{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:27:58Z","timestamp":1791440878555,"version":"4.3.3"},"reference-count":48,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T00:00:00Z","timestamp":1691452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Proximal and distal colorectal cancers (CRCs) exhibit different clinical, molecular and biological patterns. The aim of this study was to determine temporal trends in the age\u2010standardized incidence rates (ASIRs) of proximal and distal CRC following the introduction of the English Bowel Cancer Screening Programme (BCSP) in 2006.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The National Cancer Registration and Analysis Service database was used to identify incident cases of CRC among adults of screening age (60\u201374\u2009years) between 2001 and 2017. ASIRs were calculated using the European Standard Population 2013 and incidence trends analysed by anatomical subsite (proximal, caecum to descending colon; distal, sigmoid to rectum), sex and Index of Multiple Deprivation (IMD) quintile using Joinpoint regression software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between 2001 and 2017, 541\u2009515 incident cases of CRC were diagnosed [236\u2009167 proximal (43.6%) and 305\u2009348 distal (56.4%)]. A marginal reduction in the proximal ASIR was noted from 2008 [annual percentage change (APC) \u22121.4% (95% CI \u22122.0% to \u22120.9%)] compared with a greater reduction in distal ASIR from 2011 to 2014 [APC \u22126.6% (95% CI \u221211.5% to \u22121.5%)] which plateaued thereafter [APC \u22120.5% (95% CI \u22123.2% to 2.2%)]. Incidence rates decreased more rapidly in men than women. Adults in IMD quintiles 4\u20135 experienced the greatest reduction in distal tumours [APC \u22123.5% (95% CI \u22124.3% to \u22122.7%)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Following the introduction of the English BCSP, the incidence of CRC has subsequently reduced among adults of screening age, with this trend being most pronounced in distal tumours and in men. There is also evidence of a reduction in the deprivation gap for distal tumour incidence. Strategies to improve the detection of proximal tumours are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16666","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T00:21:05Z","timestamp":1691540465000},"page":"1771-1782","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Colorectal cancer incidence trends by tumour location among adults of screening\u2010age in England: a population\u2010based study"],"prefix":"10.1111","volume":"25","author":[{"given":"Sam. P.","family":"Granger","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Bristol Royal Infirmary  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan. A. D.","family":"Preece","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Bristol Royal Infirmary  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael. G.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Bristol Royal Infirmary  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven. W.","family":"Dixon","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Bristol Royal Infirmary  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam. C.","family":"Chambers","sequence":"additional","affiliation":[{"name":"School of Cellular and Molecular Medicine University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9880-2073","authenticated-orcid":false,"given":"David. E.","family":"Messenger","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Bristol Royal Infirmary  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,8]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32319-0"},{"key":"e_1_2_11_4_1","unstructured":"Office for National Statistics (ONS).ONS website Statistical Bulletin National Life Tables\u2010Life Expectancy in the UK: 2018\u20132020.2021."},{"key":"e_1_2_11_5_1","volume-title":"Screening KPI data sumary factsheets","author":"Public Health England","year":"2020"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60551-X"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)03386-7"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.2147\/RMHP.S109116"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-300843"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-322545"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1301969"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdu275"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02234301"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(21)00199-6"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.11486"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djw322"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200011303432203"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S213677"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13556"},{"key":"e_1_2_11_20_1","unstructured":"National Cancer Registration and Analysis Service. Available from:http:\/\/www.ncin.org.uk\/home"},{"key":"e_1_2_11_21_1","unstructured":"ONS Office for National Stastictics.Revised European Standard Population 2013 (2013 ESP). The impact of calculating cancer incidence rates using the 2013 European Standard Population.2015."},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15361"},{"key":"e_1_2_11_23_1","volume-title":"The English indices of deprivation 2019","author":"Noble S","year":"2019"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.236430"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c5531"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djp436"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.40.4772"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21601"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12061409"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2018.07.135"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-018-4786-7"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(21)00368-X"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1258\/jms.2010.009120"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0253854"},{"key":"e_1_2_11_35_1","unstructured":"Public Health England.National Diet and Nutrition Survey: Years 9\u201311 of the Rolling Programme (2016\/2017\u20132018\/2019).2020b."},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwu357"},{"key":"e_1_2_11_37_1","unstructured":"House of Commons Research Library.Obesity Statistics 2022. Available from:https:\/\/researchbriefings.files.parliament.uk\/documents\/SN03336\/SN03336.pdf"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.03.040"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6604961"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-016-2133-4"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.10.054"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2208375"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-301848"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1309086"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2018.09.006"},{"issue":"1","key":"e_1_2_11_46_1","first-page":"53","article-title":"Retroflexion, a costless endoscopic maneuver, increases adenoma detection rate in the ascending colon","volume":"34","author":"Michopoulos S","year":"2021","journal-title":"Ann Gastroenterol"},{"issue":"1","key":"e_1_2_11_47_1","first-page":"20","article-title":"Longer mean colonoscopy withdrawal time is associated with increased adenoma detection: evidence from the Bowel Cancer Screening Programme in England","volume":"45","author":"Lee TJ","year":"2013","journal-title":"Endoscopy."},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-314889"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-10597-y"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.16666","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T19:28:36Z","timestamp":1700681316000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.16666"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,8]]},"references-count":48,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1111\/codi.16666"],"URL":"https:\/\/doi.org\/10.1111\/codi.16666","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,8]]},"assertion":[{"value":"2023-01-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}