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. […] According to GLOBOCAN 2018 data, cancer of the colon is the fourth most incident cancer in the world, while cancer of the rectum is the eighth most incident. Together, CRCs are the third most commonly diagnosed form of cancer globally, comprising 11% of all cancer diagnoses. […] 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.

• #2 Concise update on colorectal cancer epidemiology

  https://atm.amegroups.org/article/view/27916/html

  The cumulative risk of dying for colorectal cancer is 0.92% between 074 years (1.14% in men and 0.72% in women, respectively). […] The leading risk factors include familial history, pre-cancerous conditions, tall stature, physical inactivity, overweight, large intake of alcoholic beverages, high consumption of red or processed meat, as well as modest intake of dairy products and foods containing wholegrains or dietary fibre. […] The association between colorectal cancer and human development index suggests that reinforcement or timely establishment of preventive measures and accurate screening programs may be advisable, especially in countries undergoing considerable societal and economic changes. […] The incidence of colorectal cancer is higher in Australia and New Zealand (36.7 cases per 100,000), followed by Europe (28.8-32.1 cases per 100,000), Eastern Asia (26.5 cases per 100,000) and North America (26.2 cases per 100,000), whilst is the lowest in Africa (6.4-9.2 cases per 100,000) and South-Central Asia (4.9 cases per 100,000).

• #3 Colorectal Cancer Statistics | How Common Is Colorectal Cancer? | American Cancer Society

  https://www.cancer.org/cancer/types/colon-rectal-cancer/about/key-statistics.html

  Excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in both men and women in the United States. […] The American Cancer Society’s estimates for the number of colorectal cancers in the United States for 2025 are: About 107,320 new cases of colon cancer (54,510 in men and 52,810 in women) […] The rate of people being diagnosed with colon or rectal cancer has dropped overall since the mid-1980s, mainly because more people are getting screened and changing their lifestyle-related risk factors. […] Overall, the lifetime risk of developing colorectal cancer is about 1 in 24 for men and 1 in 26 for women. […] In the United States, colorectal cancer is the third-leading cause of cancer-related deaths in men and the fourth leading cause in women, but it’s the second most common cause of cancer deaths when numbers for men and women are combined. It’s expected to cause about 52,900 deaths during 2025. […] The death rate from colorectal cancer has been dropping in older adults for several decades. […] In people under 55, however, death rates have been increasing about 1% per year since the mid-2000s.

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

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

  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. […] The relation between trends in CRC incidence and mortality can be characterised into three distinct global categories. […] 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. […] 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. […] 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.

• #5 Colon Cancer: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/277496-overview

  Estimates for mortality from colon and rectal cancer (the two are combined because of classification difficulties) are for 52,900 deaths in 2025. […] Worldwide, colon cancer was the fourth most common cancer, with an estimated 1,142,286 million new cases in 2022, and the fifth most common cause of cancer mortality, with 538,167 deaths. […] Geographically, the incidence varies as much as 10-fold. […] The highest estimated rates are in AustraliaNew Zealand, Europe, and Northern America, and the lowest in south-central Asia and middle Africa. […] Mortality rates worldwide vary six-fold, with the highest estimated mortality rates in southern and eastern Europe and the lowest in south-central Asia and middle Africa. […] An epidemiologic study from the European Union (EU) concluded that in 2018, colorectal cancer would account for the second highest number of cancer deaths, at 98,000 deaths in men and 79,400 in women.

• #6 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. […] 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. […] The rate of new cases of colorectal cancer was 37.1 per 100,000 men and women per year based on 20182022 cases, age-adjusted. […] 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 20192023 deaths, age-adjusted. […] Using statistical models for analysis, age-adjusted rates for new colorectal cancer cases have been falling on average 0.7% each year over 20132022. Age-adjusted death rates have been falling on average 1.3% each year over 20142023.

• #7 Colon Cancer: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/277496-overview

  The incidence and mortality from colon cancer have been on a slow decline over the past several decades in the United States, with the incidence falling on average 2.4% each year and death rates falling on average 2.2% each year over 2007-2019. […] However, the overall decline has been driven by a decreasing incidence in individuals age 65 years and older; rates have stabilized in those age 55-64 and have increased by 1% to 2% per year since the mid-1990s in those younger than 55 years of age. […] Colorectal cancers remain the third most common cancer in US men and women, the third most common cause of cancer-related mortality in US men, and the fourth most common cause of cancer-related mortality in women. […] The American Cancer Society estimates that 107,320 new cases of colon cancer will be diagnosed in the United States in 2025.

