Participation Rate, Risk Factors, and Incidence of Colorectal Cancer in the Screening Program Among the Population Covered by the Health Centers in Arak, Iran

Background: Colorectal cancer (CRC) is among the most common and preventable cancers, the incidence and risk factors of which are different in various populations. Objectives: The present study aims at assessing incidence rate, risk factors, and symptoms of CRC among the populations aged 50 to 70 years old covered by the health centers in Arak, as well as evaluating participation rate in the CRC screening program. Methods: The present cross-sectional study was conducted from 2016 to 2019 among all of the individuals aged 50 to 70 years old, who were referred to rural, urban, and suburban health centers in Arak for CRC screening, and their data were recorded in the Sib system. The participation rate, risk factors (family and individual history of CRC, colorectal adenoma, and inflammatory bowel disease), symptoms (lower gastrointestinal bleeding, constipation with or without diarrhea, and weight loss), and crude incidence rate of CRC were calculated in the age range. Results: The mean (SD) age of the CRC was 59.72 (5.56) years. In addition, the individuals’ participation rate in the program was about 44.2%, which was more among women (55.5%) and villagers (93.7%). Most subjects complained of constipation in the last month and CRC family history. The CRC crude incidence rates were 35.93 (95% CI: 25.55 - 50.54), 40.96 (95% CI: 29.81 - 56.29), 43.76 (95% CI: 32.22 - 59.43), and 52.84 (95% CI: 40.05 - 69.71) per 100000 individuals during 2016, 2017, 2018, and 2019, respectively. Conclusions: The participation rate in the CRC screening program was low, and the trend of the cancer crude incidence rate increased among the populations aged 50 to 70 years. Finally, informing about the recognition of the risk factors and symptoms of cancer, as well as the timely referral for screening was considered essential.

Trends of Colorectal Cancer Epidemiology and Morphology in Tehran Metropolis, Iran from 2006 to 2015

Objectives: This study aimed at reporting a 10-years trend in epidemiology and morphology of colorectal cancer (CRC) in Tehran Metropolis, using the data of the National Cancer Registry. Methods: The main sources for data collection included pathology, clinical/paraclinical, as well as death registries. The quality assessment of data was performed based on standard protocols and international reference. Age-standardized incidence rates (ASR) per 100 000 were reported at province levels. Results: Totally, 16280 patients with CRC, who were diagnosed from 2006 to 2015 in Tehran Metropolis, were enrolled in the study; 56.86% of cases were male. The ASRs of adenocarcinoma and other morphology types were higher in males than females. The highest and lowest overall ASR (95% confidence interval (CI)) were reported in 2013 and 2006 with the value of 22.46 (95% CI: 21.58 - 23.35) and 5.55 (95% CI: 5.04 - 6.07) per 100 000 person-years, respectively. The average annual percentage change (AAPC) indicated that from 2006 to 2015, the overall ASR had a statistically upward trend with the value of 15.0 (95% CI: 1.80 - 30.00) in total CRC patients. Besides, the AAPC of adenocarcinoma type in males and females was 15.6 (95% CI: 1.10-32.20) and 12.9 (95% CI: 0.60 - 26.60) over the study period, respectively, which showed a significant upward trend. The ASR was much higher in age ≥ 50 years old compared to age < 50 years old. Conclusions: The results showed a growing trend in registry coverage in Tehran Province. Tehran is a high-risk area for the incidence of CRC. Cancer control programs need to be adjusted based on the status of cancer incidence in Tehran Province.