Colorectal cancer incidence, survival analysis and predictions (Monastir, Tunisia: 2002–2030)

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BACKGROUND: Colorectal cancer (CRC) ranks as the third most common cancer and the second leading cause of cancer death in Tunisia. The aim of this study was to describe the incidence and mortality rates, to determine CRC trends, prediction and burden and to analyses the CRC survival outcomes. METHODS: We conducted population-based cohort study.of all CRC cases diagnosed between 2002 and 2014 in the governorate of Monastir, with follow-up until 2022. Data were obtained from the Central Cancer Registry, the Hospital Morbidity and Mortality Registry, and national mortality databases, ensuring comprehensive case identification. Incidence, mortality, disability-adjusted life years (DALYs), Annual Percentage Change (APC), and survival were analyzed using standardized methods. RESULTS: We identified 876 cases of CRC. The age-standardized incidence rate (ASIR) was 13.5/100,000 PY (95% CI: 9.8-17.2), with a significant upward trend (APC = +6.09% (95% CI: + 0.64; + 11.82).). The predicted ASIR for 2030 was 60.4 per 100,000 PY (95% CI: 52.0-68.2). The rectum being the most frequent site (32.9%), followed by the recto-sigmoid region (28.3%). The age-standardized mortality rate was 9.6/100,000 PY (95% CI: 6.5-12.7). The DALY/year/ 100,000 PY was 96.0 (86.2-105.8). Survival rate was 64% (95% CI: 62.3-66.2), at one year and 21.1% (95% CI: 19.3-22.9) at five years. CONCLUSION: CRC incidence and mortality in Monastir have increased significantly, with projections indicating a continued rise by 2030. Strengthening population-based screening and early detection could help reverse these trends and improve prognosis.

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