REED - Revista Española de Enfermedades Digestivas

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Año 2024 / Volumen 116 / Número 6
Original

Investigating temporal patterns of colorectal cancer incidence in Spain: a comprehensive analysis of age, period and cohort effects, 1990-2019

312-318

DOI: 10.17235/reed.2024.10317/2024

Lucía Cayuela, Gema Flox-Benítez, Clara Peiró Villalba, Álvaro Giráldez Gallego, Aurelio Cayuela Domínguez,

Resumen

Aim: This study aimed to evaluate how age, period, and cohort (A-P-C) impact colorectal cancer (CRC) incidence in Spain from 1990 to 2019. Method: Using data from the Global Burden of Disease Study 2019, we used joinpoint analysis to identify long-term trends and A-P-C modelling to quantify net drift, local drift, longitudinal age curves, and rate ratios (RRs) of period and cohort effects. Results: CRC incidence increased steadily in Spain from 1990 to 2019, with a more significant rise in males than in females. The age standardized rates rose from 84.9 to 129.3 cases per 100,000 in males and from 56.9 to 70.3 cases per 100,000 in females. Joinpoint analysis revealed distinct patterns for men and women: male incidence showed three phases (a surge until 1995, a slowdown until 2012, and a subsequent decrease) while female incidence showed a single increase until 2011 and then stabilized. Local drifts increased in all age groups over 45, with stability in males under 45 and a decrease in females aged 30-39. The risk of CRC increased with age, with males consistently having a higher risk than females. The risk of CRC increased over time for both men and women but at different rates. The risk for cohorts born in the early to mid-20th century peaked in the 1960s and remained stable until the late 1990s. Conclusion: The increasing incidence of CRC in Spain, with distinct patterns by gender and birth cohort, underlines the importance of preventive strategies adapted to temporal and demographic variations to address this public health challenge.

Resumen coloquial

This study examined how age, period and birth cohort influence the incidence of colorectal cancer (CRC) in Spain from 1990 to 2019. Using data from the Global Burden of Disease Study 2019, the researchers identified patterns that showed a steady increase in CRC incidence rates, which were significantly higher in males. Different trends emerged for each sex: males had three phases of increase, slowdown and subsequent decline, while females had a single increase followed by stabilization. The study revealed temporal and age-related changes in CRC risk, which was consistently higher in men. Individuals born since the early 20th century had an increased risk, which peaked in the 1960s and remained stable until the late 1990s. The findings highlight the need for a comprehensive approach to CRC prevention, addressing age, period and cohort factors, and promoting lifestyle changes to reduce incidence and improve public health in Spain.

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