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Prof. John K. Triantafillidis

Descriptive epidemiology of colorectal cancer : The size of the problem and the significance of preventive Strategies. Prof. John K. Triantafillidis. Objectives. The size of malignancies worldwide The size of malignancies in Europe Epidemiology of CRC worldwide

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Prof. John K. Triantafillidis

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  1. Descriptive epidemiology of colorectal cancer: The size of the problem and the significance of preventive Strategies Prof. John K. Triantafillidis

  2. Objectives • The size of malignancies worldwide • The size of malignancies in Europe • Epidemiology of CRC worldwide • Epidemiology of CRC in Europe • Preventive strategies: description and significance

  3. Design • Sex-specific CRC incidence and mortality rates in 2012, were extracted from the GLOBOCAN database. • Temporal patterns were assessed using data from Cancer Incidence in Five Continents and the WHO mortality database.

  4. CANCER INCIDENCE WORLDWIDE

  5. The number of new cases of cancer is expected to rise 70% over the next 2 decades. • Cancer is one of the leading causes of morbidity worldwide with 14 million new cases in 2012.

  6. CANCER MORTALITY WORLDWIDE

  7. Cancer was responsible for 8.8 million deaths in 2015. • Cancer is the second leading cause of death globally.

  8. Deaths from CRC globally • Lung (1.69 million) • Liver (788,000) • Colorectal(774,000) • Stomach (754,000) • Breast (571,000)

  9. Sex ratio • The overall age standardized cancer incidence rate is 25% higher in men than in women, with rates of 205 and 165/100,000, respectively.

  10. Male incidence rates vary almost fivefold across the different regions of the world… • …with rates ranging from 79/100,000 in Western Africa to 365/100,000 in Australia/New Zealand.

  11. There is less variation in female incidence rates (threefold)... • ...with rates ranging from 103/100,000 in South-Central Asia to 295/100,000 in Northern America.

  12. CANCER IN EUROPE

  13. With 3.7 million new cases and 1.9 million deaths each year, cancer represents the second most important cause of death and morbidity in Europe. • Europe represents 1/8 of the world population but has one quarter of the global cancer cases.

  14. CANCER ECONOMIC IMPACT Key points • The economic impact of cancer is significant and continuously increasing. • The total annual economic cost of cancer in 2010 was estimated approximately at US$ 1.16 trillion.

  15. COLORECTAL CANCERWORLDWIDE

  16. CRC INCIDENCE RATES WORLDWIDE • 1,360,602 new cases • 3rd most common cancer • 9.7% of all cancers • (2012 GLOBOCAN)

  17. CRC MORTALITY RATES WORLDWIDE • 693,933 deaths • 8.5% of the total number of cancer deaths • 4thmost common cause of cancer related deaths • (2012 GLOBOCAN)

  18. COLORECTAL CANCER 5-year prevalence worldwide • 3,543,582 patients • or • 68.2survivors/100,000 population • (2012 GLOBOCAN)

  19. COLORECTAL CANCER IN EUROPE

  20. CRC INCIDENCE IN EUROPE • 447,136 new cases • 2nd most common cancer • 13.0% of all cancers • (2012 GLOBOCAN)

  21. CUMULATIVE RISK OF CRC IN EUROPE (2012) (persons aged <75)

  22. CRC MORTALITY IN EUROPE • 214,866 deaths • 2nd most common cause of cancer related deaths • 12.2% of the total number of cancer deaths • (2012 GLOBOCAN)

  23. COLORECTAL CANCER 5-year prevalence in Europe • 1,203,943 patients • Or • 192.3 CRC survivors/100,000 population • (2012 GLOBOCAN)

  24. Trends inincidenceof CRC in selected countries: age-standardized rate /100,000, men

  25. Trends in incidence of CRC in selected countries: age-standardized rate / 100,000, men

  26. Trends in incidence of CRC in selected countries: age-standardized rate / 100,000, men

  27. Trends in mortalityfrom CRC in selected countries: age-standardized rate /100,000, men

  28. Trends in mortalityfrom CRC in selected countries: age-standardized rate /100,000,men

  29. Estimated CRC incidence in 2012: Women

  30. Estimated CRC incidence in 2012:Women

  31. Estimated CRC incidencein 2012:Women

  32. Estimated CRC mortalityin 2012: Women

  33. Estimated CRC mortalityin 2012: Women

  34. Estimated CRC mortalityin 2012: Women

  35. The Growing Challenge of Young Adults With Colorectal Cancer B. Weinberg, J. Marshall, M. Salem, May 16, 2017

  36. Trends in CRC incidence and mortality: threegroups of temporal pattern Arnold M, et al. Gut 2016;0:1-9

  37. Group 1: increasing incidence and mortality • Increase in both incidence and mortality rates over the most recent 10-year period in men was seen in Eastern European countries, and in Latin America and Asia. • The largest increase in incidence was seen in Brazil, Costa Rica and Bulgaria. • In females, trends were similar to those in males Arnold M, et al. Gut 2016;0:1-9

  38. Group 2: increasing incidence and decreasing mortality • These trends were observed in several European countries, as well as in Canada and Singapore. • Stable trends were observed in Northern European countries. • A declining mortality rate was observed in the UK, along with a small increase in incidence rate. Arnold M, et al. Gut 2016;0:1–9

  39. Group 3: decreasing incidence and mortality • Decreases in both CRC incidence and mortality rates were restricted to the countries with the highest human development index, such as Australia, New Zealand and Japan. • Again, patterns were similar for males and females. Arnold M, et al. Gut 2016;0:1–9

  40. … In summary • The distribution of CRC burden varies widely, with more than 2/3 of all cases and about 60% of all deaths occurring in countries with a high or very high human development index.

  41. Rapid increases in both CRC incidence and mortality rates are now observed in many medium-to-high human development index countries, particularly in Eastern Europe, Asia and South America.

  42. In contrast, CRC incidence and mortality rates have been stabilizing or declining in some of those countries with the highest human development index: the USA, Australia, and several Western European countries.

  43. The reasons for the declining trends in incidence rate in these countries may reflect an increased early detection and prevention through polypectomy.

  44. Improvements in perioperative care, chemotherapy and radiotherapy, have contributed to the decreasing trends in CRC mortality in many high income settings.

  45. Future predictions Given the temporal profiles and demographic projections, the global burden of CRC is expected to increase by 60% to more than 2.2 million new cases and 1.1 million cancer deaths by 2030. Arnold M, et al. Gut 2016;0:1–9

  46. Epidemiological features of CRC in Greece

  47. Greece: Demographic data • Data from IARCGlobalCan (2012)

  48. Incidence and mortality from cancer in Greece (men)

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