Heterogeneity of colon and rectum cancer incidence across 612 SEER counties, 2000–2014

Abstract

Recent analyses have suggested decreases over time in colorectal cancer incidence at older ages (≥55 years) but increases at younger ages (20-54 years). Understanding the geographic heterogeneity of incidence facilitates resource allocation for potential interventions and advances our knowledge of differential etiologies for these cancers. We performed age-period-cohort analysis using 2000-2014 county-level incidence from the Surveillance, Epidemiology, and End Results (SEER) database, estimating relative risk (RR) and age-adjusted annual percent change (Net Drifts) simultaneously for 612 counties via a hierarchical model, separately for colon and rectum cancer, stratified by age group (20-54 vs. 55-84). We also studied correlates of RR and Net Drift with various county-level characteristics. In all SEER counties, colon and rectum cancer incidence rates increased at ages 20-54, whereas rates decreased at ages 55-84. There was marked heterogeneity in both RR and Net Drift among states and counties for both cancer types. Maps of county RR and Net Drift revealed localized clusters in several states. For both cancer types, counties with high RR and unfavorable Net Drift tended to have higher prevalence of obesity and diabetes and to be of a lower socioeconomic status. Counties with higher overall screening rates tended to have lower Net Drifts for both cancer types. Increasing colorectal cancer incidence in the younger age group is geographically widespread, although there is significant heterogeneity in temporal trends and risk both within and between states. These geographic patterns correlate with different county-level characteristics depending on cancer type and age group. This article is protected by copyright. All rights reserved.

Designing an Effective Colorectal Cancer Screening Program in Egypt: A Qualitative Study of Perceptions of Egyptian Primary Care Physicians and Specialists

“…Countries that have implemented prevention programs have shown a reduction in CRC incidence [13][14][15]. For example, CRC death rates in the U.S. have declined 53% from 1970 to 2016, largely because of screening and improvements in treatment [16].…”

A systematic review of methods to estimate colorectal cancer incidence using population-based cancer registries

“…Eighteen studies (11%) reported the incidence rate with no further specification. Two of these studies described the incidence as mainly the frequency of new cases [ 77 , 150 ], four obtained incidence rates via linear modelling [ 32 , 41 , 48 , 159 ], and two defined incidence as the percentage of CRC cases among different age groups [ 119 , 120 ]. Additional details are provided in Additional files 1 , 3 : Table 3.2.…”

Decreasing Incidence of Estrogen Receptor–Negative Breast Cancer in the United States: Trends by Race and Region

“…In each of these analyses, we included data from all 17 SEER registries. We used the novel Bayesian hierarchical APC models described in Chernyavskiy et al ( 7 , 8 ). These models extend traditional APC models ( 13-15 ) by including registry-specific random intercepts to allow mean incidence rates, compared with the SEER average, to vary between registries.…”

“…Here, we use novel multi-level age-period-cohort (APC) models ( 7 , 8 ) to determine how incidence patterns of ER-negative breast cancer among NHW, NHB, and HW women vary across different regions of the United States, represented by 17 SEER registries. Our models allow us to produce stable estimates of mean rates and age-adjusted trends (so-called net drifts) for each combination of registry, race or ethnic group, and age group, taking into account the limited numbers of women in some strata.…”