Background: For both men and women worldwide, colorectal cancer is among the leading causes of cancer-related death. This study aimed to assess the mortality trends of colorectal cancer in Serbia between 1991 and 2010...Background: For both men and women worldwide, colorectal cancer is among the leading causes of cancer-related death. This study aimed to assess the mortality trends of colorectal cancer in Serbia between 1991 and 2010, prior to the introduction of population-based screening.Methods: Joinpoint regression analysis was used to estimate average annual percent change(AAPC) with the corresponding 95% confidence interval(CI). Furthermore, age-period-cohort analysis was performed to examine the effects of birth cohort and calendar period on the observed temporal trends.Results: We observed a significantly increased trend in colorectal cancer mortality in Serbia during the study period(AAPC = 1.6%, 95% CI 1.3%–1.8%). Colorectal cancer showed an increased mortality trend in both men(AAPC –2.2%) and women(AAPC rend of colorectal cancer mo= 2.0%, 95% CI 1.7%= 1.0%, 95% CI 0.6%–1.4%). The temporal trtality was significantly affected by birth cohort(P < 0.05), whereas the study period did not significantly affect the trend(P = 0.072). Colorectal cancer mortality increased for the first several birth cohorts in Serbia(from 1916 to 1955), followed by downward flexion for people born after the 1960 s. According to comparability test, overall mortality trends for colon cancer and rectal and anal cancer were not parallel(the final selected model rejected parallelism, P < 0.05).Conclusions: We found that colorectal cancer mortality in Serbia increased considerably over the past two decades. Mortality increased particularly in men, but the trends were different according to age group and subsite. In Serbia, interventions to reduce colorectal cancer burden, especially the implementation of a national screening program, as well as treatment improvements and measures to encourage the adoption of a healthy lifestyle, are needed.展开更多
Background:As the result of dramatic political changes,civil wars,and a long-term refugee crisis from the end of the last to beginning of this century,the population of Serbia has experienced significant health proble...Background:As the result of dramatic political changes,civil wars,and a long-term refugee crisis from the end of the last to beginning of this century,the population of Serbia has experienced significant health problems.The aim of this study was to assess cancer mortality trends in Serbia.Methods:This nationwide study was carried out to analyze cancer mortality in Serbia during 1991-2015 using offi-cial data.The age-standardized mortality rates(per 100,000)were calculated by direct standardization,using the world standard population by Segi.The average annual percent change(AAPC)and corresponding 95%confidence interval(CI)were computed using joinpoint regression analysis.Age-period-cohort analysis was performed to address the possible underlying reasons for the observed temporal trends.Results:Over the 25-year study period,there were 466,075 cancer deaths(266,043 males and 200,032 females)in Serbia.Overall cancer mortality increased between 1991 and 2009 in both males(by+0.9%per year)and females(by+0.8%per year)and has been decreasing since then,by−0.9%annually in both sexes.For almost all major cancers except stomach cancer,cancer mortality in Serbia demonstrated upward trends during the study period.The largest increases were noted in lung cancer among females(AAPC=+3.7,95%CI 3.5-3.9)and prostate cancer in males(AAPC=+1.9,95%CI 1.4-2.3).Conclusions:After two decades of increase,cancer mortality rates are finally declining in Serbia.Despite this,these rates place Serbia among the countries with the highest cancer mortality in the world.展开更多
基金supported by the Ministry of Education and Science of the Republic of Serbia (Contract No.175042)
文摘Background: For both men and women worldwide, colorectal cancer is among the leading causes of cancer-related death. This study aimed to assess the mortality trends of colorectal cancer in Serbia between 1991 and 2010, prior to the introduction of population-based screening.Methods: Joinpoint regression analysis was used to estimate average annual percent change(AAPC) with the corresponding 95% confidence interval(CI). Furthermore, age-period-cohort analysis was performed to examine the effects of birth cohort and calendar period on the observed temporal trends.Results: We observed a significantly increased trend in colorectal cancer mortality in Serbia during the study period(AAPC = 1.6%, 95% CI 1.3%–1.8%). Colorectal cancer showed an increased mortality trend in both men(AAPC –2.2%) and women(AAPC rend of colorectal cancer mo= 2.0%, 95% CI 1.7%= 1.0%, 95% CI 0.6%–1.4%). The temporal trtality was significantly affected by birth cohort(P < 0.05), whereas the study period did not significantly affect the trend(P = 0.072). Colorectal cancer mortality increased for the first several birth cohorts in Serbia(from 1916 to 1955), followed by downward flexion for people born after the 1960 s. According to comparability test, overall mortality trends for colon cancer and rectal and anal cancer were not parallel(the final selected model rejected parallelism, P < 0.05).Conclusions: We found that colorectal cancer mortality in Serbia increased considerably over the past two decades. Mortality increased particularly in men, but the trends were different according to age group and subsite. In Serbia, interventions to reduce colorectal cancer burden, especially the implementation of a national screening program, as well as treatment improvements and measures to encourage the adoption of a healthy lifestyle, are needed.
基金supported by Ministry of Education,Science and Technological Development,Republic of Serbia,2011-2016(Contract No.175042).
文摘Background:As the result of dramatic political changes,civil wars,and a long-term refugee crisis from the end of the last to beginning of this century,the population of Serbia has experienced significant health problems.The aim of this study was to assess cancer mortality trends in Serbia.Methods:This nationwide study was carried out to analyze cancer mortality in Serbia during 1991-2015 using offi-cial data.The age-standardized mortality rates(per 100,000)were calculated by direct standardization,using the world standard population by Segi.The average annual percent change(AAPC)and corresponding 95%confidence interval(CI)were computed using joinpoint regression analysis.Age-period-cohort analysis was performed to address the possible underlying reasons for the observed temporal trends.Results:Over the 25-year study period,there were 466,075 cancer deaths(266,043 males and 200,032 females)in Serbia.Overall cancer mortality increased between 1991 and 2009 in both males(by+0.9%per year)and females(by+0.8%per year)and has been decreasing since then,by−0.9%annually in both sexes.For almost all major cancers except stomach cancer,cancer mortality in Serbia demonstrated upward trends during the study period.The largest increases were noted in lung cancer among females(AAPC=+3.7,95%CI 3.5-3.9)and prostate cancer in males(AAPC=+1.9,95%CI 1.4-2.3).Conclusions:After two decades of increase,cancer mortality rates are finally declining in Serbia.Despite this,these rates place Serbia among the countries with the highest cancer mortality in the world.
