Materiały źródłowe

• #1 Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6791134/

  According to GLOBOCAN 2018 data, colorectal cancer (CRC) is the third most deadly and fourth most commonly diagnosed cancer in the world. Nearly 2 million new cases and about 1 million deaths are expected in 2018. CRC incidence has been steadily rising worldwide, especially in developing countries that are adopting the western way of life. […] The CRC is more incident among men than women and 34 times more common in developed than in developing nations. Age-standardised (world) incidence rates per 100,000 of CRC in both sexes is 19.7, in males is 23.6, and in females is 16.3. […] The CRC is the second most deadly cancer worldwide, with about 881,000 deaths estimated for 2018. Colon cancer is the fifth most deadly cancer with 551,000 deaths projected for 2018, comprising 5.8% of all cancer deaths. Meanwhile, rectal cancer is the 10th most deadly, with 310,000 deaths, which constitutes 3.2% of all cancer deaths.

• #2 Colorectal cancer statistics | World Cancer Research Fund

  https://www.wcrf.org/preventing-cancer/cancer-statistics/colorectal-cancer-statistics/

  Colorectal (also known as bowel) cancer is the 3rd most common cancer worldwide. […] There were 1,926,425 new cases of colorectal cancer in 2022. […] The following table gives the top 5 countries by ASR for colorectal cancer incidence for both sexes combined. […] China, the US and Japan had the highest number of colorectal cancer cases in 2022. […] Hungary had the highest overall mortality rate from colorectal cancer in 2022, followed by Croatia.

• #3 Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6791134/

  The global burden of CRC is expected to increase by 60%, to over 2.2 million new cases and 1.1 million annual deaths, by the year 2030. This growth is expected as a product of the economic development of transitioning and low-to-medium-HDI nations, as well as generational changes in developed nations. […] Improvements in CRC treatment have led to decreases in CRC mortality in the second and third categories of nations, even in the face of increased incidence. A driver of greater survival has been the removal of polyps and other early detection efforts, such as colonoscopies, flexible sigmoidoscopies, computed tomography (CT) colonography, faecal immunochemistry, and faecal occult blood testing. […] Variations in survival within a nation can be race and status dependent. In the US, African Americans and Native Americans, underprivileged minorities often with less access to quality healthcare, pre-emptive screenings, and healthy foods, suffer lower survival among all stages of CRC.

• #4 Colorectal Cancer — Cancer Stat Facts

  https://seer.cancer.gov/statfacts/html/colorect.html

  Estimated New Cases in 2025 154,270. […] Estimated Deaths in 2025 52,900. […] % of All New Cancer Cases 7.6%. […] % of All Cancer Deaths 8.6%. […] The rate of new cases of colorectal cancer was 37.1 per 100,000 men and women per year. […] Colorectal cancer represents 7.6% of all new cancer cases in the U.S. […] In 2025, it is estimated that there will be 154,270 new cases of colorectal cancer and an estimated 52,900 people will die of this disease. […] Colorectal cancer is more common in men than women and among the non-Hispanic American Indian/Alaska Native population. […] For colorectal cancer, death rates increase with age. Colorectal cancer is the second leading cause of cancer death in the United States. […] The death rate was 12.9 per 100,000 men and women per year based on 2019-2023 deaths, age-adjusted.

• #5 Bowel cancer statistics | Cancer Research UK

  https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/bowel-cancer

  There are around 44,100 new bowel cancer cases in the UK every year, that’s around 120 every day (2017-2019). […] Bowel cancer is the 4th most common cancer in the UK, accounting for 11% of all new cancer cases (2017-2019). […] Bowel cancer incidence rates are projected to fall by 8% in the UK between 2023-2025 and 2038-2040. […] There are around 16,800 bowel cancer deaths in the UK every year, that’s 46 every day (2017-2019). […] Bowel cancer is the 2nd most common cause of cancer death in the UK, accounting for 10% of all cancer deaths (2017-2019). […] Mortality rates for bowel cancer and anal cancer combined are generally lower in people of non-White minority ethnicity, compared with the White ethnic group, in England and Wales (2017-2019). […] Bowel cancer mortality rates are projected to fall by 10% in the UK between 2023-2025 and 2038-2040. […] More than 1 in 2 (52.9%) people diagnosed with bowel cancer in England survive their disease for ten years or more, it is predicted (2013-2017). […] Bowel cancer survival has more than doubled in the last 50 years in the UK. […] 54% of bowel cancer cases in the UK are preventable.

