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Epidemiology of colorectal cancer in the Czech Republic

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svod.cz: epidemiology of malignant tumours in the Czech Republic

J. Gregor, D. Krejčí, J. Mužík, L. Šnajdrová

Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic

CONTENTS

Introduction

The Czech National Cancer Registry (CNCR) is the main source of data on cancer epidemiology in the Czech Republic. CNCR has become an integral part of comprehensive cancer care, containing more than 2.3 million records from the period 1977–2015 and covering 100% of the Czech population. Registration of malignant tumours is stipulated by law and is obligatory [1]. CNCR data is publicly available on the website www.svod.cz [2].

Incidence and mortality rates

Colorectal cancer (CRC) is among the most commonly diagnosed cancers and its incidence rates in all developed countries are growing steadily. Unfortunately, the Czech Republic ranks among the countries with highest colorectal cancer incidence rates worldwide. According to the latest data from GLOBOCAN 2012 [3], Czech colorectal cancer incidence rates in men rank 3rd in Europe after Slovakia and Hungary, while women’s rates rank 10th in Europe (see more details in Epidemiology of colorectal cancer: international comparison). The population burden is very high indeed: each year around 8,000 patients are diagnosed with colorectal cancer in the Czech Republic, and there are nearly 4,000 deaths from colorectal cancer among the Czech population (Fig. 1a). Both incidence and mortality rates for colorectal cancer are higher in men than in women (Figs. 1b, 1c).

Apart from absolute numbers of newly diagnosed cases and deaths per year (Figs. 1a-c), CRC incidence and mortality rates can be recalculated per 100,000 persons (or men, women) in the population (Figs. 2a-c) or standardized on a certain age standard; the most common ones include the age-standardized world rate (ASR-W, Figs. 3a-c) and the age-standardized European rate (ASR-E, Figs. 4a-c). Such recalculations make it possible to compare CRC incidence and mortality rates with those of other countries (see more details in Epidemiology of colorectal cancer: international comparison).

Absolute numbers of new cases / deaths

Fig. 1a: C18–C21 incidence and mortality, both sexes. Data source: CNCR Fig. 1b: C18–C21 incidence and mortality, men. Data source: CNCR Fig. 1c: C18–C21 incidence and mortality, women. Data source: CNCR

Rates per 100,000 persons

Fig. 2a: C18–C21 incidence and mortality, both sexes. Data source: CNCR Fig. 2b: C18–C21 incidence and mortality, men. Data source: CNCR Fig. 2c: C18–C21 incidence and mortality, women. Data source: CNCR

Age-standardized world rates (ASR-W)

Fig. 3a: C18–C21 incidence and mortality (ASR-W), both sexes. Data source: CNCR Fig. 3b: C18–C21 incidence and mortality (ASR-W), men. Data source: CNCR Fig. 3c: C18–C21 incidence and mortality (ASR-W), women. Data source: CNCR

Age-standardized European rates (ASR-E)

Fig. 4a: C18–C21 incidence and mortality (ASR-E), both sexes. Data source: CNCR Fig. 4b: C18–C21 incidence and mortality (ASR-E), men. Data source: CNCR Fig. 4c: C18–C21 incidence and mortality (ASR-E), women. Data source: CNCR

Prevalence rates

Some signs of improvement have been shown in recent years: in particular, mortality rates have stabilized and even begun to decrease (see above). This trend, however, when combined with the steadily growing incidence rates, inevitably leads to an increase in prevalence rates, i.e. a higher number of colorectal cancer survivors. In 2015, the prevalence of people with a history of colorectal cancer reached 64,126 in the Czech Republic, corresponding to an almost 40% increase in comparison with 2005 (46,053 colorectal cancer survivors (Fig. 5a); the increase was 42% in men (Fig. 5b) and 35% in women (Fig. 5c).

Absolute numbers of CRC survivors

Fig. 5a: C18–C21 prevalence, both sexes. Data source: CNCR Fig. 5b: C18–C21 prevalence, men. Data source: CNCR Fig. 5c: C18–C21 prevalence, women. Data source: CNCR

Rates per 100,000 persons

Fig. 6a: C18–C21 prevalence, both sexes. Data source: CNCR Fig. 6b: C18–C21 prevalence, men. Data source: CNCR Fig. 6c: C18–C21 prevalence, women. Data source: CNCR

Clinical stages

It is widely known that a cancer diagnosed at an early stage (or even at the stage of precancerous changes) is much more likely to be treated successfully and that the chance of survival in such cases is much higher. Available population-based data on colorectal cancer epidemiology in the Czech Republic, however, describes a rather gloomy situation: Figs. 7a-c show that a high proportion of new colorectal cancer patients in the Czech Republic are diagnosed with tumours in clinical stages III or IV, and that the numbers of these cases diagnosed in advanced stages are on the rise (Figs. 8a-c). This inevitably leads to markedly poorer treatment results, let alone related costs. Moreover, the situation has not much improved over time. Data also shows that the high proportion of advanced stages has been reported from all Czech regions (see more details in Epidemiology of colorectal cancer: comparison of Czech regions).

Proportion of clinical stages

Fig. 7a: C18–C21 – proportion of clinical stages, both sexes. Data source: CNCR Fig. 7b: C18–C21 – proportion of clinical stages, men. Data source: CNCR Fig. 7c: C18–C21 – proportion of clinical stages, women. Data source: CNCR

Incidence rates according to clinical stages

Fig. 8a: Incidence rates for C18–C21 according to clinical stages, both sexes. Data source: CNCR Fig. 8b: Incidence rates for C18–C21 according to clinical stages, men. Data source: CNCR Fig. 8c: Incidence rates for C18–C21 according to clinical stages, women. Data source: CNCR

Age structure of patients

Colorectal cancer markedly affects patients in working age. The typical age of Czech colorectal cancer patients is between 60 and 79 years, but almost 19% of all patients are under the age of 60 (Figs. 9a-c). The profiles of age-specific incidence rates for colorectal cancer (Figs. 10a-c) demonstrate the importance of the problem that colorectal cancer presents in oldest groups of the Czech population.

Number of cases in different age categories (analyzed period: 2011–2015)

Fig. 9a: Age structure of patients with C18–C21, both sexes. Data source: CNCR Fig. 9b: Age structure of patients with C18–C21, men. Data source: CNCR Fig. 9c: Age structure of patients with C18–C21, women. Data source: CNCR

Age-specific incidence rates (analyzed period: 2011–2015)

Fig. 10a: C18–C21 – age-specific incidence rate, both sexes. Data source: CNCR Fig. 10b: C18–C21 – age-specific incidence rate, men. Data source: CNCR Fig. 10c: C18–C21 – age-specific incidence rate, women. Data source: CNCR

References

  1. Institute of Health Information and Statistics of the Czech Republic: Czech National Cancer Registry (CNCR) [11 May 2018]. Available from WWW: http://www.uzis.cz/registry-nzis/nor
  2. 2. Dušek, L., Mužík, J., Kubásek, M., Koptíková, J., Žaloudík, J., Vyzula, R.: Epidemiology of malignant tumours in the Czech Republic [online]. Masaryk University, Brno (Czech Republic) 2005. Available from WWW: http://www.svod.cz. ISSN 1802-8861.
  3. 3. Ferlay, J., Soerjomataram, I., Ervik, M., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., Parkin, D.M., Forman, D., Bray, F.: GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [online]. International Agency for Research on Cancer, Lyon (France) 2013. Available from WWW: http://globocan.iarc.fr.

Last updated on 11 May 2018