Colorectal Cancer in the 21st Century: Insights from SEER and National Health Surveys

Calvin Ghimire, Jerry Kenmoe, Pujan Kandel, Sajana Poudel, Sajan Acharya, Matthew Jankowski, Bibek Karki, Manoj Ghimire, Alex Rabadi, Utkarsh Arora, Arvind Kunadi, Mustafa Alnounou.

Abstract

Background: Colorectal Carcinoma (CRC) is one of the leading causes of deaths worldwide and forth most common cancer in the United States. Overall incidence rates of CRC has been decreasing in United States with evolution of colorectal cancer screening over the years. Colonoscopy is gold standard for screening colonoscopy.

Methods: We used Surveillance, Epidemiology, and End Results (SEER), 22 Registries database to analyze the incidence rate based on different domains like gender, race and extent of disease to determine the rates and differences in rates in different domains. Join point software was used to assess trends further and their significance level. We used National Health Interview Survey to correlate the trends.

Results: Significantly higher rates of CRC are found among males and black population. However, rates for both genders have been declining over the years with soaring decline at almost double rate of 3.8% annually from 2007 to 2011. Similar decline in rates were notes in white population at 4.1% from 2007 to 2011. Black population have steady decline in CRC incidence rates. Incidence rates of localized and advanced CRC both are declining at approximately 4% annually, but rates plateaued for advanced CRC in 2011. There is increasing trend of CRC with lower socioeconomic class. Sigmoidoscopy and colonoscopy rate trends have been improving in both gender and all races except for Hispanic population whose rates remain below national average.

Conclusion: The incidence rate of CRC is decreasing with largest decline from 2007 to 2011. CRC was more prevalent among patients with low income class and nonmetropolitan counties. The sigmoidoscopy/colonoscopy trend has improving with highest leap in rates in earlier years. These trends are complementary to each other. However, the effect of a decrease in smoking and red meat consumption should be taken into account.