Colorectal Cancer in Sweden a Descriptive Epidemiologic Study

Gerhardsson, Maria; Steineck, Gunnar; Norell, Staffan E.

doi:10.3109/02841869009096379

Cited by 18 publications

(7 citation statements)

References 16 publications

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“…Rectal cancer increased with age more steeply in males than in females. This pattern is essentially consistent with recent reports from Sweden (Gerhardsson et aL, 1990) and Switzerland (Levi et a/., 1991). It is also consistent with previous reports of the age-incidence curves for the left colon and the rectum being steeper for males than for females (De Jong et aL, 1972;Jensen, 1984;Faivre et al, 1989).…”

Section: Table IV -Slopes (Standard Errors) Of the Log-log Plots Of Asupporting

confidence: 93%

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Age‐period‐cohort modelling of large‐bowel‐cancer incidence by anatomic sub‐site and sex in connecticut

Dubrow

Bernstein

Holford

1993

Intl Journal of Cancer

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In order to investigate etiologic distinctions among the anatomic sub-sites of the large bowel by sex, the relationship between large-bowel-cancer incidence and age at diagnosis, time period at diagnosis, and birth cohort was analyzed by anatomic sub-site and by sex, using data from the Connecticut Tumor Registry. Included in the study were all incident largebowel-cancer cases occurring between 1950 and 1984 among Connecticut residents aged 40 to 79. Cancers of the large bowel were classified into 5 anatomic sub-sites: ascending colon (including cecum), transverse colon (including flexures), descending colon, sigmoid colon, and rectum (including rectosigmoid junction, anal canal, and anus). The data were fitted to loglinear age-period-cohort models. For each of the sub-sites, the age-period-cohort patterns for males and females differed. Within each sex, sub-site groupings with common patterns were indicated. Among males, the age-period-cohort patterns for the colon sub-sites were fairly similar; but the pattern for the rectum differed markedly from that for the colon sub-sites. There were secondary differences among the colon sub-sites that pointed to a secondary distinction between the right and the left colons. Among females, the age-period-cohort patterns for the left colon sub-sites and the rectum were fairly similar. The pattern for the transverse colon differed moderately from that of the left colon, and differed substantially from that of the rectum and the ascending colon. The ascending colon differed markedly from each of the other sub-sites. It is possible that these differences in age-period-cohort patterns reflect etiologic distinctions among sub-site groupings and between the sexes. 0 1993 Wiley-Liss, Inc.

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Section: Table IV -Slopes (Standard Errors) Of the Log-log Plots Of Asupporting

confidence: 93%

“…In addition, sub-site-specific differences in time trends and in age-incidence curves have been observed between males and females, suggesting etiologic distinctions between the sexes (De Jong et aL, 1972;Potter, 1980, 1983;Jensen, 1984;Vobecky et al, 1984;Faivre et al, 1989;Gerhardsson et al, 1990;Levi et a[., 1991).…”

mentioning

confidence: 99%

Age‐period‐cohort modelling of large‐bowel‐cancer incidence by anatomic sub‐site and sex in connecticut

Dubrow

Bernstein

Holford

1993

Intl Journal of Cancer

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“…In contrast, the slopes of the ageincidence curves for the sigmoid colon and rectum were substantially higher among males compared with females in Denmark and Connecticut, accounting for the large malefemale differences in the age-period-cohort patterns for these sub-sites. Similar patterns in age-incidence curves by sub-site and sex have been observed with cross-sectional data (De Jong et al, 1972;Jensen, 1984;Faivre et al, 1989;Gerhardsson et al, 1990;Levi et al, 1991;Devesa and Chow, 1993;Dos Santos Silva and Swerdlow, 1993).…”

Section: Discussionsupporting

confidence: 79%

Age‐period‐cohort modelling of large‐bowel‐cancer incidence by anatomic sub‐site and sex in Denmark

Dubrow

Johansen

Skov

et al. 1994

Intl Journal of Cancer

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In a previous investigation, statistical modelling was used to examine the relationship between large-bowel-cancer incidence and age, time period and birth cohort by anatomic sub-site and sex, using data from the Connecticut Tumor Registry (CTR) for the period 1950 to 1984. This analysis revealed differences in age-period-cohort patterns that suggested etiologic distinctions among sub-site groupings and between the sexes. To test the generalizability of the Connecticut findings, we have conducted a similar age-period-cohort analysis using data from the Danish Cancer Registry (DCR) for the period 1953 to 1987. Cancers of the large bowel were classified into 6 anatomic sub-sites: cecum, ascending colon, transverse colon, descending colon, sigmoid colon and rectum. Data were fitted to log-linear age-period-cohort models. If we interpret differences in age-period-cohort patterns as reflecting etiologic distinctions, the Denmark analysis, in conjunction with the Connecticut findings, was consistent with there being etiologic distinctions between cancers of the colon vs. the rectum in both males and females, between cancers of the cecum and the ascending colon vs. the remainder of the colon in females and between males vs. females for cancers of the sigmoid colon and rectum. Cancers of the cecum and the ascending colon were the most similar between males and females. Due to the ambiguities of age-period-cohort modelling, these should be considered only tentative conclusions that can be tested by analytical epidemiologic studies.

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“…[19][20] The results among the fishermen are in good agreement with these data. The other industrial cohorts in this study were, however, with the exception of the reference cohort, originally assembled from industrial settings with suspected carcinogens of different kinds.…”

Section: Discussionsupporting

confidence: 76%

Asbestos, cement, and cancer in the right part of the colon.

1994

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Objective-The aim was to investigate associations between exposure to mineral fibres and dust, and cancer in subsites within the large bowel. Design-Pooled retrospective cohort studies. Subjects and settings-Blue collar workers, employed for at least one year in different trades; asbestos cement or cement workers (n = 2507), other industrial workers (n = 3965), and fishermen (n = 8092). Main outcome measures-Standardised incidence ratios (SIRs, national reference rates) were calculated for cause specific cancer morbidity between 1958 and 1989. The observation period began 15 years after first employment. Results-The asbestos cement and cement workers had a slightly increased risk of colorectal cancer (SIR 1l5; 95% confidence interval (95% CI) 1*1-2-0). This was due to an increase only in the right part of the colon (SIR 2.5; 95% CI 1.6-3.8). The ratio of right (7th revision of the International Classification of Diseases ICD-7) 1530-1531)ileft (ICD-7 1532-1533) colon cancer among the asbestos cement and cement workers of 4-8 differed significantly from the ratio both among the other blue collar workers (0.4) and among the fishermen (1-5). As the sensitivity and accuracy was insufficient, mortality data did not show the excess of cancers in the right part of the colon. Conclusions-An increased incidence of cancer in the right part of the colon was evident in the asbestos cement and cement workers. The distribution of cancers within the colon was noticeably different from that in other blue collar workers, indicating that our findings cannot be explained by socioeconomic confounding factors. A detailed and appropriate disease classification, based on incidence data, is necessary in order not to obscure or underestimate effects of exposure in epidemiological studies on colorectcal cancer. (OccupEnviron Med 1994;51:95-101)

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Colorectal Cancer in Sweden a Descriptive Epidemiologic Study

Cited by 18 publications

References 16 publications

Age‐period‐cohort modelling of large‐bowel‐cancer incidence by anatomic sub‐site and sex in connecticut

Age‐period‐cohort modelling of large‐bowel‐cancer incidence by anatomic sub‐site and sex in connecticut

Age‐period‐cohort modelling of large‐bowel‐cancer incidence by anatomic sub‐site and sex in Denmark

Asbestos, cement, and cancer in the right part of the colon.

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