Concise update on colorectal cancer epidemiology
Colorectal cancer is a type of gastrointestinal malignancy originating from either the colon or rectum. In this short report we provide a concise update on recent colorectal cancer statistics, especially concerning frequency, mortality, life expectancy and risk factors. 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 age-standardized rate increases by over 10-fold before the age of 50 up to ≥85 years, whilst men have ~50% enhanced risk compared to women (the 0–74 years risk is 2.75% in men and 1.83% in women, respectively). Although colorectal cancer screening has contributed to slightly reduce the number of diagnoses at advanced stages, most cases are only identified after symptoms onset. 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 5-year cumulative survival is 64–67%, being 89–90% in patients with localized cancer, 70–71% in those with regional cancer, decreasing to 14–15% in those with distant cancer. 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.