ABC of colorectal cancer: Epidemiology

In countries with a westernised lifestyle about half of all deaths are caused by circulatory disease and a quarter by cancer. Cancer is an important problem in both public health and political terms worldwide, irrespective of a country's development. The most recent estimates of the global cancer burden suggest that there were 8.1 million new cases, excluding non.melanoma skin cancer, worldwide in 1990. About 10 million new cases are now diagnosed each year.

Colorectal cancer is the fourth commonest form of cancer occurring worldwide, with an estimated 783 000 new cases diagnosed in 1990, the most recent year for which international estimates are available. It affects men and women almost equally, with about 401 000 new cases in men annually and 381 000 in women. The number of new cases of colorectal cancer worldwide has been increasing rapidly since 1975 (when it was 500 000).

Worldwide, colorectal cancer represents 9.4% of all incident cancer in men and 10.1% in women. Colorectal cancer, however, is not equally common throughout the world. If the westernised countries (North America; those in northern, southern, and western Europe; Australasia; and New Zealand) are combined, colorectal cancer represents 12.6% of all incident cancer in westernised countries in men and 14.1% in women. Elsewhere colorectal cancer represents 7.7% and 7.9% of all incident cases in men and women respectively.

Large differences exist in survival, according to the stage of disease. It is estimated that 394 000 deaths from colorectal cancer still occur worldwide annually, and colorectal cancer is the second commonest cause of death from any cancer in men in the European Union. Substantial differences in cancer survival seem to exist between Great Britain, Europe as a …