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

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

  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. […] 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.

• #9 Colon Cancer: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/2500006-overview

  However, while the total number of colorectal deaths in the EU has risen since 2012 because of the aging population, since 2012 the age-standardized death rate has fallen by 6.7% (to 15.8 per 100,000 in men and 7.5% (to 9.2 per 100,000) in women. […] A study by Sung et al that examined colorectal cancer incidence trends in younger adults versus older adults in 50 countries and territories found that from 2013 to 2017, early-onset colorectal cancer (diagnosed at ages 25 to 49 years) increased in 27 countries.

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

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

  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. […] 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.

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

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

  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. […] Family history is also an important risk factor even outside of the syndromes with a defined genetic predisposition. Having a single affected first-degree relative with CRC increases the risk approximately twofold over that of the general population. Risk is further increased if two first, or one first and one or more first or second-degree relatives on either side of the family have colon cancer, or if a first-degree relative is diagnosed below 50 years of age. […] 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, while disease that is limited to the left side of the colon is associated with approximately a threefold relative risk.

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

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

  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. In a meta-analysis, the pooled standardized incidence ratio was 10.91, 95% CI 8.42-14.11, and it was two- to fivefold higher following lung transplantation. […] 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.

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

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

  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. […] 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.

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

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

  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. […] 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. […] Specific types of diets may reduce the risk of CRC. Despite the uncertainty, a protective diet can be defined for clinical purposes to include avoidance of processed and charred red meat, inclusion of vegetables, and an adequate amount of folate intake from food.

• #15 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. […] The association between the risk of CRC with low physical activity or sedentary lifestyle was reported in different populations. The results of a study on data from the Asia-Pacific Cohort Studies Collaboration suggested that any physical activity was associated with 0.25 to 0.30 reduction in the hazard of CRC mortality. The inverse association between physical activity and CRC incidence was suggested by several observational studies with RR reduction of 0.30 to 0.50 and similar findings in men and women.

• #16 Colorectal cancer – Wikipedia

  https://en.wikipedia.org/wiki/Colorectal_cancer

  In people who have ulcerative colitis, approximately 16% develop either a cancer precursor or cancer of the colon over 30 years. […] It has been estimated that about half of colorectal cancer cases are due to lifestyle factors, and about a quarter of all cases are preventable. […] Increasing surveillance, engaging in physical activity, consuming a diet high in fiber, quitting smoking and limiting alcohol consumption decrease the risk. […] As more than 80% of colorectal cancers arise from adenomatous polyps, screening for this cancer is effective for both early detection and prevention. […] Diagnosis of cases of colorectal cancer through screening tends to occur 23 years before diagnosis of cases with symptoms. […] Screening has the potential to reduce colorectal cancer deaths by 60%.

• #17 Colorectal Cancer Overview – American Association for Cancer Research

  https://www.aacr.org/patients-caregivers/cancer/colorectal-cancer/

  Colon cancer is cancer that forms in the tissues of the first part of the large intestine. […] Among the most common forms of cancer diagnosed in the United States, an estimated 154,270 people in the United States are expected to be diagnosed with these cancers and 52,900 are expected to die of these diseases in 2025, according to the National Cancer Institute. […] Screening for colorectal cancer, the second leading cause of cancer death in the United States, by colonoscopy can both detect these cancers at an early stage, when successful treatment is more likely, and prevent them from developing in the first place, by detecting and removing precancerous polyps during colonoscopy. […] Although colonoscopy has been found to cut the risk of dying from colorectal cancer in half, over a quarter of Americans are not up to date on screenings for this disease, according to a U.S. Centers for Disease Control and Prevention analysis. Current guidelines recommend that individuals with an average risk of colorectal cancer begin screenings at age 45. Those with a higher risk of colorectal cancer may be recommended to begin screenings earlier. Risk factors for colorectal cancer include family history, certain hereditary conditions, ulcers in the lining of the large intestine, and a personal history of polyps in the colon or rectum.

• #18

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

  Colonoscopy is the gold standard for colorectal cancer screening. […] Colonoscopy is considered the optimal method of screening in order to visualize the entire colon. […] For people with no risk factors, screening starts at age 45. […] People with a close relative (parent or sibling) with colorectal cancer or polyps will start screening at age 40, or 10 years before the youngest age at which a relative was diagnosed. […] 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.

