A Snapshot of Colorectal Cancer

Incidence and Mortality

Colorectal cancer is the third most common cancer and the third leading cause of cancer-related mortality in men and in women in the United States. Over the past decade, colorectal cancer incidence and mortality rates have decreased in all racial/ethnic populations. Men and women have similar incidence and mortality rates through age 50; after age 50, rates are higher in men.

Differences exist between racial and ethnic groups in both incidence and mortality. African Americans have higher incidence and mortality rates than other racial/ ethnic groups, while incidence and mortality rates are lowest among Hispanics and Asians/Pacific Islanders. The overall colorectal cancer incidence and mortality rates have been declining over the past two decades; these declines largely have been attributed to increased use of screening tests.

Risk factors for colorectal cancer include increasing age, colorectal polyps, a family history of colorectal cancer, and certain genetic mutations. Effective colorectal cancer screening tests include fecal occult blood test, sigmoidoscopy, and colonoscopy. These screening tests enable detection and removal of polyps that may progress to cancer. Standard treatments include surgery, chemotherapy, radiation therapy, and targeted therapy.

It is estimated that approximately $14.1 billion¹ is spent in the United States each year on colorectal cancer treatment. 

Trends in NCI Funding for Colorectal Cancer Research

The National Cancer Institute’s (NCI) investment² in colorectal cancer research increased from $258.4 million in fiscal year (FY) 2007 to $265.1 million in FY 2011. In addition to this funding, NCI supported $58.6 million in colorectal cancer research in FY 2009 and 2010 using funding from the American Recovery and Reinvestment Act (ARRA).³

Examples of NCI Activities Relevant to Colorectal Cancer

• NCI’s Transdisciplinary Research on Energetics and Cancer initiative supports studies on the biology, genomics, and genetics of energy balance and on behavioral, sociocultural, and environmental factors that influence cancer risk, including one clinical trial that is examining whether exercise and/or metformin can reduce levels of fasting insulin in colorectal cancer survivors.
• The Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, a large-scale clinical trial, is determining whether specific cancer-screening tests, including flexible sigmoidoscopy for colorectal cancer screening, reduce deaths from these cancers. Results showed that screening with flexible sigmoidoscopy was associated with a decrease in both incidence and mortality of colorectal cancer.
• The Colorectal Cancer Risk Assessment Tool helps health providers assess a person’s risk of developing colorectal cancer.
• NCI’s Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) program supports multisite, coordinated transdisciplinary research on cancer screening to better understand how to improve the screening process, including recruitment, diagnosis, and referral for treatment. Three sites are focused on colorectal cancer screening.
• NCI's Cancer Imaging Program supports The Cancer Imaging Archive—a large collection of medical images of cancer, including CT colonography images.
• Seven gastrointestinal-cancer-specific Specialized Programs of Research Excellence (SPOREs), two focused on colorectal cancer, are conducting translational research on the gastrointestinal system.

Selected Advances in Colorectal Cancer Research

• A study revealed that racial and ethnic disparities in colorectal screening persist among Medicare recipients, despite expansion of coverage for screening. Published May 2011. [PubMed Abstract]
• Researchers identified genetic variants of inflammatory mediators associated with increased risk of colon cancer among African Americans. Published January 2012. [PubMed Abstract]
• Gene expression profiling identified a marker of intestinal stem cells that functions as a tumor suppressor. Published March 2012. [PubMed Abstract]
• Results from the PLCO trial showed that screening with flexible sigmoidoscopy was associated with a decrease in colorectal cancer incidence (in both the distal and proximal colon) and mortality (in the distal colon only). Published May 2012. [PubMed Abstract]
• See this PubMed list of selected free full-text journal articles on NCI-supported research relevant to colorectal cancer. You can also search PubMed for additional scientific articles.

• ¹ Cancer Trends Progress Report, in 2010 dollars.
• ² The estimated NCI investment is based on funding associated with a broad range of peer-reviewed scientific activities. For additional information on research planning and budgeting at the National Institutes of Health (NIH), see About NIH.
• ³ For more information regarding ARRA funding at NCI, see Recovery Act Funding at NCI.
• ⁴ Scientific Area Codes
• ⁵ NCI Funded Research Portfolio