Epidemiology

Colorectal cancer is the third most common cancer in the world.

In UK:

• there are around 42,000 new bowel cancer cases in the UK every year, that's more than 110 every day (2014-2016)

bowel cancer is the 4th most common cancer in the UK, accounting for 12% of all new cancer cases (2016)

in females in the UK, bowel cancer is the 3rd most common cancer, with around 18,600 new cases in 2016

in males in the UK, bowel cancer is the 3rd most common cancer, with around 23,500 new cases in 2016

over half of bowel cancer cases are diagnosed at a late stage in England (2014), Scotland (2014-2015), and Northern Ireland (2010-2014)

most bowel cancers occur in the rectum.

incidence rates for bowel cancer are projected to fall by 11% in the UK between 2014 and 2035, to 74 cases per 100,000 people by 2035

bowel cancer in England is more common in males living in the most deprived areas. There is no association for females

bowel cancer is more common in White people than in Asian or Black people

an estimated 230,200 people who had previously been diagnosed with bowel cancer were alive in the UK at the end of 2010

The incidence of colorectal cancer

• increases with age:
  • in the UK between 2007 and 2009, an average 72% of bowel cancer cases were diagnosed in people aged 65 years and over
  • the incidence rates
    • increase sharply from around age 50, peaking in the over-80s
    • incidence rates for bowel cancer in the UK are highest in people aged 85 to 89 (2014-2016).
    • are higher for males than females and this gap is widest between the ages of 65 and 74 (male:female incidence ratio is about 17:10)
    • since the early 1990s, bowel cancer incidence rates have remained stable in the UK. Rates in females have remained stable and rates in males have remained stable.
    • over the last decade, bowel cancer incidence rates have decreased by less than a twentieth (2%) in the UK. Rates in females have remained stable, and rates in males have decreased by a twentieth (5%)
      
      
• have overall increased in Britain since the mid-1970s and the largest increases have been in people aged 60-69 and 70-79

Approximately 30% of patients with colorectal cancer present with advanced disease, which is defined as either metastatic or locally invasive to the extent that surgical resection with curative intent is unlikely to be carried out

Five percent of tumours in the large bowel are multiple or synchronous, and 5% of patients who previously had resection for cancer develop new primary lesions - metachronous cancer.

The lifetime risk of developing bowel cancer in the UK is estimated to be 1 in 15 for men and 1 in 19 for women (calculated using 2008 data) (1).

Reference:

• (1) Cancer Research UK 2020. Bowel cancer incidence statistics
• (2) NICE (July 2005). Final Appraisal Determination Irinotecan, oxaliplatin and raltitrexed for the treatment of advanced colorectal cancer (review of Technology Appraisal 33)