Spatio-temporal distribution of Colorectal Cancer incidence in Cordoba, Argentina

Abstract Purpose: To analyse the spatio-temporal distribution of CRC incidence in Cordoba and its association with the level of urbanisation in Argentina (2004-2014). Methods: An ecological time-series study using data from an 11years (2004-2014) was conducted. Age-standardised incidence rates (ASIR) (standard national and world population) by sex were calculated for the province and 26 counties for CRC in Cordoba using the provincial tumour registry database. Joinpoint regression models were adjusted to provincial ASIRs. Counties’ ASIRs were mapped in quintiles. The counties were grouped into three strata according to urbanisation: High (n1=6, >107,000 inhabitants); Intermediate (n2=13, 33,000-107,000 inhabitants); and Low (n3=7, <33,000 inhabitants). Spatio-temporal correlation analysis of counties’ rates was fulfilled using the multilevel modelling strategy. Results: ASIRs of CRC in Cordoba province were 30.9 ±1.5 and 24.3 ±1.5 cases/100,000 for men and women, respectively. During 2004-2014, ASIRs tended to decrease (annual per cent change: -0.6; CI95% -1.8, 0.6). Maps reflected different geospatial patterns by sex. CRC incidence in males was higher than in females in all strata (high urbanisation, IRR: 1.66; intermediate, IRR: 1.59; and low, IRR: 1.70). There was a significant downward temporary variation in the most populous counties (3% per year). Conclusions: CRC presents a non-random spatial pattern across the territory with a decreasing temporal variation in the most populous counties. Differential incidence and temporospatial tendency burden in Cordoba involve sex and urbanisation. Men continue to be the population at greatest risk; this pattern is more noticeable in less urban settings.