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

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

  Most organizations recommend screening average-risk individuals for CRC beginning at 50 years of age. […] However, it is recommended that persons at increased risk of CRC undergo more frequent or earlier testing. […] This includes individuals with a personal or family history of advanced adenomas or CRC, a personal history of inflammatory bowel disease, a risk of hereditary nonpolyposis colorectal cancer (HNPCC), or genetic polyposis syndromes. […] Currently, all organizations and guidelines recommend colonoscopy for screening or surveillance in individuals at increased risk of CRC. […] However, a recent meta-analysis reviewed the diagnostic accuracy of the fecal immunochemical test (FIT) for screening individuals who are at increased risk of CRC and found that FIT has good diagnostic accuracy for CRC (sensitivity = 93%; specificity = 91%; positive likelihood ratio = 10.30; negative likelihood ratio = 0.08).

• #20 Screening and Surveillance of Colorectal Cancer: A Review of the Literature

  https://www.mdpi.com/2072-6694/16/15/2746

  Guidelines on colorectal screening have been issued by several organizations, such as the American Cancer Society (ACS), the U.S. Preventive Services Task Force (USPSTF), the American College of Physicians (ACP), and the American College of Gastroenterology (ACG). […] Colonoscopy screening had a higher benefit in terms of preventing colorectal cancer when compared to sigmoidoscopy, preventing 12 (95% CI, 10–14) colorectal cancer cases and four (95% CI, 3–5) colorectal cancer-related deaths as compared to sigmoidoscopy per 100,000 person-years. […] The primary quality indicator for colonoscopy (depending on the performance of the endoscopist) is the adenoma detection rate (ADR). It is defined as the proportion of screening colonoscopies detecting at least one adenoma; ideally, it should be at least 25%.

• #21 Surveillance and Survivorship after Treatment for Colon Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4655110/

  Colorectal cancer is the third most common cancer diagnosed in the United States. Majority of patients have localized disease that is amenable to curative resection. Disease recurrence remains a major concern after resection. In addition, patients are at an increased risk for developing a second or metachronous colon cancer. The principal goal of surveillance following treatment of colon cancer is to improve disease-free and overall survival. Survivorship is a distinct phase following surveillance to help improve quality of life and promote longevity. […] The main goal of surveillance is to improve overall survival by detecting recurrences in the asymptomatic stage when radical surgical treatment could still be a viable option. Other potential benefits include the identification of metachronous colorectal cancers, monitoring outcomes, psychological support, and identifying treatment complications and related medical issues.

• #22 Surveillance and Survivorship after Treatment for Colon Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4655110/

  Since more than 500,000 patients undergo postoperative follow-up after treatment for colorectal cancer in the United States, it is important to outline appropriate surveillance strategies for colon cancer surveillance. […] The follow-up after colorectal surgery (FACS) randomized clinical trial by Primrose et al, recently published, confirmed previous data that intensive follow-up increases the likelihood of detecting early recurrences that can be treated with curative intent. […] The results from the FACS trial confirm the importance of frequent follow-up surveillance post treatment of colon cancer regardless of the stage. […] Surveillance colonoscopies are primarily done to detect and remove metachronous polyps and cancers. The secondary goal is to identify local recurrences at the anastomosis at a stage that can allow curative resection.

• #23 Surveillance and Survivorship after Treatment for Colon Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4655110/

  Currently, recommendations for colon cancer surveillance post-curative surgery and after completion of adjuvant chemotherapy are based on analysis from randomized trials showing 80% of the recurrences occurring in the first 3 years postsurgical resection and another study showing 95% recurrence in the first 5 years. […] Surveillance following colorectal cancer treatment is essential to ensure early detection of cancer recurrence. Survivorship should be considered as a distinct phase of colorectal cancer treatment where a multimodality approach is used to improve the quality of life and disease-free survival and decrease overall mortality.

• #24 Colorectal Cancer Screening and Surveillance | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0115/p93.html

  If colorectal cancer is found during colonoscopy, the remainder of the colon should be viewed proximal to the cancer before surgery. After curative resection of the cancer, patients should undergo colonoscopy one, three, and five years after the initial colonoscopy if findings on these surveillance colonoscopies remain normal. […] Adherence to surveillance guidelines is variable with reports of overutilization in low-risk groups and underutilization in high-risk groups. Following evidence-based guidelines can help reduce the cost and risk of unnecessary procedures, and prevent cancer in high-risk individuals.

