The Colorectal Carcinoma in the Course of Time. Incidence Progress: Myth or Reality?

Background and Purpose: Publications about incidences of, and mortality resulting from, colorectal carcinoma diverge. The aim of this article is to evaluate the trend concerning colorectal carcinoma, especially with regard to Austria, Germany, and other European countries, and to demonstrate changes and reasons of mortality. Methods: Statistics of various statistic institutes, the World Health Organization (WHO) and the Organization for Economic Cooperation and Development (OECD) have been screened, compared and presented. The term "colorectal carcinoma" also includes the anal carcinoma (ICD-10: C18-C21) as the majority of the statistic institutes include the latter in their statistics as well. Furthermore, mortality has also been studied in relation to the gross domestic product (GDP) and the "per-head health expenses" of the European countries. Results: Different countries show different tendencies. Therefore, a general, pan-European decrease of incidences regarding colorectal carcinoma cannot be observed. Concerning the mortality rates, a considerable recessive development in North, Central, and West Europe was detected - but not in South and East Europe. Conclusion: There is a greater decline in mortality than in incidence rates. However, in the context of incidences the "screening effect" must not be overlooked. With regard to mortality the GDP and the "per-head health expenses" can be seen as indicators, as a low GDP acts reciprocally to mortality rates.