Global Distribution of Colorectal Cancer Staging at Diagnosis: An Evidence Synthesis.

IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Lanwei Guo, Le Wang, Lin Cai, Yuelun Zhang, Xiaoshuang Feng, Chenxin Zhu, Wendong Gao, Rafael Cardoso, Haiyan Yang, Min Dai, Hermann Brenner, Hongda Chen
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引用次数: 0

Abstract

Background & aims: Stage at diagnosis is a key prognostic factor for colorectal cancer (CRC) survival. We aimed to assess the global distribution of CRC staging at diagnosis using population-based or hospital-based registry data.

Methods: We systematically searched in MEDLINE and Embase from their inception until December 6, 2023. Gray literature was searched through published cancer reports. Studies from population-based or hospital-based cancer registries reporting the stage distribution of diagnosed CRC were included. We extracted stage-specific proportions among patients with CRC based on TNM; Surveillance, Epidemiology, and End Results; or Dukes staging systems. Subgroup analyses by sex, age, tumor site, calendar period, and status of population-based screening were performed. Correlations between the Human Development Index (HDI), Socio-Demographic Index (SDI), and the distant metastatic CRC proportion were also evaluated.

Results: A total of 84 eligible studies/reports from 46 countries were analyzed, covering 3.8 million patients. Among 36 countries included in the main analysis, the most recent distant metastatic CRC proportions varied from 16.2% in Puerto Rico to 28.2% in Oman and Latvia, with a median of 23.7% (interquartile range, 21.8%-26.3%). Higher metastatic proportions were observed in younger patients, those with colon cancer, and those without screening implementation, with no apparent difference between males and females. Over time, some countries/regions, such as Southern Portugal (36.5% in 2000 to 22.2% in 2016), showed declining proportions of metastatic CRC, whereas others remained stable (eg, Austria, Belgium) or increased (eg, United States, Slovenia, Spain). Higher HDI and SDI were correlated with lower proportions of distant metastatic CRC (HDI: ρ = -0.48; SDI: ρ = -0.26).

Conclusion: Global disparities in CRC staging exist, indicating a need for targeted interventions to enhance early detection and management, especially in high-metastasis areas.

结直肠癌诊断分期的全球分布:证据综合。
背景与目的:诊断分期是结直肠癌(CRC)生存的关键预后因素。我们的目的是使用基于人群或基于医院的登记数据来评估诊断时CRC分期的全球分布。方法:我们系统地检索MEDLINE和Embase自成立至2023年12月6日。灰色文献是通过发表的癌症报告进行搜索的。研究纳入了基于人群或基于医院的癌症登记处报告诊断的结直肠癌分期分布的研究。我们根据TNM、SEER或Dukes分期系统提取结直肠癌患者的分期特异性比例。按性别、年龄、肿瘤部位、日历期和以人群为基础的筛查状况进行亚组分析。我们还评估了人类发展指数(HDI)、社会人口指数(SDI)与远处转移性结直肠癌比例之间的相关性。结果:分析了来自46个国家的84项符合条件的研究/报告,涵盖380万患者。在主要分析的36个国家中,最近发生的远处转移性结直肠癌比例从波多黎各的16.2%到阿曼和拉脱维亚的28.2%不等,中位数(四分位数范围)为23.7%(21.8%-26.3%)。在年轻患者、结肠癌患者和未进行筛查的患者中观察到更高的转移率,在男性和女性之间没有明显差异。随着时间的推移,一些国家/地区,如葡萄牙南部(2000年为36.5%,2016年为22.2%)的转移性结直肠癌比例下降,而其他国家/地区保持稳定(如奥地利、比利时)或增加(如美国、斯洛文尼亚、西班牙)。较高的HDI和SDI与较低的远处转移性CRC比例相关(HDI: ρ=-0.48;SDI:ρ= -0.26)。结论:全球结直肠癌分期存在差异,需要有针对性的干预措施来加强早期发现和治疗,特别是在高转移区。
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来源期刊
CiteScore
16.90
自引率
4.80%
发文量
903
审稿时长
22 days
期刊介绍: Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion. As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.
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