• #6 Colorectal cancer statistics | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/colorectal/statistics

  Colorectal cancer is expected to be the 4th most commonly diagnosed cancer in Canada in 2024 (excluding non-melanoma skin cancers). It is the 2nd leading cause of death from cancer in men and the 3rd leading cause of death from cancer in women. […] It is estimated that in 2024: […] 25,200 Canadians will be diagnosed with colorectal cancer. This represents 10% of all new cancer cases in 2024. […] 9,400 Canadians will die from colorectal cancer. This represents 11% of all cancer deaths in 2024. […] 14,100 men will be diagnosed with colorectal cancer and 5,300 will die from it. […] 11,100 women will be diagnosed with colorectal cancer and 4,200 will die from it. […] On average, 69 Canadians will be diagnosed with colorectal cancer every day. […] On average, 26 Canadians will die from colorectal cancer every day.

• #7 Colorectal Cancer: Epidemiology, Risk Factors, and Prevention

  https://www.mdpi.com/2072-6694/16/8/1530

  According to the GLOBOCAN estimates provided by the International Agency for Research on Cancer (IARC), colorectal cancer (CRC) was the second most common cause of cancer-related death (after lung cancer) worldwide, with an estimated number of 935,173 deaths and an age-standardized mortality rate (ASMR) of 9.0 per 100,000 person-years in 2020. The highest ASMR of CRC was estimated for Europe (12.3), and the lowest one was reported for Africa (5.6) and the eastern Mediterranean region (EMRO) (5.3). The rates were almost comparable for other regions, including Oceana (9.3), Asia (8.6), Latin America (8.2), and North America (8.2). […] CRC was reported as the third most common cancer worldwide (after breast and lung cancers) in 2020. The number of new cases of CRC was estimated to be 1,931,590 with an age-standardized incidence rate (ASR) of 19.5 per 100,000 person-years. The highest ASRs were estimated for Europe (30.4), followed by Oceana (29.8) and North America (26.2). After Asia (17.6) and Latin America (16.6), EMRO (9.1) and Africa (8.4) had the lowest ASRs for CRC.

• #8

  https://fascrs.org/patients/diseases-and-conditions/a-z/screening-and-surveillance-for-colorectal-cancer

  Colorectal cancer is the third most common non-skin cancer, affecting men and women of all ethnic groups. Over 140,000 people will be diagnosed with colorectal cancer each year and more than 50,000 will die; the lifetime risk is 1 in 23 (4.4%) for men and 1 in 25(4.1%) for women. […] Colorectal cancer rarely causes symptoms in its early stages. […] Early cancers can be cured in up to 90% of cases with surgery. Once colorectal cancer causes bleeding, change in bowel habits, or abdominal pain, it has usually progressed to a more advanced stage where less than 50% of patients are cured. […] Colonoscopy is the gold standard for colorectal cancer screening. […] For people with no risk factors, screening starts at age 45. […] People who have precancerous polyps completely removed should have a colonoscopy every 3 to 5 years, depending on the size, type and number of polyps found. […] Most colorectal cancer patients should have a colonoscopy within 1 year of the removal of the cancer. […] Patients with Ulcerative Colitis or Crohns Disease for 8 or more years should have a colonoscopy with multiple biopsies every 1 to 2 years.

• #9 Epidemiology and risk factors for colorectal cancer – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-risk-factors-for-colorectal-cancer

  In the United States, CRC incidence rates had been declining by approximately 2 percent per year, but this rate of decline has slowed to approximately 1.2 percent per year in the period 2014 to 2018. Incidence rates in most other western countries have been stable or increased slightly during this period. By contrast, CRC incidence rates have rapidly increased in several areas historically at low risk, including Spain, and a number of countries within Eastern Asia and Eastern Europe. […] Death rates from CRC have declined progressively since the mid-1980s in the United States and in many other western countries. This improvement in outcome can be attributed, at least in part, to detection and removal of colonic polyps, detection of CRCs at an earlier stage, and more effective primary and adjuvant treatments.

