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, 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. […] About 704,000 new cases of rectal cancer are expected. Together, these comprise 1.8 million new cases of CRC. […] The CRC is more incident among men than women and 34 times more common in developed than in developing nations. […] The CRC is the second most deadly cancer worldwide, with about 881,000 deaths estimated for 2018. […] The mortality from CRC varies with the developmental status of a nation, but to a lesser degree than incidence (about a 23-fold difference between low and high HDI). […] 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.

• #2 Resources and Publications – Cancer Surveillance Program

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

  Rectal cancer accounts for about 30% of colorectal cancers. […] Over 1,100 people are newly diagnosed with rectal cancer every year in Los Angeles County. […] Rectal cancer occurs most frequently in the older population with an incidence rate of 26 per 100,000 for 50-64 year olds and 52 per 100,000 for 65+ year olds. […] Non-Hispanic Blacks experience excess burden of rectal cancer as they have highest proportion of distant disease and the highest rate of mortality. […] Compared to Non-Hispanic Whites, risk of dying for Non-Hispanic Black male patients is 23% higher and for Hawaiian/Samoan male patients is 44% higher. […] All other Asians/Pacific Islander groups and Hispanics have lower mortality than non-Hispanic Whites. […] Mortality rates have also declined significantly for those over 65 years of age, but have remained stable for the other age groups. […] Risk for rectal 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.

• #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 46,950 new cases of rectal cancer (27,950 in men and 19,000 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. […] 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. […] In people under 55, however, death rates have been increasing about 1% per year since the mid-2000s.

• #4 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 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. […] The overall death rate from colorectal cancer has also been falling, decreasing 57% from 1970 to 2022 from 29.2 to 12.6 per 100,000, respectively because of changing patterns in risk factors, increased screening, and improvements in treatment.

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

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

  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. […] About 704,000 new cases of rectal cancer are expected. Together, these comprise 1.8 million new cases of CRC. […] The CRC is more incident among men than women and 34 times more common in developed than in developing nations. […] The CRC is the second most deadly cancer worldwide, with about 881,000 deaths estimated for 2018. […] The mortality from CRC varies with the developmental status of a nation, but to a lesser degree than incidence (about a 23-fold difference between low and high HDI). […] 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.

• #6 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 46,950 new cases of rectal cancer (27,950 in men and 19,000 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. […] 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. […] In people under 55, however, death rates have been increasing about 1% per year since the mid-2000s.

• #7 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 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. […] The overall death rate from colorectal cancer has also been falling, decreasing 57% from 1970 to 2022 from 29.2 to 12.6 per 100,000, respectively because of changing patterns in risk factors, increased screening, and improvements in treatment.

• #8 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 46,950 new cases of rectal cancer (27,950 in men and 19,000 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. […] 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. […] In people under 55, however, death rates have been increasing about 1% per year since the mid-2000s.

• #9 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 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. […] The overall death rate from colorectal cancer has also been falling, decreasing 57% from 1970 to 2022 from 29.2 to 12.6 per 100,000, respectively because of changing patterns in risk factors, increased screening, and improvements in treatment.

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

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

  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. […] About 704,000 new cases of rectal cancer are expected. Together, these comprise 1.8 million new cases of CRC. […] The CRC is more incident among men than women and 34 times more common in developed than in developing nations. […] The CRC is the second most deadly cancer worldwide, with about 881,000 deaths estimated for 2018. […] The mortality from CRC varies with the developmental status of a nation, but to a lesser degree than incidence (about a 23-fold difference between low and high HDI). […] 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.

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

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

  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. […] About 704,000 new cases of rectal cancer are expected. Together, these comprise 1.8 million new cases of CRC. […] The CRC is more incident among men than women and 34 times more common in developed than in developing nations. […] The CRC is the second most deadly cancer worldwide, with about 881,000 deaths estimated for 2018. […] The mortality from CRC varies with the developmental status of a nation, but to a lesser degree than incidence (about a 23-fold difference between low and high HDI). […] 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.

• #12 Concise update on colorectal cancer epidemiology

  https://atm.amegroups.org/article/view/27916/26441

  The cumulative risk of developing rectal cancer is considerably higher in Europe (1.17-1.55% between 0-74 years), Australia and New Zealand (1.40% between 0-74 years) and Eastern Asia (1.35% between 0-74 years) compared to Africa (0.27-0.52% between 0-74 years) and South-Central Asia (0.24% between 0-74 years), as well as in countries with very high HDI (1.30% between 0-74 years) compared to those with low HDI (0.32% between 0-74 years). […] The 5-year cumulative prognosis is quite similar (i.e., 67%), with 89% survival in patients with localized cancer (e.g., stages I, IIA, and IIB), 70% in those with regional cancer (stages IIC and III), also decreasing to 15% in those with distant cancer (stage IV).

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

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

  The incidence of colorectal cancer tends to be higher in Western nations than in Asian and African countries; however, within the United States, differences in incidence exist among Whites, Blacks, and Asians: the rate of new cases per 100,000 population is highest in Blacks (52.4 in men, 38.6 in women), then Whites (43.5 in men, 33.3 in women), then Hispanics (41.1 in men, 29.0 in women). […] The incidence of colorectal malignancy is slightly higher in males than in females. […] The incidence of colorectal cancer starts to increase after age 35 and rises rapidly after age 50, peaking in the seventh decade. More than 90% of colon cancers occur after age 50. […] In the United States, the incidence rates of colorectal cancer increased by more than 2% per year in adults younger than age 50 from 2012 to 2021, largely because of increases in rectal cancer. […] The American Cancer Society estimates that in 2025, colorectal cancer will account for 9% of cancer deaths in men and 8% in women, making it the third and fourth most common cause of cancer deaths, respectively.

