Incidence

Cancers are amongst the commonest causes of death in this country, accounting for about one in every four deaths - almost 130,000 per annum1. The majority of cancer deaths are from tumours found in four principal sites: lung, colorectal, breast and prostate (Figure 1).

Figure 1. Cancer deaths in England and Wales by sex, 1996.

These cancers are common in Western countries but there is a much lower incidence in third world countries (Figure 2). It has been observed that immigrants moving from a low risk area to one of high risk acquire the same risk as the indigenous population within one or two generations suggesting that environmental factors are responsible2.

Figure 2. Geographic variation in the incidence of colon and rectal cancer in men 2.

Tobacco smoking, electromagnetic radiation, environmental chemicals, hormones, bacterial or viral infection, level of physical activity, reproductive and sexual behaviour are thought to be important in the aetiology of cancer at certain sites3. However, it is thought that diet remains the most important factor and it has been estimated that dietary change could result in a reduction of fatal cancers of between 35 and 70%4.

Colorectal cancer is the second most common cause of death from cancer in the Western world. In 1985, there was estimated to be 677,500 new cases and 394,100 deaths worldwide5,6. In the United Kingdom there is approximately a 4% lifetime risk, 31,000 new cases annually and 16,000 deaths7.

The prevalence increases with age with over 90% of cases occurring after the age of 55 (Table 1). The incidence of colon cancer varies little between the sexes8,9, whereas rectal cancer is twice as common in men as in women2

Age (years All Colorectal Cancers Estimated Distal Bowel Cancer
  (% of total) (% of all colorectal cancers)
<40 345 (1) 200 (58)
40 - 49 1071 (4) 707 (66)
50 - 54 1119 (4) 750 (67)
55 - 59 1986 (7) 1350 (68)
60 - 64 3083 (11) 2096 (68)
65 - 69 4006 (14) 2644 (66)
70 - 74 4710 (17) 3014 (64)
75 - 79 5068 (18) 3041 (60)
80 6605 (24) 3302 (50)
Total 27994 17104 (63)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Table 1. New Diagnoses of Colorectal Cancer by Age, U.K., 1987.10 

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