A Snapshot of Colorectal Cancer
Incidence and Mortality
Colorectal cancer is the third most common non-skin cancer and the second leading cause of cancer-related mortality in men and women in the United States. Over the past decade, colorectal cancer incidence and mortality rates have decreased in all racial/ethnic populations except American Indians/Alaska Natives. 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 mortality rates than all other racial/ethnic groups and higher incidence rates than all except American Indians/Alaska Natives. Incidence and mortality rates are lowest among Hispanics and Asians/Pacific Islanders. Overall colorectal cancer incidence and mortality rates have been declining over the past two decades; these declines have been attributed largely 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 the fecal occult blood test, sigmoidoscopy, and colonoscopy. These screening tests enable detection and removal of polyps that may progress to cancer. Standard treatments for colorectal cancer 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.
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 high insulin levels, which may be associated with poor prognosis, in colorectal cancer survivors.
- NCI currently is supporting an extended follow-up of the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, a large-scale clinical trial that examined whether specific cancer screening tests reduce deaths from these cancers. Results from the PLCO have shown that screening with flexible sigmoidoscopy is effective in reducing both the incidence and mortality of colorectal cancer.
- The Colorectal Cancer Risk Assessment Tool helps health care 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 PREVENT Cancer Preclinical Drug Development Program supports efforts to move cancer-preventive chemical and biological agents and biomarkers from preclinical development toward clinical trial testing. Three projects are looking at drug efficacy for colon cancer, and another project is testing immunization against colon cancer.
- Eight gastrointestinal-cancer-specific Specialized Programs of Research Excellence (SPOREs) are conducting translational research on gastrointestinal system cancers, including colorectal cancer.
Selected Advances in Colorectal Cancer Research
- A chemically modified form of the chemoprevention agent sulindac is less toxic and more effectively suppresses colon cancer cell growth. Published May 2012. [PubMed Abstract]
- The genomic alterations in colon and rectal tumors are the same; thus, colon and rectal tumors constitute a single type of cancer. Published July 2012. [PubMed Abstract]
- There is a correlation between the number of colorectal polyps and the frequency of mutations in the tumor suppressor gene APC among people with classic polyposis. Published August 2012. [PubMed Abstract]
- A comprehensive search for gene-gene interactions in colorectal cancer may provide insights into the genetic etiology of colorectal cancer. Published December 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 or to complete a search tutorial.
Trends in NCI Funding for Colorectal Cancer Research
The National Cancer Institute's (NCI) investment2 in colorectal cancer research decreased from $273.4 million in fiscal year (FY) 2008 to $256.3 million in FY 2012. In addition to this funding, NCI supported $58.6 million in colorectal cancer research in FY 2009 and FY 2010 using funding from the American Recovery and Reinvestment Act (ARRA).
Additional Resources for Colorectal Cancer
- Colon and Rectal Cancer Home Page
NCI's gateway for information about colon and rectal cancer.
- Test to Detect Colorectal Cancer and Polyps
A fact sheet that discusses the advantages and disadvantages of several colorectal cancer screening tests.
- Colon Cancer Treatment (PDQ®)
Expert-reviewed information summary about the treatment of colon cancer.
- Rectal Cancer Treatment (PDQ®)
Expert-reviewed information summary about the treatment of rectal cancer.
- Clinical Trials for Colon Cancer
- Clinical Trials for Rectal Cancer