• #25 Colorectal Cancer Screening and Surveillance | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0115/p93.html

  Colorectal cancer is the third most common cancer in men and women. The incidence and mortality rate of the disease have been declining over the past two decades because of early detection and treatment. Screening in persons at average risk should begin at 50 years of age; the U.S. Preventive Services Task Force recommends against routine screening after 75 years of age. Options for screening include high-sensitivity fecal occult blood testing annually, flexible sigmoidoscopy every five years with high-sensitivity fecal occult blood testing every three years, or colonoscopy every 10 years. […] In 2012, the U.S. Multi-Society Task Force on Colorectal Cancer updated its surveillance guidelines to promote the appropriate use of colonoscopy resources and reduce harms from delayed or unnecessary procedures; these guidelines provide recommendations for when to repeat colonoscopy based on findings. Adenomatous and serrated polyps have malignant potential and warrant early surveillance colonoscopy. Patients with one or two tubular adenomas that are smaller than 10 mm should have a repeat colonoscopy in five to 10 years. Repeat colonoscopy at five years is recommended for patients with nondysplastic serrated polyps that are smaller than 10 mm. Patients with three to 10 adenomas found during a single colonoscopy, an adenoma or serrated polyp that is 10 mm or larger, an adenoma with villous features or high-grade dysplasia, a sessile serrated polyp with cytologic dysplasia, or a traditional serrated adenoma are at increased risk of developing advanced neoplasia during surveillance and should have a repeat colonoscopy in three years. More than 10 synchronous adenomas warrant surveillance colonoscopy in less than three years. Colonoscopy may be repeated in 10 years if distal, small (less than 10 mm) hyperplastic polyps are the only finding.

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

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

  Therefore, screening with FIT may be an option in individuals at increased risk of CRC who decline colonoscopy. […] 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. […] HNPCC, formerly called Lynch syndrome, is characterized by an increased risk of CRC and other malignancies, namely endometrial cancer. […] It accounts for 2% to 4% of all cases of CRC, and the lifetime risk of CRC in persons with HNPCC is 75% to 80%.

• #27 Data and Progress – American Cancer Society National Colorectal Cancer Roundtable

  https://nccrt.org/our-impact/data-and-progress/

  Colorectal cancer is the second leading cause of cancer death in the U.S. when men and women are combined, but it doesn’t have to be. Few preventive interventions are as reliably effective in reducing avoidable death as screening for colorectal cancer. […] Colorectal cancer incidence and mortality rates have dropped by over 30% in the U.S. among adults 50 and older in the last fifteen years, with a substantial fraction of these declines due to screening. Declines in CRC incidence and mortality have slowed from 3%-4% per year during the 2000s to 1% per year and 2% per year, respectively, during the past decade. […] Significant disparities in colorectal cancer screening, incidence, and mortality persist by socioeconomic status, race/ethnicity, geography, and other factors. In addition, recent research indicates colorectal cancer incidence rates are rising in young and middle-aged adults.

• #28 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. Guidelines from the Acromegaly Consensus Group recommend colonoscopy for early detection and treatment of premalignant colonic polyps at the time of diagnosis. […] Renal transplantation, in association with long-term immunosuppression, has been linked with increased CRC risk. In general, cancer rates in kidney transplant recipients are similar to those of non-transplanted individuals 20 to 30 years older.