• #10 Colorectal Cancer: Epidemiology, Risk Factors, and Prevention

  https://www.mdpi.com/2072-6694/16/8/1530

  There are discrepancies in the pattern of time trends in the incidence of CRC worldwide. Considering the estimated annual percentage changes (EAPCs) in the ASRs for CRC during recent decades, constant or even slightly declining trends have been reported for formerly high-risk (transitioned) countries, including Denmark, Sweden, Australia, Canada, and the USA. In contrast, transitioning countries with relatively low-risk of CRC, including Brazil, Costa Rica, Colombia, Kuwait, and India, have shown increasing trends in the ASRs for CRC during the last decades. […] According to the GLOBOCAN 2020 estimates, the number of new cases of CRC will increase from 1,931,590 in 2020 to 3,154,674 in 2040, worldwide, suggesting a 63.3% increase in the number of new CRC cases. The greatest changes were estimated for currently low-risk population regions, including Africa (95.0%), EMRO (92.0%), Latin America (74.0%), and Asia (70.8%).

• #11 Epidemiology and risk factors for colorectal cancer – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-risk-factors-for-colorectal-cancer

  The regional incidence of CRC varies globally. The highest incidence rates are in Australia and New Zealand, Europe, and North America, and the lowest rates are found in Africa and South-Central Asia. These geographic differences appear to be attributable to differences in dietary and environmental exposures, low socioeconomic status, and lower rates of CRC screening that are imposed upon a background of varying susceptibility. […] In the United States, the lifetime incidence of CRC in patients at average risk is approximately 4 percent. CRC incidence is higher in males than in females and in Black Americans than in White Americans. The incidence is also higher in patients with specific inherited conditions that predispose them to the development of CRC. […] A gradual shift toward right-sided or proximal colon cancers has been observed both in the United States and internationally with the greatest relative increase in incidence in cecal primaries. This change in the anatomic distribution of CRCs may be, in part, related to improvements in diagnosis and treatment, and increased screening with removal of adenomatous polyps in the distal colon.

• #12 Colorectal Cancer: Epidemiology, Risk Factors, and Prevention

  https://www.mdpi.com/2072-6694/16/8/1530

  Early-onset CRC (EOCRC) occurs in individuals younger than 50 years old. According to the GLOBOCAN estimates, there were 188,069 new cases of EOCRC, with an ASR of 2.9 per 100,000 person-years worldwide. The ASRs for EOCRC were 3.0 and 2.7 per 100,000 person-years in men and women, respectively. The highest ASRs for EOCRC were estimated for North America (6.1) and Oceania (5.3), while Africa (2.0), Asia (2.6), and Latin America (2.9) were reported as low-risk areas. Recent evidence suggested an increasing incidence rate for EOCRC in different populations, with greater changes in developing countries. […] Considering the available evidence on CRC risk factors, high-risk groups for CRC include individuals with a personal history of adenomatous polyps or CRC, a family history of CRC, those with hereditary CRC syndrome (e.g., FAP, HNPCC), those with a personal history of IBD, and a history of abdominal or pelvic radiation. Identifying the high-risk individuals/groups for CRC will help researchers and health policymakers to design targeted preventive methods and develop effective CRC control programs.

• #13 Epidemiology and risk factors for colorectal cancer – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-risk-factors-for-colorectal-cancer

  Age is a major risk factor for sporadic CRC. CRC is uncommon before the age of 40; the incidence begins to increase significantly between the ages of 40 and 50, and age-specific incidence rates increase in each succeeding decade thereafter. […] Although increasing age is a major risk factor for CRC, there is a global epidemiologic trend towards early onset colorectal cancer (EOCRC), or the diagnosis of CRC in people under the age of 50 years. Efforts to reduce the incidence and mortality of EOCRC include assessing for potential modifiable risk factors, identifying individuals eligible for earlier CRC surveillance, and promoting both clinician and patient awareness of the potential symptoms associated with CRC. […] The incidence of CRC is increasing in individuals under the age of 50 years while it is decreasing in older individuals in the United States and Western countries. In the United States, the proportion of new CRC cases among adults under the age of 55 years increased from 11 to 20 percent between 1995 and 2019.

• #14 Rectal Cancer: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/281237-overview

  Colon and rectal cancer is the third most common cancer in both females and males. The American Cancer Society (ACS) estimates that 107,320 new cases of colon cancer and 46,950 new cases of rectal cancer will occur in 2025. […] The incidence and epidemiology, etiology, pathogenesis, and screening recommendations are common to both colon cancer and rectal cancer. These areas are addressed together. […] The incidence of colorectal cancer has generally declined since the mid-1980s. The decrease has accelerated since 2000, thanks largely to greater use of screening. However, the overall trend is driven by older adults (who have the highest rates) and masks the situation in younger adults, who have experienced rising incidence rates since at least the mid-1990s. […] Currently, adults born circa 1990 have quadruple the risk of rectal cancer compared with those born circa 1950.

