Fig 1.
Model of a successful screening program.
The widely accepted concept is that colonic neoplasia progress from less advanced to more advanced stages (from adenoma to localized to regional to distant) and become more symptomatic as they progress. As screening quality is improved and more people are being screened, as has been the case in the US since 2000, we expect a screening effect that reduces the incidence rates of all stages of disease. This model predicts that a successful screening program would exert its largest reduction in incidence on distant CRC.
Fig 2.
The incidence rate of distant CRC is decreasing much more slowly than non-distant disease.
Green squares, localized; yellow triangles, regional; red stars, distant. Incidence rates are expressed per 100,000.
Table 1.
Summary of localized, regional, and distant joinpoint models.
Fig 3.
Incidence rates of distant, regional, and localized CRC by age, sex, site, and race.
Change in the incidence rates (per 100,000) of CRC by stage stratified by (A) age (<50, 50–64, 65+), (B) site (distal, proximal), (C) race (Native American/Alaskan Native, Asian or Pacific Islander, Black or African American, and White), and (D) sex. Green squares, localized; yellow triangles, regional; red stars, distant.
Table 2.
Summary of localized, regional, and distant joinpoint models for early-onset CRC.