Typology and description of the endemic areas with a long-time and smallest colorectal mortality rates within Silesia voivodeship
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Zakład Epidemiologii i Śląski Rejestr Nowotworów. Kierownik: dr hab. n. med. A. Tukiendorf
Zakład Radioterapii. Kierownik: prof. dr hab. n. med. L. Miszczyk Centrum Onkologii-Instytut im. M. Skłodowskiej-Curie, Oddział w Gliwicach
Brunon Zemła   

Zakład Epidemiologii i Śląski Rejestr Nowotworów Centrum Onkologii-Instytut im. M. Skłodowskiej-Curie Oddział w Gliwicach ul. Wybrzeże Armii Krajowej 15 44-101 Gliwice
Med Srod. 2013;16(3):28–35
In the years 1999–2009, in Silesia voivodeship, 7339 males and 6635 females were died for the colorectal cancers (C18–C21, by ISCD&HRP, X revision). Mortality, especially among men increase. Mortality, among both sexes, is very unequal, taking into account a small administrative units (counties). Therefore an attempt looking for endemic areas with a long – time biggest and smallest mortality rates.

Material and Methods:
For the 13 974 cases of deaths because of the colorectal cancer, and at used demographic data, the following mortality rates were calculated to be average for 11 years period (in this two periods extreme, each 4-years): a) age specific (for 5-years age groups), b) crude rates („intensity rates”) for all ages and a particular administrative unit type of counties, c) age-adjusted (standardized) rates by direct M. Spiegelman’s method and the age structure of „world population” according to M. Segi’s and M. Kurihara’s method and modified by R. Doll’s. Age – adjusted mortality rates for particular counties (R1) to the whole voivodeship (R2) were compared with used 95% confidence interval for the ratio (R1/R2) according to O.S. Miettinen’s method. Basing on the data the endemic areas with a biggest and smallest cancer colorectal rates were described.

In the years 1999–2009 within Silesia voivodeship 13974 patients died because of the colorectal cancers, i.e. 52.5% males and 47.5% females. Standardized mortality rate for whole Silesia voivodeship is 20.9 per 100 thousands among males and 12.1/100 thousands among females (at the small increase between two periods comparising, i.e. 1999–2002:2006–2009 for females, and bigger among males). Standardized, average minimum mortality rate for the colorectal cancers for the whole Silesia voivodeship and the period 1999–2009 is 17.1/100 thousands for males (bieruńsko-lędziński county) and 10.0/100 thousands for females (myszkowski county); and maximum equaled to 27.9/100 thousands (Ruda Śl., town) for men and 16.5/100 thousands (Mysłowice, town) for women. The endemic areas of the biggest mortality rates for colorectal cancer among males, it following administrative units: Częstochowa (town) and with Mysłowice (town), and among females it: Sosnowiec (town) with Mysłowice (town) and Chorzów with Ruda Śl. (towns) (fig. 1D and 2D).

There is a strong correlation (coherence) between the biggest mortality rates for colorectal cancer among males and females for endemic areas of towns (Chorzów + Ruda Śl.); as well a high risk to Częstochowa (males) and Sosnowiec and Mysłowice (females). These populations should have priming in screening examinations.

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