• #15 Epidemiology and risk factors for colorectal cancer – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-risk-factors-for-colorectal-cancer

  The reason(s) underlying EOCRC may be multifactorial, with contributions from genetic influences as well as environmental and lifestyle exposures. Possible risk factors for EOCRC include hereditary CRC syndromes, metabolic dysregulation, history of CRC in a first-degree relative, alcohol consumption, lack of regular use of NSAIDs, and vitamin D intake. […] Environmental and genetic factors can increase the likelihood of developing CRC. Although inherited susceptibility results in the most striking increases in risk, the majority of CRCs are sporadic rather than familial. These risk factors can be separated into those that confer a sufficiently high risk to alter recommendations for CRC screening, factors that may alter screening recommendations, and those that do not alter screening recommendations because they are thought to confer a small or uncertain magnitude of risk.

• #16 Epidemiology and risk factors for colorectal cancer – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-risk-factors-for-colorectal-cancer

  Factors that influence screening recommendations include hereditary CRC syndromes, personal or family history of CRC or adenomas, inflammatory bowel disease, and exposure to abdominal radiation therapy. […] Several specific genetic disorders, most of which are inherited in an autosomal-dominant fashion, are associated with a very high risk of developing colon cancer. Familial adenomatous polyposis (FAP) and Lynch syndrome (hereditary nonpolyposis colorectal cancer [HNPCC]) are the most common of the familial colon cancer syndromes, but together these two conditions account for only approximately 5 percent of CRC cases. […] Patients with a personal history of CRC or adenomatous polyps of the colon are at risk for the future development of colon cancer. In patients undergoing resection of a single CRC, metachronous primary cancers develop in 1.5 to 3 percent of patients in the first five years postoperatively.

• #17 Epidemiology and risk factors for colorectal cancer – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-risk-factors-for-colorectal-cancer

  There is a well-documented association between chronic ulcerative colitis and colonic neoplasia, with the extent, duration, and activity of disease being the primary determinants. Pancolitis confers a 5- to 15-fold increase in risk compared with the expected incidence in the general population. […] Cancer survivors who received abdominopelvic radiation therapy in childhood or as adults are at significantly increased risk of subsequent gastrointestinal neoplasms, the majority being CRC. […] Patients with cystic fibrosis (CF) have an elevated risk of CRC. The Cystic Fibrosis Foundation (CFF) has developed guidelines for CRC screening for adults with CF. […] The rising incidence of early onset CRC, particularly among those in the 40 to 49 year old age group, has prompted at least two groups to lower the recommended age of first screening. In 2018, the American Cancer Society issued a „qualified” recommendation to begin screening persons at average risk for CRC at age 45 years. In 2021, the United States Preventive Services Task Force changed its recommendation to include screening for CRC in adults starting at age 45.

• #18 Colorectal Cancer Screening and Surveillance in Individuals at Increased Risk | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0115/p111.html

  Individuals who have one first-degree relative with CRC or advanced adenoma diagnosed before 60 years of age, or two first-degree relatives diagnosed at any age, should be advised to start screening colonoscopy at 40 years of age or 10 years younger than the earliest diagnosis in their family, whichever comes first. Screening colonoscopy should be repeated every five years in these patients. […] Individuals with inflammatory bowel disease have a 5% lifetime incidence of CRC, which is responsible for 10% to 15% of deaths in those with inflammatory bowel disease. Screening for CRC should begin eight to 10 years after the onset of symptoms in individuals who have Crohn disease with colonic involvement or ulcerative colitis. Regular surveillance colonoscopy should be performed after initial colonoscopy every one to three years.

• #19 Epidemiology and risk factors for colorectal cancer – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-risk-factors-for-colorectal-cancer

  Black Americans, Native Americans, and Alaskan Native individuals have among the highest incidence and mortality rates for CRC of all racial and ethnic groups in the United States. In addition, CRCs occur at a younger age, as there is a higher frequency of CRC under age 50 in these populations. […] Most reports suggest that colonic adenomas and CRC both occur with increased frequency in acromegaly, particularly in those with uncontrolled disease. […] Renal transplantation, in association with long-term immunosuppression, has been linked with increased CRC risk. […] A number of clinical environmental and lifestyle factors are associated with a small and/or uncertain increased risk of CRC. Although many of these associations have been seen consistently in observational studies, the causal relationship of these associations is largely unproven.