• #14 ACS releases colorectal cancer estimates for 2024 | Colorectal Cancer Alliance

  https://colorectalcancer.org/article/acs-releases-colorectal-cancer-estimates-2024

  More than half of CRC diagnoses can be attributed to potentially modifiable risk factors, such as excess body weight, and lifestyle choices, such as long-term smoking and high intake of red or processed meat. […] Nearly 30% of individuals under the age of 50 who are diagnosed with colorectal cancer can attribute their condition to either a family history or an increased likelihood based on genetic factors. Screening is crucial, and most people should begin getting checked at age 45. Those with a family history of colorectal cancer may need to get checked even earlier. […] Previously reported data show that Black Americans are 15% more likely to develop colorectal cancer and 35% more likely to die from it than their non-Hispanic white counterparts. Alaska Native individuals have the highest colorectal cancer incidence and mortality rates globally.

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

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

  The incidence of colorectal cancer tends to be higher in Western nations than in Asian and African countries; however, within the United States, differences in incidence exist among Whites, Blacks, and Asians: the rate of new cases per 100,000 population is highest in Blacks (52.4 in men, 38.6 in women), then Whites (43.5 in men, 33.3 in women), then Hispanics (41.1 in men, 29.0 in women). […] The incidence of colorectal malignancy is slightly higher in males than in females. […] The incidence of colorectal cancer starts to increase after age 35 and rises rapidly after age 50, peaking in the seventh decade. More than 90% of colon cancers occur after age 50. […] In the United States, the incidence rates of colorectal cancer increased by more than 2% per year in adults younger than age 50 from 2012 to 2021, largely because of increases in rectal cancer. […] The American Cancer Society estimates that in 2025, colorectal cancer will account for 9% of cancer deaths in men and 8% in women, making it the third and fourth most common cause of cancer deaths, respectively.

• #16 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. […] 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 20132022. Age-adjusted death rates have been falling on average 1.3% each year over 20142023.

• #17 Concise update on colorectal cancer epidemiology

  https://atm.amegroups.org/article/view/27916/26441

  Colorectal cancer is a type of gastrointestinal malignancy originating from either the colon or rectum. […] Overall, colorectal cancer is the third more frequent malignant disease around the world (1.85 million of new cases/years; 10.2% of total malignancies), with 2.27% cumulative risk of onset between 0-74 years. […] The number of worldwide deaths for colorectal cancer has been estimated at 0.88 million in 2018, representing ~1.4% of all-cause and ~8.9% of cancer-related deaths, with over 30% increase occurred during the past 15 years and a further 25% growth expected by the year 2030. […] The cumulative risk of dying for colorectal cancer is 0.92% between 0-74 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.

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

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

  Colorectal cancer (CRC) is the third most common cancer and the second most common cause of cancer mortality worldwide. There are disparities in the epidemiology of CRC across different populations, most probably due to differences in exposure to lifestyle and environmental factors related to CRC. Prevention is the most effective method for controlling CRC. Primary prevention includes determining and avoiding modifiable risk factors (e.g., alcohol consumption, smoking, and dietary factors) as well as increasing protective factors (e.g., physical activity, aspirin). Further studies, especially randomized, controlled trials, are needed to clarify the association between CRC incidence and exposure to different risk factors or protective factors. Detection and removal of precancerous colorectal lesions is also an effective strategy for controlling CRC. Multiple factors, both at the individual and community levels (e.g., patient preferences, availability of screening modalities, costs, benefits, and adverse events), should be taken into account in designing and implementing CRC screening programs. Health policymakers should consider the best decision in identifying the starting age and selection of the most effective screening strategies for the target population. This review aims to present updated evidence on the epidemiology, risk factors, and prevention of CRC.

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

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

  The incidence of colorectal cancer tends to be higher in Western nations than in Asian and African countries; however, within the United States, differences in incidence exist among Whites, Blacks, and Asians: the rate of new cases per 100,000 population is highest in Blacks (52.4 in men, 38.6 in women), then Whites (43.5 in men, 33.3 in women), then Hispanics (41.1 in men, 29.0 in women). […] The incidence of colorectal malignancy is slightly higher in males than in females. […] The incidence of colorectal cancer starts to increase after age 35 and rises rapidly after age 50, peaking in the seventh decade. More than 90% of colon cancers occur after age 50. […] In the United States, the incidence rates of colorectal cancer increased by more than 2% per year in adults younger than age 50 from 2012 to 2021, largely because of increases in rectal cancer. […] The American Cancer Society estimates that in 2025, colorectal cancer will account for 9% of cancer deaths in men and 8% in women, making it the third and fourth most common cause of cancer deaths, respectively.

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

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

  Individuals at increased risk of developing colorectal cancer include those with a personal or family history of advanced adenomas or colorectal cancer, a personal history of inflammatory bowel disease, or genetic polyposis syndromes. […] In general, these persons should undergo more frequent or earlier testing than individuals at average risk. […] Individuals who have a first-degree relative with colorectal cancer 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. […] In individuals with ulcerative colitis or Crohn disease with colonic involvement, colonoscopy should begin eight to 10 years after the onset of symptoms and be repeated every one to three years.

