Age–period–cohort analysis of colorectal cancer in East Anglia, 1971–2005

Wessler, Jeffrey D.; Pashayan, Nora; Greenberg, David C.; Duffy, Stephen W.

doi:10.1016/j.canep.2010.03.012

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Volume 34, Issue 3 , Pages 232-237, June 2010

Age–period–cohort analysis of colorectal cancer in East Anglia, 1971–2005

Jeffrey D. Wessler
- Harvard Medical School, 260 Longwood Avenue, Boston, MA 02115, USA
- Department of Public Health and Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 OSR, UK
- Corresponding author at: Harvard Medical School, Holmes Society, MEC, 2nd Floor, 260 Longwood Avenue, Boston, MA 02115, USA. Tel.: +1 978 8862056; fax: +1 617 432 2500.
Nora Pashayan
- Department of Public Health and Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 OSR, UK
David C. Greenberg
- Eastern Cancer Registration and Information Centre, Unit C – Magog Court, Shelford Bottom, Cambridge CB22 3AD, UK
Stephen W. Duffy
- Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK

Accepted 23 March 2010. published online 08 April 2010.

Abstract

Background: This study aimed to investigate the incidence trends of colorectal cancer by sex and subsite, in East Anglia from 1971 to 2005. Methods: Using data from the Eastern Cancer Registration and Information Centre, we examined the time trends and the effect of age, period of diagnosis and birth cohort on the incidence of colorectal cancer by sex and subsite. Results: Between 1971 and 2005, 23875 males and 22651 females were registered with colorectal cancer in East Anglia. During this period, the increase in the incidence trends was higher among males, more recent periods of diagnosis, and proximal colon. Cohort effects were statistically significant in distal and rectal cancers in males (p<0.001 and p=0.05, respectively), and in proximal colon in females (p<0.001). Period effects were statistically significant across all subsites and both sexes (p<0.001 for all). Conclusions: Period effects were significant across all subsites for both sexes, whereas cohort effects varied in their significance levels depending on subsite and sex. We suggest that the period effect may be due to an increase in the use of colonoscopy for diagnostic or opportunistic screening, and the cohort effect may be due to aetiological differences in CRC between sexes and subsites.