• #20 Epidemiology and risk factors for colorectal cancer – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-risk-factors-for-colorectal-cancer

  Obesity is a risk factor for CRC. A systematic review and meta-analysis of data from 13 studies reported that a weight gain between early adulthood and midlife was associated with a modest but significant increase in the risk of CRC. […] Diabetes mellitus is associated with an elevated risk of CRC. A meta-analysis of 14 studies estimated that the risk of colon cancer among diabetics was approximately 38 percent higher than nondiabetics, and for rectal cancer it was 20 percent higher. […] Although the data are not entirely consistent, long-term consumption of red meat or processed meats appears to be associated with an increased risk of CRC, particularly for left-sided tumors. […] Cigarette smoking has been associated with increased incidence and mortality from CRC. A meta-analysis of 106 observational studies estimated that the risk of developing CRC was increased among cigarette smokers compared with those who never smoked.

• #21 Epidemiology and risk factors for colorectal cancer – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-risk-factors-for-colorectal-cancer

  An association between alcohol consumption and an increased risk of CRC has been observed in several studies. A meta-analysis concluded that, compared with never drinkers, there was a significant increase in risk of CRC for moderate and heavy drinkers, but not light drinkers. […] Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) may protect against the development of colonic adenomas and are associated with a decreased long-term risk of colorectal cancer. […] A substantial body of evidence supports a protective effect of aspirin and other NSAIDs on the development of colonic adenomas and cancer. […] A number of factors have been reported by at least some studies to be associated with a decreased risk of CRC. These include regular physical activity, a variety of dietary factors, the regular use of aspirin or NSAIDs, and hormone replacement therapy in postmenopausal females.

• #22 Epidemiology and risk factors for colorectal cancer – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-risk-factors-for-colorectal-cancer

  Substantial observational data and several systematic reviews have concluded that regular physical activity, either occupational or leisure time, is associated with protection from CRC. […] Many epidemiologic studies have shown an association between the intake of a diet high in fruits and vegetables and protection from CRC. […] A number of laboratory, nutritional, and epidemiologic studies have identified a role for dietary fiber in the pathogenesis of CRC. […] A number of studies have reported a protective effect of higher calcium intake on the risk of CRC. […] Vitamin D and its metabolites act as inhibitors of CRC progression in model systems by effects that influence both initiation and progression. […] Consumption of garlic has been associated with a reduced risk of colonic adenomas in some observational studies of patients with CRC and in laboratory studies.

• #23 UK Screening and Surveillance For Bowel Cancers – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK599509/

  Colorectal cancer is the fourth-deadliest cancer in the world and causes approximately 900,000 deaths annually. Early detection of colorectal cancer through effective screening programmes has the potential to reduce the incidence and mortality associated with the disease. Within the United Kingdom (UK) National Health Service (NHS), evidence-based screening and surveillance strategies aim to reduce morbidity and mortality secondary to colorectal cancer in asymptomatic and high-risk patients. […] The primary aim of disease surveillance is to reduce colorectal cancer incidence in patients at higher risk of disease by identifying and resecting de novo and missed polyps, thereby preventing their progression to cancer. The secondary aim of disease surveillance is to reduce mortality from bowel cancer.

• #24

  https://www.who.int/news-room/fact-sheets/detail/colorectal-cancer

  Colorectal cancer is the third most common cancer worldwide, accounting for approximately 10% of all cancer cases and is the second leading cause of cancer-related deaths worldwide. […] The incidence and impact of colorectal cancer can be significantly reduced by implementing primary prevention strategies such as adopting a healthy lifestyle, avoiding risk factors, and practicing early detection through screening. […] Regular screenings are crucial for early detection. […] Incidence rates of colorectal cancer have been decreasing in high-income countries, largely as a result of effective screening programmes. […] Regular screening for colorectal cancer (secondary prevention) is the best way to catch the disease early. […] Studies have shown that screening can reduce both the incidence and mortality of colorectal cancer through early detection and removal of precancerous growths. […] After treatment, regular follow-up visits and surveillance are essential to monitor for any signs of recurrence or new cancer. […] The WHO is actively involved in addressing the global burden of colorectal cancer and implementing strategies to reduce its impact.