• #21 Concise update on colorectal cancer epidemiology

  https://atm.amegroups.org/article/view/27916/26441

  Colorectal cancer is a type of gastrointestinal malignancy originating from either the colon or rectum. […] Overall, colorectal cancer is the third more frequent malignant disease around the world (1.85 million of new cases/years; 10.2% of total malignancies), with 2.27% cumulative risk of onset between 0-74 years. […] The number of worldwide deaths for colorectal cancer has been estimated at 0.88 million in 2018, representing ~1.4% of all-cause and ~8.9% of cancer-related deaths, with over 30% increase occurred during the past 15 years and a further 25% growth expected by the year 2030. […] The cumulative risk of dying for colorectal cancer is 0.92% between 0-74 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.

• #22 Resources and Publications – Cancer Surveillance Program

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

  Rectal cancer accounts for about 30% of colorectal cancers. […] Over 1,100 people are newly diagnosed with rectal cancer every year in Los Angeles County. […] Rectal cancer occurs most frequently in the older population with an incidence rate of 26 per 100,000 for 50-64 year olds and 52 per 100,000 for 65+ year olds. […] Non-Hispanic Blacks experience excess burden of rectal cancer as they have highest proportion of distant disease and the highest rate of mortality. […] Compared to Non-Hispanic Whites, risk of dying for Non-Hispanic Black male patients is 23% higher and for Hawaiian/Samoan male patients is 44% higher. […] All other Asians/Pacific Islander groups and Hispanics have lower mortality than non-Hispanic Whites. […] Mortality rates have also declined significantly for those over 65 years of age, but have remained stable for the other age groups. […] Risk for rectal 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.

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

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

  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. […] 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. […] Variations and trends in CRC incidence suggest that the disease has a large behavioural component and that effective prevention is possible.

• #24 Inflammatory Bowel Disease and Colorectal Cancer: Epidemiology, Etiology, Surveillance, and Management

  https://www.mdpi.com/2072-6694/15/16/4154

  Patients with inflammatory bowel diseases (IBDs), such as ulcerative colitis and Crohn’s disease, have an increased risk of developing colorectal cancer (CRC). […] Although advancements in endoscopic imaging techniques, integrated surveillance programs, and improved medical therapies have contributed to a decreased incidence of CRC in patients with IBD, the rate of CRC remains higher in patients with IBD than in individuals without chronic colitis. […] In this review, we present an updated overview of the epidemiology, etiology, risk factors, surveillance strategies, treatment recommendations, and prognosis of IBD-related CRCs. […] The risk of CRC is significantly increased (by as much as two–three-fold) in patients with a long-standing history of UC and CD; however, the exact risk value may vary according to studies, time periods, and individual risk factors.

• #25 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.

• #26 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.

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

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

  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). […] 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.

• #28 Inflammatory Bowel Disease and Colorectal Cancer: Epidemiology, Etiology, Surveillance, and Management

  https://www.mdpi.com/2072-6694/15/16/4154

  Patients with inflammatory bowel diseases (IBDs), such as ulcerative colitis and Crohn’s disease, have an increased risk of developing colorectal cancer (CRC). […] Although advancements in endoscopic imaging techniques, integrated surveillance programs, and improved medical therapies have contributed to a decreased incidence of CRC in patients with IBD, the rate of CRC remains higher in patients with IBD than in individuals without chronic colitis. […] In this review, we present an updated overview of the epidemiology, etiology, risk factors, surveillance strategies, treatment recommendations, and prognosis of IBD-related CRCs. […] The risk of CRC is significantly increased (by as much as two–three-fold) in patients with a long-standing history of UC and CD; however, the exact risk value may vary according to studies, time periods, and individual risk factors.

• #29

  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.

• #30 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.

• #31 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 has a recommendation statement on aspirin use for the primary prevention of cardiovascular disease and colorectal cancer in average-risk adults.

• #32

  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.

• #33

  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.

• #34 Surveillance strategies following curative resection and non-operative approach of rectal cancer: How and how long? Review of current recommendations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9988648/

  Different follow-up strategies are available for patients with rectal cancer following curative treatment. […] However, there is currently no consensus about the types of tests to perform, the timing of the testing, and even the need for follow-up at all has been questioned. […] According to the follow-up strategies available, the office visit is not efficient but represents the only way to maintain direct contact with the patient and is recommended by all authoritative specialty societies. […] In colorectal cancer surveillance, carcinoembryonic antigen represents the only established tumor marker. […] Since local relapse in rectal cancer is higher than in colon cancer, endoscopic surveillance is mandatory. […] The available data do not allow the drawing of final conclusions on the ideal surveillance methods and the frequency with which they should be applied.

• #35 Surveillance strategies following curative resection and non-operative approach of rectal cancer: How and how long? Review of current recommendations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9988648/

  The aim of this study was to review the evidence of the impact of different follow-up tests and programs in patients with non-metastatic disease following surgery of the primary tumor. […] The key point is to find the best surveillance programs that allow the early detection of recurrent cancer when it is still responsive to curative treatment. […] The most common sites of distant metastasis are the liver followed by the lungs; however, rectal cancer is correlated more often to local failure than colon cancer, carrying a significantly higher risk of local recurrence. […] Therefore, surveillance programs following radical rectal cancer resection are an integral part of the therapeutic pathway. […] The rate of distant metastasis in colon and rectal cancer is similar instead. […] The pressure of rising health care costs has forced clinicians to review surveillance protocols to make them more effective and cheaper, trying to save unnecessary tests.

