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Increasing crude and adjusted mortality rates of colorectal cancer in a developing South American country
Colorectal Disease, 06/20/2012  Clinical Article

Zarate AJ et al. – The crude mortality rate from Colorectal cancer (CRC) has doubled in Chile in this period. After adjustment of mortality rates, it appears that much of this increase is due to the aging population. However, part of this increase could be explained by other factors.

Methods
  • The authors analyzed the mortality database in Chile from 1983 to 2008.
  • Cases were selected using ICD-9/10 codes.
  • They calculated mortality rates per 100.000 inhabitants according to sex, age group, and type of cancer--colon (CC) and rectal (RC).
  • The rates were adjusted by direct method using the WHO-2000 standard population.
  • Time trends were assessed with Prais-Winsten regression models.

Results
  • There were 26.250 deaths from CRC (75.7% for CC).
  • There was a higher frequency of deaths from CC (57.6%) in women compared to men who had a higher frequency of deaths from RC (51.3%).
  • The crude CC mortality rate increased by 116% (3.6 to 7.8), while the overall RC rate increased by 71% (1.4 to 2.4).
  • After adjusting for age, a significant increase in mortality rate was found for CC (coefficient: 0.09, 95% CI: 0.08 to 0.11, p<0.001) and RC (coefficient: 0.02, 95% CI: 0.009 to 0.04, p=0.002) in men.
  • In women, this increase was significant for CC (coefficient: 0.03, 95% CI: 0.005 to 0.05; p=0.02), but not for RC (coefficient: -0.007, 95% CI: -0.02 to 0.005, p=0.23).

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