• #29 Resources and Publications – Cancer Surveillance Program

  https://csp.usc.edu/resources-and-publications/

  Colon cancer is the third most commonly diagnosed cancer for both men and women in Los Angeles County. Over 2,700 people are newly diagnosed with colon cancer every year in Los Angeles County. Colon cancer occurs most commonly in the older population with an incidence rate of 45 per 100,000 for 50-64 year olds and 163 per 100,000 for 65+ year olds. Due to active screening for those 50 years of age or older, localized disease is more common in the older population, but younger patients are more frequently diagnosed with distant disease for whom screening recommendations are lacking. Non-Hispanic Blacks experience the worst burden of colon cancer as they have the highest incidence rate, highest proportion of distant disease and the highest rate of mortality. Compared to Non-Hispanic Whites, Non-Hispanic Blacks have 30% higher risk of being diagnosed with colon cancer and 60% higher risk of dying from colon cancer. Hispanics and most Asians/Pacific Islanders have lower incidence and lower mortality than non-Hispanic Whites. Hawaiian/Samoans are the exception with incidence rates 50% higher than Non-Hispanic Whites. Incidence rates of this cancer have steadily declined since 2000, most notably among Non-Hispanic Blacks and for localized and regional diseases, but not among Hispanics. Mortality rates have also declined significantly for those over 65 years of age, but have remained stable for the other age groups. Risk for colon cancer is increased with an excess weight, sedentary lifestyle, red meat consumption, smoking, and alcohol intake. Those with family history of colon cancer or adenomatous polyps, Lynch syndrome and inflammatory bowel disease are also at elevated risk of colon cancer.

• #30 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%). The estimated changes in the number of new CRC cases are considerably lower in very-high-HDI countries (35.0%) compared to countries with low (10.2.6%), medium (72.1%), and high HDIs (67.9%).

• #31 Screening and Surveillance of Colorectal Cancer: A Review of the Literature

  https://www.mdpi.com/2072-6694/16/15/2746

  Colorectal cancer (CRC) is a significant health issue, being the third most common cancer and the second leading cause of cancer deaths worldwide. Most CRC cases are diagnosed at an advanced stage, especially in symptomatic patients, highlighting the need for effective early detection methods. […] This study aims to review existing research on the effectiveness of various CRC screening methods. Early detection through screening significantly improves survival rates, making it crucial for better health outcomes. […] Colorectal cancer (CRC) has the highest mortality rate among men and is the second highest among women under fifty, with incidence and mortality rates rising in younger populations. […] In recent years, mortality rates of CRC in Western countries have been on a steady decline, which is largely attributed to widespread screening programs and advancements in treatment modalities.

• #32 U.S. Cancer Statistics Colorectal Cancer Stat Bite | U.S. Cancer Statistics | CDC

  https://www.cdc.gov/united-states-cancer-statistics/publications/colorectal-cancer-stat-bite.html

  Based on the most recent data available, in the United States in 2021, 141,902 new colorectal cancers were reported and in 2022, 52,967 people died from colorectal cancer. […] Males had higher rates than females of getting and dying from colorectal cancer. […] From 2017 to 2021, about 1 in 3 colorectal cancer cases were diagnosed at a localized stage, meaning the cancer had not spread outside the colon or rectum. Almost 4 in 10 colorectal cancers were found at a regional stage (the cancer had spread to nearby lymph nodes, tissues, or organs), and about 2 in 10 were found at a distant stage (the cancer had spread to distant parts of the body). […] Overall, 64% of colorectal cancer patients had not died from their cancer 5 years later. However, survival varied by stage at diagnosis. […] Survival is higher when colorectal cancer is found before it spreads to other parts of the body. Screening tests can prevent colorectal cancer or find it early, when treatment works best.

• #33 Concise update on colorectal cancer epidemiology

  https://atm.amegroups.org/article/view/27916/html

  The 5-year survival rate approximates 90% when colorectal cancer is diagnosed at an early stage, compared with 13% when the diagnosis is delayed. […] Although reinforced efforts made on colorectal cancer screening have contributed to slightly reduce the number of diagnoses at advanced stages, most cases—up to 90%—are still diagnosed after symptoms onset, by diagnostic colonoscopy (~80%) or even during emergent surgery (~10%).

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

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

  The CRC usually begins with the non-cancerous proliferation of mucosal epithelial cells. […] Patients with chronic IBD have a two-fold risk of developing CRC. […] Both obesity and physical inactivity constitute the most significant behavioural contributor to CRC development and probably explain the majority of variations among people. […] Diet can play an adverse or protective role in the development of CRC irrespective of obesity. […] Smoking is the leading preventable cause of cancer deaths, largely due to its impact on lung cancer. […] Moderate to heavy alcohol consumption (greater than one daily serving) are associated with increased risk of CRC. […] Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin has been shown to lower the risk of CRC. […] Variations and trends in CRC incidence suggest that the disease has a large behavioural component and that effective prevention is possible. […] Ultimately, avoidance of physical inactivity, obesity, red and processed meat, alcohol, and smoking, and a greater intake of fibre and certain supplements and medications hold the most promise in preventing CRC among the general population around the world.

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