• #36 Surveillance strategies following curative resection and non-operative approach of rectal cancer: How and how long? Review of current recommendations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9988648/

  The suggested surveillance program considers, in the first 2-4 years, more intensive testing since 80% of recurrences occur in the first 2-2.5 years from surgery. […] The ASCRS guidelines are very similar to the previous recommendations but support the advantage of follow-up in terms of survival in patients with stage I disease. […] The major scientific societies suggest colonoscopy as a follow-up modality for removing early adenomatous polyps and detecting metachronous cancer. […] The main purpose of a surveillance program must be early identification of a recurrence when curative interventions are still possible.

• #37

  http://www.bccancer.bc.ca/books/colon/follow-up-and-surveillance-of-colon-cancer-patients-treated-with-curative-intent

  Following completion of definitive surgery and chemotherapy, patients are typically advised to undergo a surveillance program for a period of up to 5 years, except colonoscopy, which should continue while the patient is a candidate for treatment should a metachronous or recurrent cancer be found. This is typically managed under the direction of their primary care provider. […] If complete colonoscopy was not performed at time of initial cancer diagnosis, it should be completed within 6 months to rule out metachronous lesions. Otherwise, repeat colonoscopy is recommended in one year, and if normal, in three years, and if normal every five years thereafter. […] For patients with specific genetic syndromes, the American Gastroenterological Association guidelines should be followed. […] No evidence of improved survival with routine imaging or blood work.

• #38

  http://www.bccancer.bc.ca/books/colon/follow-up-and-surveillance-of-colon-cancer-patients-treated-with-curative-intent

  History and physical examination every three to six months for the first three years and then every six months for two additional years. Rectal examination at least annually. […] If the patient is not a candidate for metastasectomy, CEA and routine imaging studies are not recommended as there is little to no utility in diagnosing an early metastatic recurrence in an asymptomatic patient. […] No standard guidelines currently exist for surveillance in Stage IV NED and are as determined by the treating oncologist.

• #39

  http://www.bccancer.bc.ca/health-professionals/clinical-resources/cancer-management-manual/gastrointestinal/rectum

  Following completion of definitive surgery and chemotherapy, patients are typically advised to undergo a surveillance program for a period of up to 5 years, except colonoscopy, which should continue while the patient is a candidate for treatment should a metachronous or recurrent cancer be found. This is typically managed under the direction of their primary care provider. […] History and physical examination every three to six months for the first three years and then every six months for two additional years. Rectal examination at least annually. If the patient is a potential candidate for hepatic or pulmonary metastasectomy: Carcinoembryonic antigen (CEA) tumour marker level should be checked at each follow-up visit. If CEA is elevated, repeat test within 28 days. Chest, abdominal and pelvic imaging (CT preferred, or chest x-ray and ultrasound if CT contraindicated or not available) should be done a minimum of two times over the first three years of follow-up (suggested at 12 months and 36 months). If complete colonoscopy was not performed at time of initial cancer diagnosis, it should be completed within 6 months to rule out metachronous lesions. Otherwise, repeat colonoscopy is recommended in one year, and if normal, in three years, and if normal every five years thereafter. If the patient is not a candidate for metastasectomy, CEA and routine imaging studies are not recommended as there is little to no utility in diagnosing an early metastatic recurrence in an asymptomatic patient. If the patient is found to have an elevated CEA and/or signs and symptoms of recurrent colon cancer, imaging of the thorax, abdomen and pelvis should be done and a re-referral to the primary oncologist is indicated. Other imaging and routine blood work are not recommended in follow-up, but may be appropriate in a patient with symptoms suggestive of recurrence.

• #40 Colonoscopy surveillance after colorectal cancer resection – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/colonoscopy-surveillance-after-colorectal-cancer-resection/

  Recommendations from the U.S. Multi-Society Task Force on Colorectal Cancer (CRC) for the surveillance of patients after CRC resection with curative intent. […] 2. Patients who have undergone curative resection of either colon or rectal cancer receive their first surveillance colonoscopy 1 year after surgery (or 1 year after the clearing perioperative colonoscopy). Additional surveillance recommendations apply to patients with rectal cancer (see “Additional Considerations in Surveillance of Rectal Cancer”). […] 4. Patients with localized rectal cancer who have undergone surgery without total mesorectal excision, those who have undergone transanal local excision (transanal excision or transanal endoscopic microsurgery) or endoscopic submucosal dissection, and those with locally advanced rectal cancer who did not receive neoadjuvant chemoradiation and then surgery using total mesorectal excision techniques are at increased risk for local recurrence. In these situations, the task force suggests local surveillance with flexible sigmoidoscopy or endoscopic ultrasound (EUS) every 3-6 months for the first 2-3 years after surgery. These surveillance measures are in addition to recommended colonoscopic surveillance for metachronous neoplasia. […] 6. There is insufficient evidence to recommend the routine use of fecal immunochemical test (FIT) or fecal DNA for surveillance after CRC resection.

