How many deaths from colorectal cancer can be prevented by 2030 ? A scenario-based quantification of risk factor modification, screening, and treatment in Norway
Menée en Norvège à partir d'un modèle de simulation intégrant des données démographiques et épidémiologiques, cette étude estime, en fonction des statégies de prévention adoptées (respect des recommandations en matière de santé, dépistage, amélioration des traitements), le nombre de décès par cancer colorectal évités sur la période 2015-2030
Background : Colorectal cancer (CRC) mortality can be reduced through risk factor modification (adherence to lifestyle recommendations), screening, and improved treatment. This study estimated the potential of these three strategies to modify CRC mortality rates in Norway.
Methods : The potential reduction in CRC mortality due to risk factor modification was estimated using the software Prevent, assuming that 50% of the population in Norway-who do not adhere to the various recommendations concerning prevention of smoking, physical activity, body weight, and intake of alcohol, red/processed meat, and fiber-started to follow the recommendations. The impact of screening was quantified assuming implementation of national flexible sigmoidoscopy screening with 50% attendance. The reduction in CRC mortality due to improved treatment was calculated assuming that 50% of the linear (positive) trend in CRC survival would continue to persist in future years.
Results : Risk factor modification would decrease CRC mortality by 11% (corresponding to 227 prevented deaths; 142 men, 85 women) by 2030. Screening and improved treatment in Norway would reduce CRC mortality by 7% (149 prevented deaths) and 12% (268 prevented deaths), respectively, by 2030. Overall, the combined effect of all three strategies would reduce CRC mortality by 27% (604 prevented deaths) by 2030.
Conclusions : Risk factor modification, screening, and treatment all have considerable potential to reduce CRC mortality by 2030, with the largest potential reduction observed for improved treatment and risk factor modification.
Impact : The estimation of these health impact measures provides useful information that can be applied in public health decision-making.
Cancer Epidemiology Biomarkers & Prevention , résumé, 2016