Colorectal Cancer

What is Colorectal Cancer?

Colorectal Cancer, also known as bowel cancer, develops in the colon or the rectum (the large bowel or the large intestine).

The colon and rectum are part of the gastrointestinal (GI) or digestive system.  Whilst the first part of the digestive system processes food for energy, the last part (colon and rectum) absorbs fluid to form solid waste (stool) that leaves the body.

The colon is about 1.5 meters long and has four sections:

  1. Ascending colon that starts with a small pouch (caecum) where the small bowel attaches to the colon and extends upward (for that reason it is called ascending) on the right side of the abdomen.
  2. Transverse colon goes across the body, from the right to the left side in the upper abdomen
  3. Descending colon continues downward on the left side
Sigmoid colon is the last section so named because of its “S” (sigmoid) shapeOverview of Colon

The wall of the colon and rectum are made up of several layers. Majority of colorectal cancers begin as a small growth on the bowel wall – a colorectal polyp or adenoma. These often times mushroom-shaped growths are usually benign, but some develop into cancer over time. If left untreated, it can grow into the muscle layer underneath, and then through the bowel wall.

Polyp
Invasive cancers that are confined within the wall of the colon (TNM stages I and II) are often curable with surgery, usually over 90% of patients diagnosed at this stage will survive the disease beyond 5 years. However, if left untreated, the cancer can spread to regional lymph nodes (stage III). 
Around 50% of patients diagnosed at this stage survive the disease beyond five years. Cancer that has spread widely around the body (stage IV) is usually not curable, with only 10-20% of patients surviving beyond 5-years. Colorectal cancer affects both men and women of all racial and ethnic groups.

The taboo surrounding cancer and in many countries the embarrassement of colorectal cancer contributes to the late diagnosis of the disease. There is often a lack of understanding of the symptoms, the risks and the prevention of the disease. In many countries there is also a low awareness of treatment choice and patient options. Above all in many European countries there is severe underfunding for the treatment of cancer. Colorectal cancer is one of the most highly treatable of all the gastrointestinal cancers and with early diagnosis and effective treatment people can live with colorectal cancer.

What is Colorectal Cancer Leaflet

With almost 1.4 million new cases of colorectal cancer each year worldwide it presents 9.7% of the total global cancer cases. The increase in the number of cases is driven by population growth and ageing as well as poor diet and lifestyle.

  • Colorectal cancer is the third most common cancer in men and the second in women worldwide with almost 55% of the cases occurring in more developed regions
     
  • In Europe it is the second most common cancer with more than 470,000 European citizens being diagnosed every year with the disease
     
  • Colorectal cancer kills 228,000 Europeans every year with the highest estimated mortality rates in both sexes being in Central and Eastern Europe
     
  • This disease is preventable in many cases and highly treatable if diagnosed in its early stages
     
  • Colorectal cancer is a disease that mainly effects the over 50’s, and there are more than 175 million citizens in Europe between the 50 to 69 years old
Estimated cases per year (worldwide):   Estimated death per year (worldwide):
 746,000 (male)  614,000 (female) 374,000 (male)  320,000 (female) 


 Burden of colorectal cancer:   Worldwide   Europe 
 Incidence  1,361,000  471,000
 Mortality  694,000  228,000

Source: Globocan 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012

Colon Cancer Survival Rates

Since the mid-1980s the colorectal cancer death rate has been dropping due in part to increased awareness and screening. By finding more polyps and cancer in the earlier (local and regional) stages, it is easier to treat the disease. Improved treatment options have also contributed to a rise in survival rates.

  • The five-year survival rate for colorectal cancer found at the local stage is 90%
     
  • The five-year survival rate for colorectal cancer found at the regional stage is 70%
     
  • The five-year survival rate for colorectal cancer found at the distant stage today is up to 20%
     
  • According to the results of EUROCARE-5 countries with lowest survival for most cancers are in Eastern Europe (Bulgaria, Estonia, Latvia, Lithuania, Poland and Slovakia). The survival in those countries is below European mean, particularly for good prognosis cancer like colorectal cancer and other (lymphoma and skin melanoma)
CRC Statistics

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