• #25 UK Screening and Surveillance For Bowel Cancers – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK599509/

  Approximately 43,000 people are diagnosed with bowel cancer annually in the UK. The incidence of colorectal cancer increases with age; most patients newly diagnosed with colorectal cancer are aged 60 years or older. Colorectal cancer survival rates vary with age at diagnosis, gender, ethnicity, and socioeconomic status but are most heavily dictated by stage at diagnosis. The 5-year survival rate for the earliest stage (Dukes A) of colorectal cancer is 85%, whereas for the latest stage (Dukes D), it is 10%. Despite the efforts of the NHS, in England, there is a reported 7% to 10% difference in the 1-year relative survival rates for colorectal cancer between the most affluent and deprived populations. […] Each of the 4 nations in the UK has a slightly different screening programme. Screening is recommended for different age groups within each nation. The recommended age-based screening brackets are: England: between 60 and 74 years of age; currently expanding to include individuals between 50 and 59 years of age; Northern Ireland: between 60 and 74 years of age; Scotland: between 50 and 74 years of age; Wales: between 51 and 74 years of age.

• #26 Recommendation: Colorectal Cancer: Screening | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening

  This recommendation applies to asymptomatic adults 45 years or older who are at average risk of colorectal cancer (ie, no prior diagnosis of colorectal cancer, adenomatous polyps, or inflammatory bowel disease; no personal diagnosis or family history of known genetic disorders that predispose them to a high lifetime risk of colorectal cancer [such as Lynch syndrome or familial adenomatous polyposis]). […] The USPSTF recommends offering colorectal cancer screening starting at age 45 years. […] The USPSTF recognizes the higher colorectal cancer incidence and mortality in Black adults and strongly encourages clinicians to ensure their Black patients receive recommended colorectal cancer screening, follow-up, and treatment. […] The USPSTF continues to conclude that screening in adults aged 76 to 85 years should be an individual decision and screening should be discontinued after age 85 years.

• #27 UK Screening and Surveillance For Bowel Cancers – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK599509/

  The National Institute for Health and Care Excellence in the UK (NICE UK) provides recommendations for surveillance following surgical management with curative intent for colorectal cancer. These surveillance recommendations comprise serum carcinoembryonic antigen (CEA) testing every 6 months for 3 years, computed tomography (CT) scans at 1 and 2 years, and colonoscopy at 1 and 3 years.

• #28

  https://fascrs.org/patients/diseases-and-conditions/a-z/screening-and-surveillance-for-colorectal-cancer-e

  Most patients who have a colorectal cancer removed surgically should have a colonoscopy within one year. If the whole colon could not be examined prior to surgery, then colonoscopy should be done within 3-6 months after surgery. If this first surveillance is normal, then follow-up colonoscopy should be done every 3-5 years. The risk of developing another colorectal cancer is estimated to be about 0.3% per year.

• #29 New research sheds light on ongoing bowel cancer surveillance needs – NIHR Imperial Biomedical Research Centre

  https://imperialbrc.nihr.ac.uk/2025/04/30/new-research-sheds-light-on-ongoing-bowel-cancer-surveillance-needs/

  The findings strongly support the 2020 UK post-polypectomy surveillance guidelines, which recommend stopping surveillance in patients with low-risk findings at the first surveillance colonoscopy. However, the study challenges more conservative approaches in the current European post-polypectomy surveillance guidelines, which recommend that patients continue surveillance until they have two consecutive surveillance colonoscopies at which low-risk findings are detected. […] These findings could reduce the number of unnecessary colonoscopies, lessening the burden on healthcare systems and sparing patients from invasive procedures they may not need. […] The study not only supports current UK policy but offers a case for revisiting surveillance recommendations elsewhere in the worldpotentially leading to a more evidence-based approach to bowel cancer prevention.

• #30 Guidelines for the management of hereditary colorectal cancer from the British Society of Gastroenterology (BSG)/Association of Coloproctology of Great Britain and Ireland (ACPGBI)/United Kingdom Cancer Genetics Group (UKCGG) | Gut

  https://gut.bmj.com/content/69/3/411

  We recommend that colonoscopy is the gold standard diagnostic and preventative method of surveillance for people with a hereditary risk of CRC. […] We recommend that all surveillance colonoscopies are performed by endoscopists who consistently achieve BSG colonoscopy KPI minimum standards, specifically caecal intubation rate, adenoma/polyp detection rate and comfort score. […] We recommend that for all people when first diagnosed with CRC, testing using immunohistochemistry (IHC) for MMR proteins or microsatellite instability is used to identify tumours with deficient DNA MMR, and to guide further sequential testing for LS. […] We recommend that colonoscopic surveillance should be performed at a 2 yearly interval for all LS patients. […] We recommend that age of onset of surveillance colonoscopy should be stratified according to the LS-associated gene. We recommend colonoscopy from age 25 years for MLH1 and MSH2 mutation carriers and 35 years for MSH6 and PMS2 mutation carriers.

