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Journal of Public Health Advance Access originally published online on April 28, 2008
Journal of Public Health 2008 30(2):194-201; doi:10.1093/pubmed/fdn019
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© The Author 2008, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

Gender differences in colorectal cancer incidence, mortality, hospitalizations and surgical procedures in Canada



Ru-Nie Gao, Senior Epidemiologist1

C. Ineke Neutel, Senior Epidemiologist1,2

Elaine Wai, Radiation Oncologist3
1 Surveillance Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, Canada
2 Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, Canada K1H 8M5
3 Department of Radiation Oncology, BC Cancer Agency – Vancouver Island Centre, 600 West 10th Avenue, Vancouver, BC, Canada V5Z 4E6

Address correspondence to Dr Ru-Nie Gao, E-mail: ru-nie_gao{at}phac.aspc.gc.ca


  Abstract

Background Over the past few decades there have been changes in incidence and mortality of colorectal cancer.

Objective To examine gender differences in incidence, hospitalization, hospital-based procedures and mortality for colorectal cancer.

Methods Data were derived from the Hospital Morbidity Database, Canadian Cancer Registry and the Canadian Mortality Database.

Results Overall incidence and mortality rates for colorectal cancer are decreasing, but remain substantially higher for males. Absolute numbers of cases are similar for men and women. The top subsite for men was rectal cancer, which was third highest for women, whereas right colon cancer was highest for women. Male/female ratios for incidence and surgeries were highest for distal cancer and are increasing with time.

Conclusions Although overall incidence rates have shown a decline, absolute numbers of new colorectal cancer cases have increased. While men have higher colorectal cancer rates, women have similar numbers and screening should target both equally. Over the years, colorectal cancer subsites are showing a rightward shift, i.e. an increase in proximal subsites, but a leftward shift in male/female ratios, i.e. a greater decrease for the more distal subsites in females. The lower rates for women for distal cancer are compatible with a degree of hormonal protection based on oral contraceptive and hormone replacement therapy. Colorectal cancer will continue to be a considerable public health problem in the foreseeable future.

Keywords: colorectal cancer, incidence, mortality, surgical procedures, survival, trends


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