Cancer of the colon and rectum (ICD-9 153, 154, 159.0)

Cancer of the colon (ICD-9 153, 159.0) excludes carcinoids but includes cancer of the rectosigmoid and unspecified intestinal tract. Rectal cancer (ICD-9 154) excludes carcinoids, cancer of the rectosigmoid junction and cancer of anal canal and anus. The division between the colon and rectum may not have been unique in all areas, and therefore mainly rates for the colon and rectum combined are presented.

Maps for cancer of the colon and cancer of the rectum are similar in the Nordic countries, but not in post-socialistic countries where rectal cancer is more common. Maps for men are similar to those for women.

The highest incidence rates for colorectal cancer were seen in Saarland, Denmark and Norway (males 353-405/106, women 278-297/106), the lowest ones in Belarus, Latvia and Lithuania (males 178-188/106, females 133-136/106). An urban excess was noticed in post-socialistic countries.

The mortality/incidence ratio in the Nordic countries except Denmark was around 0.5. In Poland, Russia and Lithuania it exceeded 0.8.

There was only little variation in the age-specific incidence or mortality rates between areas up to the age of 70; the east-west difference was only seen in the oldest age categories.

Comment

Diet characteristic to a high standard of living seems to be important in colon cancer but not that much in rectum cancer. Variation in mortality/incidence ratio and in age curves may be explained by diagnostic activity: it is likely that people in post-socialistic countries are under rather systematic surveillance in the working ages but thereafter they only go to see a doctor if the symptoms are serious.

Graphs:

    colon colon rectum rectum colorectal colorectal
National rates incidence & mortality males females males females males females
  mortality/incidence males females males females males females
Age curves incidence (Nordic+Saa, rest)         males females
  mortality (Nordic+Saa, rest)         males females
Map incidence males females males females males females
  mortality males females males females males females
  mortality/incidence males females males females males females

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