• #41 Monitoring for Colorectal Cancer Recurrences | Colorectal Cancer Alliance

  https://colorectalcancer.org/treatment/you/survivors/monitoring-colorectal-cancer-recurrences

  Keep your scheduled follow-up visits. These visits are important. While you cannot guarantee that cancer will not come back, routine visits will increase your chance of catching a recurrence earlier, making it easier to treat. […] ctDNA testing is an option for survivors who have finished curative treatment who are stage II or stage III. Along with CEA, ctDNA is currently approved for monitoring disease recurrence in survivors of stage II and III colorectal cancer. […] ctDNA can also be used to monitor any residual (leftover) cancer after surgery in low-risk stage II and III colon cancer and stage IIA rectal cancer. […] Recurrent colorectal cancer might come back in the same place it was originally, or it might come back in another area of the body. […] Recurrence is divided into three categories: Local recurrence, Regional recurrence, Distant recurrence.

• #42 Limited Benefits of ctDNA Testing in Colorectal Cancer Surveillance, Study Finds

  https://www.ajmc.com/view/limited-benefits-of-ctdna-testing-in-colorectal-cancer-surveillance-study-finds

  Serial circulating tumor DNA (ctDNA) testing showed limited clinical benefit in colorectal cancer (CRC) surveillance when frequent imaging is used. […] Only 1.6% of the surveilled population benefited from ctDNA testing, highlighting its limited utility in this context. […] Future prospective trials are necessary to evaluate ctDNA’s impact on clinical outcomes and its cost-effectiveness in CRC surveillance. […] Our findings suggest that there may be a more limited role for serial ctDNA testing in the surveillance setting when using a more frequent imaging schedule, as recommended by the current National Comprehensive Cancer Network (NCCN) guidelines. […] Despite these limitations, the researchers believe the study finds limited clinical benefit of adding ctDNA assays to standard of care surveillance for patients with stage II to IV CRC. […] Future prospective trials are needed to evaluate whether the addition of ctDNA to surveillance improves relevant clinical outcomes, including patient-reported outcomes, over the standard of care and whether the frequency of testing is worth the cost and psychological impact on patients.

• #43 Surveillance strategies following curative resection and non-operative approach of rectal cancer: How and how long? Review of current recommendations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9988648/

  Different follow-up strategies are available for patients with rectal cancer following curative treatment. […] However, there is currently no consensus about the types of tests to perform, the timing of the testing, and even the need for follow-up at all has been questioned. […] According to the follow-up strategies available, the office visit is not efficient but represents the only way to maintain direct contact with the patient and is recommended by all authoritative specialty societies. […] In colorectal cancer surveillance, carcinoembryonic antigen represents the only established tumor marker. […] Since local relapse in rectal cancer is higher than in colon cancer, endoscopic surveillance is mandatory. […] The available data do not allow the drawing of final conclusions on the ideal surveillance methods and the frequency with which they should be applied.

• #44 Surveillance strategies following curative resection and non-operative approach of rectal cancer: How and how long? Review of current recommendations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9988648/

  Follow-up programs following rectal cancer curative treatment are widely accepted as an integrated part of the therapeutic pathway, but there is still no consensus regarding which test should be performed, the time schedule, the frequency and the duration of surveillance. […] The aim of this study was to review the evidence of the impact of different follow-up tests and programs in patients with non-metastatic disease following surgery of the primary tumor. […] Given the great risk of relapse, to improve prognosis of patients with disease recurrence, follow-up regimens should detect cancer recurrence early. […] Follow-up has an important psychological impact indeed: on the one hand it may provide comfort, reassuring the cancer survivor that there is no evidence of recurrence; on the other hand, it may induce negative effects such as stress and anxiety due to the intensive testing the patient is forced to go through.

• #45 Current Surveillance After Treatment is Not Sufficient for Patients With Rectal Cancer With Negative Baseline CEA in: Journal of the National Comprehensive Cancer Network Volume 20 Issue 6 (2022)

  https://jnccn.org/view/journals/jnccn/20/6/article-p653.xml

  The sensitivity of elevated CEA levels during surveillance for overall recurrence was significantly lower in patients with negative baseline CEA than in those with elevated baseline CEA levels (41.3% vs 69.4%; P=.007). […] The addition of CA19-9 to the CEA assay significantly improved the sensitivity in recurrence surveillance for patients with negative baseline CEA (49.2% vs 41.3%; P=.037). […] Our findings support the current CEA-based surveillance protocols for patients with elevated baseline CEA. However, we recommend that the role of CEA in recurrence surveillance for patients with negative baseline CEA should be reconsidered, and additional surveillance assays and examinations, including CA19-9 assay, medical visit, and radiologic imaging, should be applied to avoid a delayed diagnosis of recurrent disease.

• #46

  https://link.springer.com/article/10.1007/BF02258397

  INTRODUCTION: The epidemiology of colorectal cancer has generated more interest recently, because recent developments in genetics, molecular biology, and genetic epidemiology have increased our understanding of the role of genes in the etiology of colorectal cancer. […] EPIDEMIOLOGY: Colorectal cancer is common in the Western world and is rare in developing countries. A sharp increase is seen in Eastern Europe and Japan. […] Environmental risk factors for colorectal cancer are found in a western diet, rich in fat, meat, and animal protein and low in fiber, fruit, and vegetables. […] Secondary prevention by interrupting the adenoma carcinoma sequence is an actual possibility, its effectiveness, however, needs to be determined. […] Molecular genetics holds a promise for identifying populations at high risk for colorectal cancer, therefore, targeting the screening to make it more cost-effective.