• #31 Guidelines for the management of hereditary colorectal cancer from the British Society of Gastroenterology (BSG)/Association of Coloproctology of Great Britain and Ireland (ACPGBI)/United Kingdom Cancer Genetics Group (UKCGG) | Gut

  https://gut.bmj.com/content/69/3/411

  We recommend that gastric, small bowel, or pancreatic surveillance in LS patients is only performed in the context of a clinical trial. […] We recommend screening for H. pylori in patients with LS and subsequent eradication therapy if indicated. […] We recommend that individuals with LS should be advised that regular use of daily aspirin reduces CRC risk. […] We recommend that individuals at increased familial risk of CRC should be strongly encouraged not to smoke, to maintain a normal body mass index (BMI), to moderate their consumption of red and processed meat, and to exercise regularly. […] We recommend that individuals with LS should be offered research opportunities to take aspirin daily at different dosages. […] We recommend that for patients with FAP who are undergoing colonoscopic surveillance, relative indications for surgery are: polyps 10mm in diameter, high grade dysplasia within polyps and a significant increase in polyp burden between screening examinations.

• #32 Guidelines for the management of hereditary colorectal cancer from the British Society of Gastroenterology (BSG)/Association of Coloproctology of Great Britain and Ireland (ACPGBI)/United Kingdom Cancer Genetics Group (UKCGG) | Gut

  https://gut.bmj.com/content/69/3/411

  We recommend that colonic surveillance should normally commence age 12-14 years in those confirmed to have FAP on predictive genetic testing. […] We recommend upper GI surveillance for FAP patients starting at age 25 years. […] We recommend that colorectal surveillance is commenced in MAP starting at the age of 18-20 years. If surgery is not undertaken then annual surveillance is suggested. […] We recommend that for monoallelic MUTYH pathogenic variant carriers, the risk of CRC is not sufficiently different to population risk to meet thresholds for screening, and routine colonoscopy is not recommended. […] We suggest that in an asymptomatic patient with PJS, GI surveillance by upper GI endoscopy, colonoscopy and video capsule endoscopy commence at the age of 8 years. […] We suggest elective polypectomy to prevent polyp related complications. Small bowel polyps greater than 1.5-2cm in size (or smaller if symptomatic) should be considered for elective resection to prevent intussusception. […] We suggest colonoscopic surveillance should commence from the age of 15 years or earlier if symptomatic. The surveillance interval should be 1-3 yearly, personalised according to colorectal phenotype.

• #33

  https://fascrs.org/patients/diseases-and-conditions/a-z/screening-and-surveillance-for-colorectal-cancer-e

  Like other serious, common medical problems such as high blood pressure and diabetes, colorectal cancer is considered to be a silent disease in its early stages. Large studies done both in the United States and in Europe have shown that routine colonoscopy with the removal of polyps may reduce the incidence of colorectal cancer by about 75%. […] Surveillance refers to the process of evaluating patients with a personal history of polyps or cancer. People who have precancerous polyps completely removed should have a colonoscopy every 3-5 years, depending on the size and number of polyps found. If there are 1-2 polyps 1 cm in size (~1/2 inch), then another colonoscopy in 5 years is appropriate. Colonoscopy at 3 years is recommended for patients with 3-4 polyps 1 cm in size or one polyp 1 cm. If there are 5 or more small or 3 or more larger polyps, then follow-up in one year is recommended. Findings on subsequent colonoscopies will determine the next follow-up interval; in general, the time between colonoscopies may be increased if fewer or no polyps are found.

• #34 Post-treatment surveillance for colorectal cancer – UpToDate

  https://www.uptodate.com/contents/post-treatment-surveillance-for-colorectal-cancer

  Colorectal cancer (CRC) is a common malignancy. Despite receiving potentially curative primary therapy, more than 40 percent of patients who present with stage II or III disease will experience disease recurrence. […] Intensive postoperative surveillance programs have been justified in the hope that early detection of asymptomatic recurrences will increase the proportion of patients who are potentially eligible for curative therapy. A survival benefit from such an approach has in fact been shown in several meta-analyses. Furthermore, periodic imaging can detect early, potentially resectable recurrences. […] There are no data available to guide post-treatment surveillance in patients with resected stage I colon or rectal cancer, and the recommendations of expert groups are variable. Consistent with updated American Society of Clinical Oncology (ASCO) guidelines, we do not pursue any post-treatment surveillance strategy for most asymptomatic patients with resected stage I colorectal cancer (CRC), with the exception of interval colonoscopy.

