AGE-PERIOD-COHORT MODELING OF COLORECTAL-CANCER INCIDENCE AND MORTALITY IN SPAIN

Spain registers a much lower rate of colorectal cancer incidence and m ortality than do other European countries, yet the rises observed in t he adjusted rates over recent decades led us to attempt to monitor the trends over time using Poisson log-linear models, Incidence data were furnished by the Zaragoza and Navarre population-based cancer registr ies, whereas mortality data corresponded to Spain as a whole. For tren d evaluation purposes, we made use of invariant parameters from age-pe riod-cohort models (net drift and curvature) and a restriction of the cohort-effect slope range, The results suggest the presence of a marke d rise in incidence of colorectal cancer for both sexes and across all age groups in the provinces studied, The rise in mortality was less p ronounced than the rise in incidence and seemed to coincide with a mar ked cohort effect present throughout the study period, Both in inciden ce and mortality, the increases were more pronounced among men, When s tudied jointly, incidence and mortality trends tend to be complementar y, rendering an approach of this nature especially important in sites with better survival, such as the case in point.