• #47 GECCO

  https://research.fredhutch.org/peters/en/genetics-and-epidemiology-of-colorectal-cancer-consortium.html

  It is recognized that genetic variants play an important role in colorectal cancer risk. […] The Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO) is a collaborative effort of researchers across the world. […] We have discovered close to 200 novel colorectal cancer risk loci through large-scale genome-wide association scans using genotype and sequencing data from a growing resource of over 60 studies and roughly 150,000 colorectal cancer patients and control participants. […] The availability of detailed individual-level phenotype data in over 100,000 participants with genome-wide genotype data allows us to conduct comprehensive investigations into gene-environment interactions, risk prediction, and integrative tumor analyses. […] The North Carolina Rectal Cancer Study (UNC-Rectal) is part of the studies working in this consortium.

• #48 Patients with Rectal Cancer May Not Need Intense Surveillance After Three Years with No Evidence of Disease

  https://www.curetoday.com/view/patients-with-rectal-cancer-may-not-need-intense-surveillance-after-three-years-with-no-evidence-of-disease

  Patients with rectal cancer who maintain a clinical complete response meaning they are found to have no evidence of disease after three years, may not need as frequent surveillance after that point, due to a decreased chance of regrowth and metastases. […] Using a watch and wait strategy, patients with rectal cancer who sustain a clinical complete response meaning they are found to have no evidence of disease for three years may not need intense surveillance after that point, according to data published in Lancet Oncology. […] The watch and wait strategy is used in patients with rectal cancer who have a clinical complete response after neoadjuvant chemoradiotherapy. […] With this study, researchers sought to determine an appropriate follow-up length for these patients using the International Watch Wait Database, an archive of patients with clinical response after neoadjuvant chemotherapy whose status is currently being managed with a watch and wait approach.

• #49 Patients with Rectal Cancer May Not Need Intense Surveillance After Three Years with No Evidence of Disease

  https://www.curetoday.com/view/patients-with-rectal-cancer-may-not-need-intense-surveillance-after-three-years-with-no-evidence-of-disease

  At a median follow up of 55.2 months, in patients who had sustained a clinically complete response, researchers found the probability of remaining free from a regrowth to be 88.1% at one year, 97.3% at three years, and 98.6% at five years. […] According to the press release, these results suggest that those with rectal cancer could possibly replace aggressive colorectal surgery with radio chemotherapy followed by close surveillance for a few years. […] For patients who survived the first year without recurrence, the risks for local regrowth and distant metastases during the two subsequent years were considerably lower, Fernandez concluded, making it unnecessary to maintain such an intense surveillance after three years.

• #50 How a Watch-and-Wait Approach May Help People with Rectal Cancer Preserve Their Quality of Life | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/news/how-watch-and-wait-approach-may-help-people-rectal-cancer-preserve-their-quality-life

  Ninety percent of the 113 MSK patients studied who were treated with watch and wait over ten years were disease free and 80% preserved their rectum. […] We are convinced watch and wait is an excellent way to treat rectal cancer for many people when their tumor completely disappears after neoadjuvant treatment. […] Around 40% of our rectal cancer patients are now treated using the watch-and-wait approach. […] Preserving normal rectal function is enormously important to quality of life. […] One of the first questions nearly every person asks is, Will I have to use a colostomy bag? […] When successful, this approach eliminates that anxiety. […] The commitment to treatment is intensive a minimum of six months initial treatment plus five years of active surveillance. […] For people in our study who entered the surveillance phase of watch and wait, the rectal tumor grew back 20% of the time.

• #51 How a Watch-and-Wait Approach May Help People with Rectal Cancer Preserve Their Quality of Life | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/news/how-watch-and-wait-approach-may-help-people-rectal-cancer-preserve-their-quality-life

  But these people may be at higher risk for the cancer to metastasize, or spread, to other tissues or organs. […] Its vital that patients be selected carefully and given a full understanding of the risks and benefits. […] People who were treated with watch and wait had a 90% likelihood of being cured of cancer and an 80% chance of preserving their rectum, which is excellent. […] So we feel watch and wait is a good approach for many people with rectal cancer who have a complete elimination of their tumor after neoadjuvant therapy.

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

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

  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. […] 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. […] Variations and trends in CRC incidence suggest that the disease has a large behavioural component and that effective prevention is possible.

• #53

  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.

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

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

  Colorectal cancer (CRC) is the third most common cancer and the second most common cause of cancer mortality worldwide. There are disparities in the epidemiology of CRC across different populations, most probably due to differences in exposure to lifestyle and environmental factors related to CRC. Prevention is the most effective method for controlling CRC. Primary prevention includes determining and avoiding modifiable risk factors (e.g., alcohol consumption, smoking, and dietary factors) as well as increasing protective factors (e.g., physical activity, aspirin). Further studies, especially randomized, controlled trials, are needed to clarify the association between CRC incidence and exposure to different risk factors or protective factors. Detection and removal of precancerous colorectal lesions is also an effective strategy for controlling CRC. Multiple factors, both at the individual and community levels (e.g., patient preferences, availability of screening modalities, costs, benefits, and adverse events), should be taken into account in designing and implementing CRC screening programs. Health policymakers should consider the best decision in identifying the starting age and selection of the most effective screening strategies for the target population. This review aims to present updated evidence on the epidemiology, risk factors, and prevention of CRC.