• #35 Recommendation: Colorectal Cancer: Screening | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening

  Colorectal cancer is the third leading cause of cancer death for both men and women, with an estimated 52,980 persons in the US projected to die of colorectal cancer in 2021. Colorectal cancer is most frequently diagnosed among persons aged 65 to 74 years. It is estimated that 10.5% of new colorectal cancer cases occur in persons younger than 50 years. Incidence of colorectal cancer (specifically adenocarcinoma) in adults aged 40 to 49 years has increased by almost 15% from 2000-2002 to 2014-2016. In 2016, 25.6% of eligible adults in the US had never been screened for colorectal cancer and in 2018, 31.2% were not up to date with screening. […] The USPSTF concludes with high certainty that screening for colorectal cancer in adults aged 50 to 75 years has substantial net benefit. The USPSTF concludes with moderate certainty that screening for colorectal cancer in adults aged 45 to 49 years has moderate net benefit. The USPSTF concludes with moderate certainty that screening for colorectal cancer in adults aged 76 to 85 years who have been previously screened has small net benefit. Adults who have never been screened for colorectal cancer are more likely to benefit.

• #36 Colorectal Cancer — Cancer Stat Facts

  https://seer.cancer.gov/statfacts/html/colorect.html

  The percent of colorectal cancer deaths is highest among people aged 65-74. […] Keeping track of new cases, deaths, and survival over time (trends) can help scientists understand whether progress is being made and where additional research is needed to address challenges, such as improving screening or finding better treatments. […] Using statistical models for analysis, age-adjusted rates for new colorectal cancer cases have been falling on average 0.7% each year over 2013-2022. Age-adjusted death rates have been falling on average 1.3% each year over 2014-2023.

• #37 Colorectal cancer statistics | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/colorectal/statistics

  The rate of new cases of colorectal cancer is declining in men and women. The recent declines are likely due in part to the increased use of colorectal cancer screening, which can identify and remove precancerous polyps, which can in turn reduce incidence. […] Death rates have also been declining. Most of this decline is likely because of fewer new cases as well as by improved diagnosis and treatment. […] It is estimated that about 1 in 16 Canadian men will develop colorectal cancer during their lifetime and 1 in 38 will die from it. […] It is estimated that about 1 in 18 Canadian women will develop colorectal cancer during their lifetime and 1 in 43 will die from it.

• #38 Lower screening age calls for more tailored bowel cancer surveillance | ScienceDaily

  https://www.sciencedaily.com/releases/2025/04/250430142954.htm

  The study revealed that a significant percentage of participants — 54.1% of younger adults and 58.1% of older adults — preferred more frequent colonoscopies than current guidelines suggest indicating a clear demand for increased monitoring among those at risk. […] Senior researcher Associate Professor Erin Symonds says that as early-onset bowel cancer continues to increase, this study reinforces the urgent need to adapt and update surveillance strategies to suit younger adults. […] „Traditional guidelines often do not address the specific concerns and preferences of this demographic, which is becoming increasingly significant as screening eligibility ages are lowered,” says Associate Professor Symonds.

• #39 Earlier Screening Age Highlights Need for Personalized Bowel Cancer

  https://bioengineer.org/earlier-screening-age-highlights-need-for-personalized-bowel-cancer-surveillance/

  This psychological component prompts a reconsideration of care delivery, emphasizing the necessity for healthcare providers to integrate emotional and cognitive factors when advising younger individuals at risk, thus fostering a more empathetic and tailored surveillance approach. […] From a clinical perspective, incorporating FIT into colorectal cancer surveillance holds promise beyond patient preference. […] Such a precision-medicine-inspired approach aligns with emerging healthcare paradigms aiming to optimize screening efficacy, patient adherence, and cost-effectiveness while mitigating system-wide pressures on endoscopy services. […] The strategic integration of FIT with traditional colonoscopy surveillance echoes a growing recognition that rigid, one-size-fits-all guidelines are insufficient in addressing nuanced patient populations, especially as screening eligibility expands to younger cohorts.

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