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Trends in colorectal cancer incidence rates in New Zealand, 1981–2004

  1. Ankit B. Shah1,2,
  2. Diana Sarfati2,*,
  3. Tony Blakely2,
  4. June Atkinson2,
  5. Elizabeth R. Dennett3

Article first published online: 17 JAN 2012

DOI: 10.1111/j.1445-2197.2011.05995.x

Issue

ANZ Journal of Surgery

ANZ Journal of Surgery

Volume 82, Issue 4, pages 258–264, April 2012

Additional Information

How to Cite

Shah, A. B., Sarfati, D., Blakely, T., Atkinson, J. and Dennett, E. R. (2012), Trends in colorectal cancer incidence rates in New Zealand, 1981–2004. ANZ Journal of Surgery, 82: 258–264. doi: 10.1111/j.1445-2197.2011.05995.x

Author Information

  1. 1

    Department of Public Health and Community Medicine, Tufts University, School of Medicine, Boston, Massachusetts, USA

  2. 2

    Department of Public Health, University of Otago, Wellington, and

  3. 3

    Department of Surgery and Anesthesia, Wellington School of Medicine and Health Sciences, Wellington, New Zealand

*Dr Diana Sarfati, Department of Public Health, University of Otago, PO Box 7343, Wellington 6242, New Zealand. Email: diana.sarfati@otago.ac.nz

Publication History

  1. Issue published online: 21 MAR 2012
  2. Article first published online: 17 JAN 2012
  3. Accepted for publication 6 May 2011.

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Keywords:

  • colorectal neoplasm;
  • epidemiology;
  • incidence;
  • subsite;
  • trend

Abstract

Background:  Incidence rates of colorectal cancer (CRC) in New Zealand rank among the highest worldwide. Internationally, there has been evidence of a shift in colon cancer from left- to right-sided. The objective of this study was to determine trends in left- and right-sided colon and rectal cancers incidence by sex, age and ethnicity.

Methods:  Using datasets created by linking data from the New Zealand Cancer Registry to the census data, we analysed a total of 47 694 CRCs from 1981 to 2004. Cancers were divided into right-sided colon (cecum to the splenic flexure); left-sided colon (descending and sigmoid colon); and rectal (rectosigmoid junction and rectum).

Results:  Left- and right-sided colon, and rectal cancer incidence rates increased by 13–20% among men. In women, colon cancer rates increased by 25% for right-sided cancers, decreased by 8% for left-sided cancers and remained unchanged for rectal cancers. This corresponds with an increase in right-sided cancers from 57% to 65% of total colon cancers in women. The incidence of all CRCs increased at a faster rate among Māori than non-Māori.

Conclusion:  We identified a left- to right-sided shift in colon cancer limited to women over the age of 65. While Māori trends in site distribution parallel those of their non-Māori counterparts, the rapid increase in Māori incidence rates is noteworthy. It is unclear why such shifts in CRC site distribution are occurring.

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