• #55 ACS releases colorectal cancer estimates for 2024 | Colorectal Cancer Alliance

  https://colorectalcancer.org/article/acs-releases-colorectal-cancer-estimates-2024

  More than half of CRC diagnoses can be attributed to potentially modifiable risk factors, such as excess body weight, and lifestyle choices, such as long-term smoking and high intake of red or processed meat. […] Nearly 30% of individuals under the age of 50 who are diagnosed with colorectal cancer can attribute their condition to either a family history or an increased likelihood based on genetic factors. Screening is crucial, and most people should begin getting checked at age 45. Those with a family history of colorectal cancer may need to get checked even earlier. […] Previously reported data show that Black Americans are 15% more likely to develop colorectal cancer and 35% more likely to die from it than their non-Hispanic white counterparts. Alaska Native individuals have the highest colorectal cancer incidence and mortality rates globally.

• #56 ACS releases colorectal cancer estimates for 2024 | Colorectal Cancer Alliance

  https://colorectalcancer.org/article/acs-releases-colorectal-cancer-estimates-2024

  More than half of CRC diagnoses can be attributed to potentially modifiable risk factors, such as excess body weight, and lifestyle choices, such as long-term smoking and high intake of red or processed meat. […] Nearly 30% of individuals under the age of 50 who are diagnosed with colorectal cancer can attribute their condition to either a family history or an increased likelihood based on genetic factors. Screening is crucial, and most people should begin getting checked at age 45. Those with a family history of colorectal cancer may need to get checked even earlier. […] Previously reported data show that Black Americans are 15% more likely to develop colorectal cancer and 35% more likely to die from it than their non-Hispanic white counterparts. Alaska Native individuals have the highest colorectal cancer incidence and mortality rates globally.

• #57

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

  After treatment, regular follow-up visits and surveillance are essential to monitor for any signs of recurrence or new cancer. Surveillance may include physical examinations, blood tests, and imaging studies (such as CT scans) to detect any potential recurrence at an early stage. […] The WHO is actively involved in addressing the global burden of colorectal cancer and implementing strategies to reduce its impact.

• #58 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 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. […] The overall death rate from colorectal cancer has also been falling, decreasing 57% from 1970 to 2022 from 29.2 to 12.6 per 100,000, respectively because of changing patterns in risk factors, increased screening, and improvements in treatment.

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

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

  The incidence of colorectal cancer tends to be higher in Western nations than in Asian and African countries; however, within the United States, differences in incidence exist among Whites, Blacks, and Asians: the rate of new cases per 100,000 population is highest in Blacks (52.4 in men, 38.6 in women), then Whites (43.5 in men, 33.3 in women), then Hispanics (41.1 in men, 29.0 in women). […] The incidence of colorectal malignancy is slightly higher in males than in females. […] The incidence of colorectal cancer starts to increase after age 35 and rises rapidly after age 50, peaking in the seventh decade. More than 90% of colon cancers occur after age 50. […] In the United States, the incidence rates of colorectal cancer increased by more than 2% per year in adults younger than age 50 from 2012 to 2021, largely because of increases in rectal cancer. […] The American Cancer Society estimates that in 2025, colorectal cancer will account for 9% of cancer deaths in men and 8% in women, making it the third and fourth most common cause of cancer deaths, respectively.

• #60 Surveillance strategies following curative resection and non-operative approach of rectal cancer: How and how long? Review of current recommendations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9988648/

  Different follow-up strategies are available for patients with rectal cancer following curative treatment. […] However, there is currently no consensus about the types of tests to perform, the timing of the testing, and even the need for follow-up at all has been questioned. […] According to the follow-up strategies available, the office visit is not efficient but represents the only way to maintain direct contact with the patient and is recommended by all authoritative specialty societies. […] In colorectal cancer surveillance, carcinoembryonic antigen represents the only established tumor marker. […] Since local relapse in rectal cancer is higher than in colon cancer, endoscopic surveillance is mandatory. […] The available data do not allow the drawing of final conclusions on the ideal surveillance methods and the frequency with which they should be applied.

• #61 Surveillance strategies following curative resection and non-operative approach of rectal cancer: How and how long? Review of current recommendations

