We extracted stage-specific proportions among
                      patients with CRC based on TNM, SEER, or Dukes staging
                      systems. Subgroup analyses by sex, age, tumor site, calendar
                      period, and status of population-based screening were
                      performed. Correlations between the Human Development Index
                      (HDI), Socio-Demographic Index (SDI), and the distant
                      metastatic CRC proportion were also evaluated.84 eligible
                      studies/reports from 46 countries were analyzed, covering
                      3.8 million patients. Among 36 countries included in the
                      main analysis, the most recent distant metastatic CRC
                      proportions varied from $16.2\%$ in Puerto Rico to $28.2\%$
                      in Oman and Latvia, with a median (interquartile range) of
                      $23.7\%$ $(21.8\%-26.3\%).$ Higher metastatic proportions
                      were observed in younger patients, those with colon cancer,
                      and those without screening implementation, with no apparent
                      difference between males and females. Over time, some
                      countries/regions, such as Southern Portugal $(36.5\%$ in
                      2000 to $22.2\%$ in 2016), showed declining proportions of
                      metastatic CRC, while others remained stable (e.g., Austria,
                      Belgium) or increased (e.g., United States, Slovenia,
                      Spain). Higher HDI and SDI were correlated with lower
                      proportions of distant metastatic CRC (HDI: ρ=-0.48; SDI:
                      ρ=-0.26).Global disparities in CRC staging exist,
                      indicating a need for targeted interventions to enhance
                      early detection and management, especially in
                      high-metastasis areas.},
      subtyp        = {Review Article},
      keywords     = {colorectal cancer (Other) / stage (Other) / systematic
                      review (Other)},
      cin          = {C070 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)HD01-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39694204},
      doi          = {10.1016/j.cgh.2024.11.019},
      url          = {https://inrepo02.dkfz.de/record/295923},
}