Subject age in colorectal cancer screening

• Published in: Journal of Gastroenterological Mass Survey Vol. 42; no. 1; pp. 49 - 55
• Main Authors: MATSUDA, Kazuo, WATANABE, Kunishige
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Cancer Screening 2004; 一般社団法人 日本消化器がん検診学会
• Subjects: 大腸がん検診; 対象年齢
• ISSN: 1345-4110; 2186-7321
• DOI: 10.11404/jsgcs2000.42.1_49

In Japan, colorectal cancer screening is performed in subjects 40 years old or older, however, in other countries, subject age is 50 years or older or 50 to 69 years. We investigated whether subjects ranging from 40 to 49 years in age or subjects 70 years old or older were candidates for screening based on the incidence of colorectal cancer and survival rate. According to the Fukui Cancer Registry, the incidences of colorectal cancer with respect to age distribution(40-49 years, 50-69 years, 70 years or older)in 1998 were 40.3,140.7, and 319.6, respectively. In subjects ranging from 40 to 49 years in age, the incidence was very low. By Kaplan-Meier analysis, 5-year survival rates with respect to age distribution were 91.1%, 89.4%, and 77.1%, respectively. In subjects 70 years old or older, the survival rate was significantly lower than that in subjects ranging from 50 to 69 years in age(P=0.048). When subjects 70 years old or older were divided into subgroups, the 5-year survival rate in subjects 75 years old or older was low(68.8%). However, in subjects ranging from 70 to 74 years in age, the 5-year survival rate was 85.1%, and was not markedly different from that in subjects ranging from 50 to 69 years in age. The risk of death was investigated using Cox's proportional hazard model. There were no significant differences in the risk ratio among the 3 age groups. In conclusion, subjects 40 to 49 years old should be further investigated ; however, colorectal cancer screening should be more aggressively recommended for subjects 70 to 74 years old than previously done.