  https://www.wjgnet.com/1948-9366/full/v15/i2/177.htm

  Surveillance strategies following curative resection and non-operative approach of rectal cancer: How and how long? Review of current recommendations. Different follow-up strategies are available for patients with rectal cancer following curative treatment. A combination of biochemical testing and imaging investigation, associated with physical examination are commonly used. However, there is currently no consensus about the types of tests to perform, the timing of the testing, and even the need for follow-up at all has been questioned. The aim of this study was to review the evidence of the impact of different follow-up tests and programs in patients with non-metastatic disease after definitive treatment of the primary. According to the follow-up strategies available, the office visit is not efficient but represents the only way to maintain direct contact with the patient and is recommended by all authoritative specialty societies. In colorectal cancer surveillance, carcinoembryonic antigen represents the only established tumor marker. Abdominal and chest computed tomography scan is recommended considering that the liver and lungs are the most common sites of recurrence. Since local relapse in rectal cancer is higher than in colon cancer, endoscopic surveillance is mandatory. Different follow-up regimens have been published but randomized comparisons and meta-analyses do not allow to determine whether intensive or less intensive follow-up had any significant influence on survival and recurrence detection rate. The available data do not allow the drawing of final conclusions on the ideal surveillance methods and the frequency with which they should be applied. It is very useful and urgent for clinicians to identify a cost-effective strategy that allows early identification of recurrence with a special focus for high-risk patients and patients undergoing a watch and wait approach. Follow-up programs following rectal cancer curative treatment are widely accepted as an integrated part of the therapeutic pathway, but there is still no consensus regarding which test should be performed, the time schedule, the frequency and the duration of surveillance. The impact on survival has also been questioned with recurrence detection not necessarily associated with curative surgery. Surveillance programs following radical rectal cancer resection are an integral part of the therapeutic pathway. The most common sites of distant metastasis are the liver followed by the lungs; however, rectal cancer is correlated more often to local failure than colon cancer, carrying a significantly higher risk of local recurrence. Given the great risk of relapse, to improve prognosis of patients with disease recurrence, follow-up regimens should detect cancer recurrence early. The key point is to find the best surveillance programs that allow the early detection of recurrent cancer when it is still responsive to curative treatment. Follow-up has an important psychological impact indeed: on the one hand it may provide comfort, reassuring the cancer survivor that there is no evidence of recurrence; on the other hand, it may induce negative effects such as stress and anxiety due to the intensive testing the patient is forced to go through. Finally, follow-up tests are costly and bring the inevitable risk of false positives, leading to pointless procedures and potential complications. In light of the clear benefits and potential risks of follow-up programs, it is urgent to establish a cost-effective strategy to guarantee early recognition of disease relapse and reduce potential shortcomings, narrowing surveillance to the highest-risk patients.

• #62 Study sets framework for precision surveillance of colorectal cancer – VUMC News

  https://news.vumc.org/2021/12/14/study-sets-framework-for-precision-surveillance-of-colorectal-cancer/

  Vanderbilt research has revealed some of the mechanisms by which polyps develop into colorectal cancer, setting the framework for improved surveillance for the cancer utilizing precision medicine. […] The findings in our atlas lay the foundation for opening novel strategies for interception of cancer progression, including better surveillance protocols, chemoprevention and pre-biotic and pro-biotic therapies said Martha Shrubsole, PhD, research professor in the Division of Epidemiology, and a corresponding author.

• #63 Limited Benefits of ctDNA Testing in Colorectal Cancer Surveillance, Study Finds

  https://www.ajmc.com/view/limited-benefits-of-ctdna-testing-in-colorectal-cancer-surveillance-study-finds

  Serial circulating tumor DNA (ctDNA) testing showed limited clinical benefit in colorectal cancer (CRC) surveillance when frequent imaging is used. […] Only 1.6% of the surveilled population benefited from ctDNA testing, highlighting its limited utility in this context. […] Future prospective trials are necessary to evaluate ctDNA’s impact on clinical outcomes and its cost-effectiveness in CRC surveillance. […] Our findings suggest that there may be a more limited role for serial ctDNA testing in the surveillance setting when using a more frequent imaging schedule, as recommended by the current National Comprehensive Cancer Network (NCCN) guidelines. […] Despite these limitations, the researchers believe the study finds limited clinical benefit of adding ctDNA assays to standard of care surveillance for patients with stage II to IV CRC. […] Future prospective trials are needed to evaluate whether the addition of ctDNA to surveillance improves relevant clinical outcomes, including patient-reported outcomes, over the standard of care and whether the frequency of testing is worth the cost and psychological impact on patients.

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

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

  Colorectal cancer (CRC) is the third most common cancer and the second most common cause of cancer mortality worldwide. There are disparities in the epidemiology of CRC across different populations, most probably due to differences in exposure to lifestyle and environmental factors related to CRC. Prevention is the most effective method for controlling CRC. Primary prevention includes determining and avoiding modifiable risk factors (e.g., alcohol consumption, smoking, and dietary factors) as well as increasing protective factors (e.g., physical activity, aspirin). Further studies, especially randomized, controlled trials, are needed to clarify the association between CRC incidence and exposure to different risk factors or protective factors. Detection and removal of precancerous colorectal lesions is also an effective strategy for controlling CRC. Multiple factors, both at the individual and community levels (e.g., patient preferences, availability of screening modalities, costs, benefits, and adverse events), should be taken into account in designing and implementing CRC screening programs. Health policymakers should consider the best decision in identifying the starting age and selection of the most effective screening strategies for the target population. This review aims to present updated evidence on the epidemiology, risk factors, and prevention of CRC.

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

  https://www.termedia.pl/Epidemiology-of-colorectal-cancer-incidence-mortality-survival-and-risk-factors,41,34580,0,1.html

  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. […] Obesity, sedentary lifestyle, red meat consumption, alcohol, and tobacco are considered the driving factors behind the growth of CRC. […] However, recent advances in early detection screenings and treatment options have reduced CRC mortality in developed nations, even in the face of growing incidence. […] Genetic testing and better family history documentation can enable those with a hereditary predisposition for the neoplasm to take preventive measures. […] Meanwhile, the general population can reduce their risk by lowering their red meat, alcohol, and tobacco consumption and raising their consumption of fibre, wholesome foods, and certain vitamins and minerals.

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